Surgery of thyroid cancer in children and adolescents

Background. Thyroid carcinoma in young patients under the age of 20 years is uncommon. Because of the slow progression of this disease, theta is still a great deal of debate as to which operation strategy is best. Methods. We undertook a retrospective study of 61 patients under 20 years of age with thyroid cancer treated at our institute between 1952 and 1995. They constitute 6.6% of the 921 thyroid cancer patients treated by us during the same period. Factors examined were: symptoms, metastases, treatment, complications, and survival. Results. Total or near-total thyroidectomy was performed in 51 patients. Regional lymph node dissection was performed in 17 patients and modified radical neck dissection in 13. Fifty-one patients underwent pretracheal and paratracheal lymph node dissection. During the 43 years of this study, two patients died of thyroid cancer. Conclusions. Although most children are initially seen with more extensive disease than adults, the overall prognosis is excellent. The excellent prognosis is the product of initial aggressive treatment: near-total or total thyroidectomy and at least pre-and paratracheal lymph node dissection, followed by radioactive iodine therapy.