Ultrasound Screening for Thyroid Carcinoma in Childhood Cancer Survivors: A Case Series

Brignardello, Enrico; Corrias, Andrea; Isolato, G; Palestini, N; Montezemolo, Luca Cordero di; Fagioli, Franca; Boccuzzi, Giuseppe

doi:10.1210/jc.2008-1528

Cited by 69 publications

(36 citation statements)

References 15 publications

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“…This subtype is the most frequent one, not only in the general population, but also following treatment for childhood malignancy. 11,13,37,38,40,41 Some authors found that being less than 10 years of age was associated with an increased risk of thyroid cancer, 11,13,38 although we did not find similar results. In contrast, we confirmed that women are at an increased risk of developing thyroid cancer (HR=4.74; P=0.002), which has been suggested by other studies 13 and observed in the general population.…”

Section: Discussioncontrasting

confidence: 95%

“…36 Many previous studies have focused on thyroid cancer after treatment for childhood cancer. 13,30,[37][38][39] The reported prevalences varied, which may be due to several factors, e.g., the studies were frequently retrospective, based on questionnaires, or included small numbers of patients. In contrast, our study was prospective and included a large number of patients.…”

Section: Discussionmentioning

confidence: 99%

“…However, the incidence of thyroid malignancies among survivors of childhood cancer is high, and neck palpation is often insufficient to detect small suspicious nodules in these high-risk patients. 37 Furthermore, in the follow-up of irradiated individuals, several studies have shown that many large, ultrasounddetected thyroid nodules escape detection via palpation. 37,44 Lastly, thyroid ultrasound scanning is a simple and non-invasive method.…”

Section: Discussionmentioning

confidence: 99%

“…37 Furthermore, in the follow-up of irradiated individuals, several studies have shown that many large, ultrasounddetected thyroid nodules escape detection via palpation. 37,44 Lastly, thyroid ultrasound scanning is a simple and non-invasive method. Taken together, these arguments lead us to consider that thyroid ultrasound scanning is a valuable method for screening for malignancies, regardless of a lack of definitive data comparing this method with other screening modalities.…”

Section: Discussionmentioning

confidence: 99%

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Late thyroid complications in survivors of childhood acute leukemia. An L.E.A. study

Oudin¹,

Auquier²,

Bertrand³

et al. 2016

Haematologica

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T hyroid complications are known side effects of irradiation. However, the risk of such complications in childhood acute leukemia survivors who received either central nervous system irradiation or hematopoietic stem cell transplantation is less described. We prospectively evaluated the incidence and risk factors for thyroid dysfunction and tumors in survivors of childhood acute myeloid or lymphoid leukemia. A total of 588 patients were evaluated for thyroid function, and 502 individuals were assessed for thyroid tumors (median follow-up duration: 12.6 and 12.5 years, respectively). The cumulative incidence of hypothyroidism was 17.3% (95% CI: 14.1-21.1) and 24.6% (95% CI: 20.4-29.6) at 10 and 20 years from leukemia diagnosis, respectively. Patients who received total body irradiation (with or without prior central nervous system irradiation) were at higher risk of hypothyroidism (adjusted HR: 2.87; P=0.04 and 2.79, P=0.01, respectively) as compared with transplanted patients who never received any irradiation. Patients transplanted without total body irradiation who received central nervous system irradiation were also at higher risk (adjusted HR: 3.39; P=0.02). Patients irradiated or transplanted at older than 10 years of age had a lower risk (adjusted HR: 0.61; P=0.02). Thyroid malignancy was found in 26 patients (5.2%). Among them, two patients had never received any type of irradiation: alkylating agents could also promote thyroid cancer. The cumulative incidence of thyroid malignancy was 9.6% (95% CI: 6.0-15.0) at 20 years. Women were at higher risk than men (adjusted HR: 4.74; P=0.002). In conclusion, thyroid complications are frequent among patients who undergo transplantation after total body irradiation and those who received prior central nervous system irradiation. Close monitoring is thus warranted for these patients.

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Section: Discussioncontrasting

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Late thyroid complications in survivors of childhood acute leukemia. An L.E.A. study

Oudin¹,

Auquier²,

Bertrand³

et al. 2016

Haematologica

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“…Thyroid carcinoma has been sporadically reported after latency periods of between 5 years and up to 15 or 30 years after exposure, depending on the study (4,49,50). With the increasing use of ultrasound scans and FNAB, thyroid carcinoma tends to be diagnosed very accurately at early stages (51). Only two other retrospective studies reported the results of ultrasound examinations for the detection of thyroid nodules and/or carcinoma during the follow-up of patients receiving TBI as part of conditioning regimens for HSCT during childhood (22,24).…”

Section: Discussionmentioning

confidence: 99%

Malignant and benign thyroid nodules after total body irradiation preceding hematopoietic cell transplantation during childhood

Vivanco

Dalle²,

Alberti³

et al. 2012

European Journal of Endocrinology

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Background: The risk of radiation-induced benign and malignant thyroid nodules is well known. Objective: The aim of this study was to determine the occurrence of thyroid nodules and carcinomas after fractionated total body irradiation (TBI) preceding hematopoietic stem cell transplantation (HSCT) for malignant hematological disease during childhood. Methods: We conducted a retrospective university hospital-based observational study. The participants were 76 patients receiving fractionated TBI between 1989 and 2009 as part of the conditioning regimen for HSCT to treat malignant hematological disease, with a median age of 8.2 (5.7-11.4) years, for whom the last ultrasound examination was performed at a median age of 14.2 (11.2-17) years. The main outcome measure was cumulative incidence of thyroid nodules detected by ultrasound scans followed by biopsy if necessary. Results: Thyroid nodules were examined in 21 (28%) patients, six (29%) of whom were diagnosed with thyroid carcinoma at the age of 2.2-18.6 years after TBI. The cumulative incidence of nodule occurrence increased with increasing time from diagnosis. The 10-year cumulative incidence of benign and malignant thyroid nodules was 16% (95% confidence interval (CI) 4-27%) and 8% (95% CI 0-16%) respectively. Seventeen (22%) patients had hypothyroidism (compensated nZ12, in five patients it was transient). No significant independent risk factors were identified in the multivariable competing risk model as a function of nodule occurrence. Conclusion: Short-term and life-long monitoring, with screening for nodules of the thyroid gland using ultrasound scans, is recommended for survivors subjected to TBI for HSCT during childhood.

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Thyroid Surgery in Paediatric Patients

2012

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Ultrasound Screening for Thyroid Carcinoma in Childhood Cancer Survivors: A Case Series

Cited by 69 publications

References 15 publications

Late thyroid complications in survivors of childhood acute leukemia. An L.E.A. study

Late thyroid complications in survivors of childhood acute leukemia. An L.E.A. study

Malignant and benign thyroid nodules after total body irradiation preceding hematopoietic cell transplantation during childhood

Thyroid Surgery in Paediatric Patients

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