Abstract:It is unclear whether patients with Hashimoto thyroiditis (HT) are predisposed to develop thyroid nodules and/or thyroid cancer. The objective of our study was therefore to assess the prevalence of thyroid nodules and/or cancer in patients with HT and to look for possible prognostic factors. A retrospective survey of 904 children/adolescents with HT (709 females, 195 males) regularly followed in nine Italian centers of pediatric endocrinology was performed. Median period of follow-up was 4.5 years (1.2 to 12.8… Show more
“…All the six studies included in the final analysis were retrospective. The 11 studies included a total number of 2,065 patients with HT, with individual study cohorts counting from 89 to 904 children [20][21][22][23][24][25].…”
Section: Resultsmentioning
confidence: 99%
“…The severity of hypoechogenity at ultrasound, anti-TPO antibodies and free T4 serum concentrations were predictive for the appearance of new nodules. Radetti et al concluded that HT seems to influence the development of thyroid nodules, but not cancer in children and adolescents [25].…”
ObjectivesThyroid cancer is the most common pediatric endocrine neoplasm representing 3% of all malignancies in children. Hashimoto’s thyroiditis (HT) is also a common disorder in the pediatric age range. Patients with HT frequently develop enlarged thyroid with nodules. We aimed to provide a literature review on the frequency of papillary thyroid carcinoma (PTC) in patients with HT.ContentA literature search of the PubMed database between 2000 and 2020 was performed, using the relevant keywords “papillary thyroid carcinoma,” “Hashimoto’s thyroiditis” and “children”. We followed the PRISMA statement guidelines during the preparation of this review. Six studies (n=2,065 patients with HT) were retained for the final analysis. The follow-up of the patients with HT was from 2 to 10 years. PTC was diagnosed in 0.67–7.87% of the HT patients included in these studies. In patients with HT and nodules, the percentage of PTC varied between 5.13 and 35%. The overall occurrence of PTC in patients with HT was 3.07%.Summary and OutlookThe number of patients developing thyroid nodules in relation to HT was increased. The development of PTC in children with HT appeared to be higher than in the normal population.
“…All the six studies included in the final analysis were retrospective. The 11 studies included a total number of 2,065 patients with HT, with individual study cohorts counting from 89 to 904 children [20][21][22][23][24][25].…”
Section: Resultsmentioning
confidence: 99%
“…The severity of hypoechogenity at ultrasound, anti-TPO antibodies and free T4 serum concentrations were predictive for the appearance of new nodules. Radetti et al concluded that HT seems to influence the development of thyroid nodules, but not cancer in children and adolescents [25].…”
ObjectivesThyroid cancer is the most common pediatric endocrine neoplasm representing 3% of all malignancies in children. Hashimoto’s thyroiditis (HT) is also a common disorder in the pediatric age range. Patients with HT frequently develop enlarged thyroid with nodules. We aimed to provide a literature review on the frequency of papillary thyroid carcinoma (PTC) in patients with HT.ContentA literature search of the PubMed database between 2000 and 2020 was performed, using the relevant keywords “papillary thyroid carcinoma,” “Hashimoto’s thyroiditis” and “children”. We followed the PRISMA statement guidelines during the preparation of this review. Six studies (n=2,065 patients with HT) were retained for the final analysis. The follow-up of the patients with HT was from 2 to 10 years. PTC was diagnosed in 0.67–7.87% of the HT patients included in these studies. In patients with HT and nodules, the percentage of PTC varied between 5.13 and 35%. The overall occurrence of PTC in patients with HT was 3.07%.Summary and OutlookThe number of patients developing thyroid nodules in relation to HT was increased. The development of PTC in children with HT appeared to be higher than in the normal population.
“…Well-differentiated thyroid cancers are the most common endocrine tumors in children and adolescents. A significant increase in the incidence of thyroid cancers was observed in children following the nuclear reactor meltdown in Ukraine and those exposed to the atomic blasts in Japan [5,6].…”
Nodular goiter is a rare condition in children and adolescents and compared with adults, thyroid nodules are more frequent malignant in pediatric population. We have investigated the prevalence of thyroid carcinoma among the thyroid disorder emphasizing on the surgical treatment in term of indication, methods and complications. Retrospective study of 35 children and adolescents with nodular goiter. Demographic data, thyroid ultrasonographic features, fine needle biopsy aspiration, hormonal profile, surgical treatment procedure as well as histological aspects were recorded. Study included 26 (74%) girls and 9 (26%) boys with a mean age of 11.66 years. Fine needle aspiration biopsy was performed in 10 cases due to the TIRADS score � 4 with Bethesda II in 3 cases, Bethesda III in 4 cases and Bethesda V in 3 cases. The surgical treatment was performed in 16 (45.7%) cases due to fine needle aspiration biopsy results or due to the relapse after medical treatment. Lobectomy was performed in 7 (43.7%) cases while total thyroidectomy was the final option for the rest of 9 (56.3%) patients. As a result of pathological examination in 8 cases the thyroid carcinoma has been found. The rest of 8 patients presented benign thyroid findings (follicular adenoma, toxic adenoma and Graves� disease with follicular adenoma). The prevalence of thyroid carcinoma among the pediatric population with thyroid nodules was 22.8% most affected being the female gender.
“…1). In other pediatric multicenter cohort, involving children and adolescents affected by HT, a very low prevalence of TC (1.1%) compared to other series has been reported [21]; these author did not demonstrate influence of TSH levels on TC occurrence, likely due to the small number of patients with TC in their cohort [21]. Furthermore, Kambalapalli et al [22] reported a 4% of prevalence of TC in a group of children and adolescents with goiter without statistical difference between positive and negative thyroid peroxidase antibody (TPOAb) patients.Fig.…”
Section: Introductionmentioning
confidence: 95%
“…Although an increased risk of TC in children and adolescents with nodular HT is still debated and not constantly reported [8, 21], it seems likely that increased levels of TSH, a consequence of the thyroid damage by the autoimmune process, could be a factor of risk of TC.…”
Thyroid cancer (TC) in childhood is a rare disease characterized by an excellent prognosis. Thyroid nodules in children, although less common than in adults, have a greater risk of malignancies, particularly in those cases associated with anamnestic, clinical and ultrasonographic risk factors.
Among the factors, which have been found to be linked with an increased relative risk of TC in children, an important role seems to be possibly played by an underlying nodular Hashimoto’s thyroiditis (HT) and by the serum levels of TSH.
Aim of this Commentary was to specifically address this last point.
According to the available pediatric literature on the relationships between these risk factors and phenotypical expression of TC in children, it is possible to conclude that: 1) It is not completely clarified if HT per se predisposes to malignancy or if it represents an incidental histologic finding in cases with TC or if it may be the result of an immune response against tumoral cells. 2) It is unclear whether phenotypic expression of TC is more severe in the cases with associated HT but normal TSH serum levels. 3) Persistently elevated TSH levels play an independent role as predictors of the likelihood of TC, especially in children but also in adults. 4) Patients with nodular HT and subclinical hypothyroidism need to be treated with Levothyroxine in order to prevent the development of both TC and severe thyroid dysfunctions.
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