Pediatric Thyroid Cancer in Europe: An Overdiagnosed Condition? A Literature Review

Abstract

Thyroid neoplastic pathology is the most common form of cancer associated with radiation exposure. The most common histopathological type of thyroid carcinoma is the differentiated thyroid cancer (these include papillary and follicular type), which represents over 90% of all cases, especially affecting girls rather than boys. Although patients are diagnosed in advanced stages as compared to adults, the prognosis of the disease is very good, with a 30-year survival rate of over 95% but post-therapeutic morbidity remains quite high. The treatment is based in particular on the therapeutic guidelines for adults, but as children have some histopathological and genetic characteristics of thyroid cancer, as well as different initial clinical presentations, we decided to review the literature on this pathology among the pediatric population, focusing on cases in Europe. The major interest is the impact of the Chernobyl accident.

Differentiated Thyroid Cancer in Children in the Last 20 Years: A Regional Study in Romania

“…The average activity of 131-I administrated was 186.68 mCi (6.9 GBq), with values between 17.88 and 990.15 mCi (0.66–36.6 GBq), Q1 = 70 mCi (2.59 GBq), and the average number of administrations being 2.38 with Q1 = 1 ( Figure 4 ) [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ]. We do not have records of the presence of pulmonary fibrosis, and no other neoplasms developed up to the time of publication of the data.…”

“…Cumulative 131-I activity and the number of 131-I administrations during initial and subsequent treatment did not differ by age groups ( p = 0.066, p = 0.217) Table 3 . There were no adverse effects of 131-I administration, such as pulmonary fibrosis or other malignancies, as described in the literature [ 3 ].…”

“…Pediatric thyroid carcinoma is a current area of interest, because there are few studies in this field; therefore, the current classification and treatment guidelines are extrapolated from adults, sometimes leading to overly aggressive treatments or incomplete treatment of the disease [ 1 , 2 , 3 ]. This pathology occurs relatively rarely in pediatric age, with an incidence at children of 0.4/100,000 (0–4 y) and 1.5/100,000 (15–19 y) [ 4 ].…”

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

“…The overall incidence of thyroid cancer in children is growing in Europe and America, being described in the literature as 0.5-1.2/million for children under 14 years of age and 4.4-11/million for children between 15 and 19 years of age [8].…”

Metastatic Papillary Thyroid Carcinoma in a Paediatric Patient

“…They are more common in older children and adolescence with a female-to-male ratio of 5 : 1 [ 2 , 3 ]. Approximately less than 3% of the patients have thyroid nodules which should raise a high index of suspicion for malignancy [ 1 , 4 ]. A definite diagnosis is usually delayed due to the subtle presentation of the primary malignancy, and therefore, they may present late with metastatic disease [ 1 ].…”