Hashimoto's Disease and Thyroid Cancer in Children: Are They Associated?

Abstract

Hashimoto's thyroiditis (HT) is the most common cause of thyroid disease in children and adolescents. Along with significant modifications of thyroid function, HT in pediatric age can be accompanied by relevant thyroid structural alterations. Over time, benign thyroid nodules, carcinoma and, rarely, primary non-Hodgkin lymphoma can develop. However, the relationships between HT and neoplasms are poorly defined. The main aim of this paper is to discuss what is presently known regarding the coexistence of HT and thyroid tumors. Moreover, we attempt to define the pathogenesis of cancer development in children with HT. Literature analysis showed that despite its rarity and relatively promising prognosis, thyroid cancer is associated with HT. Although not all reasons for the coexistence of these diseases are clearly defined, children with HT should be considered at higher risk for thyroid cancer development. Strict correlations between high levels of serum TSH and anti-thyroid antibodies with cancer must be remembered. The same is true for the presence of nodules, especially if multiple nodules are present and ultrasonography and thyroid fine needle aspiration cytology should be promptly used in uncertain cases.

Clinical Analysis of Preoperative Anti-thyroglobulin Antibody in Papillary Thyroid Cancer Between 2011 and 2015 in Beijing, China: A Retrospective Study

“…Recent studies by Hosseini and Grani have also suggested the use of preoperative TgAb levels as a marker for well-differentiated thyroid cancer (21,22). Although multiple studies have reported a correlation between AITD and DTC, this relationship is still controversial (27)(28)(29). It appears that the diagnostic method used influences the association between HT and DTC.…”

Imaging and Imaging-Based Management of Pediatric Thyroid Nodules

“…In a study including 108 pediatric thyroid cancer cases, HT was detected in 28.7% of the enrolled patients [16]. Furthermore, congenital hypothyroidism caused by dyshormonogenesis or by an iodine transporter defect increases the risk of nodules in children that can evolve to thyroid cancer of the follicular type [16]. A causal association between external radiation exposure and thyroid cancer is strongly supported by epidemiologic studies, since the young thyroid gland is particularly radiosensitive.…”

“…According to the results of these studies, the frequency of PTC in children and adolescents with HT is variable, from 0.7 tõ 3%, while in patients with PTC the prevalence of coexisting HT varies from 6.3% to more than 40% of the cases. In a study including 108 pediatric thyroid cancer cases, HT was detected in 28.7% of the enrolled patients [16]. Furthermore, congenital hypothyroidism caused by dyshormonogenesis or by an iodine transporter defect increases the risk of nodules in children that can evolve to thyroid cancer of the follicular type [16].…”

Papillary thyroid carcinoma in children with Hashimoto’s thyroiditis – a review of the literature between 2000 and 2020

“…Currently, HT is being considered the most common cause of hypothyroidism in iodine sufficient areas in both the adult and pediatric patients. Although considered benign for many years, HT proved its unfavorable evolution being involved in altering the reproductive system, influencing mental and intellectual activity, influencing other autoimmune diseases and last but not least in the occurrence of malignant processes such as PTC [12,13]. Potential causal associations between Hashimoto's thyroiditis and PTC have been studied previously and were first reported by Dailey et al in 1955, linking chronic inflammation to neoplastic changes [14].…”