부산대학교 도서관

INTRODUCTION Thyroid cancer is an uncommon malignancy in childhood and adolescence; however, it is the most common endocrine cancer in this age group (1). Between 1973 and 2013, the annual [...]
Objective: Differentiated thyroid cancer accounts for 1.5% of all pediatric malignancies. Papillary thyroid cancer (PTC) is the most common subtype and is associated with more advanced disease at diagnosis compared to adults. This study aimed to identify long-term outcomes of pediatric PTC. Material and Method: Records of 30 patients with PTC diagnosed in childhood and adolescence and followed up at the Istanbul Faculty of Medicine were reviewed retrospectively. Result: The mean age of 30 patients (21 females, 9 males) at diagnosis was 14.7 [+ or -] 2.3 years. The mean duration of follow-up was 10.6 [+ or -] 3.8 years. The patients underwent total thyroidectomy (n=9), total thyroidectomy with central lymph node dissection (n=9), or total thyroidectomy with central and lateral lymph node dissection (n = 12). The mean tumor diameter was 1.6 [+ or -] 1.5 cm and was microcarcinoma in 12 of the patients. There were five patients with T2 and two patients with T3 disease. At diagnosis, half of the patients had lymph node metastasis to the neck or upper mediastinum (N1a=5, N1b=10), and two also had lung metastasis. Post-operative radioactive iodine (RAI) treatment was administered to 22 patients, the median cumulative dose was 150 mCi (range 50 to 1100)]. Sixteen patients had excellent responses following single (n = 13) or multiple (2 for persistent and 1 for recurring disease after 8.3 years) RAI administrations. The remaining three patients had structural incomplete and three had indeterminate responses. Conclusion: Although PTC presented at a more advanced stage in childhood and adolescence, the response to treatment was fairly good with appropriate management. Keywords: Papillary thyroid cancer, thyroid, pediatric, radioactive iodine Amac: Diferansiye tiroid kanseri, tum pediatrik malignitelerin %1,5'ini olusturur. Papiller tiroid kanseri (PTK) en sik gorulen alt tiptir ve tani aninda hastalik evresi eriskinlere kiyasla daha ileridir. Bu calismanin amaci, pediatrik PTK'nin uzun vadeli sonuclarini degerlendirmekti. Gerec ve Yontem: Istanbul Tip Fakultesi'nde takip edilen cocukluk ve adolesan doneminde PTK tanisi konulan 30 hastanin retrospektif olarak verileri incelendi. Bulgular: Otuz hastanin (21 kadin, 9 erkek) tani anindaki ortalama yasi 14,7 [+ or -] 2,3 idi. Ortalama takip suresi 10,6 [+ or -] 3,8 yildi. Dokuz hastaya total tiroidektomi, dokuz hastaya santral lenf nodu diseksiyonu ile total tiroidektomi, 12 hastaya ise santral ve lateral lenf nodu diseksiyonu ile total tiroidektomi uygulandi. Ortalama tumor capi 1,6 [+ or -] 1,5 cm idi ve 12 hastada mikrokarsinom saptandi. T2 hastaligi olan bes hasta ve T3 hastaligi olan iki hasta vardi. Tani sirasinda hastalarin yarisinda boyun veya ust mediastende lenf nodu metastazi (N1a=5, N1b=10), iki hastada da ayrica akciger metastazi vardi. Ameliyat sonrasi 22 hastaya radyoaktif iyot (RAI) tedavisi uygulandi, ortanca kumulatif doz 150 mCi (aralik 50-1100) idi. Hastalarin 13'u tekli doz, 3'u (2 hasta persistan hastalik, 1 hasta 8,3 yil sonra gelisen nuks hastalik nedeniyle) coklu doz RAI uygulamasinin ardindan mukemmel yanit verdi. Kalan uc hastada yapisal inkomplet ve uc hastada indetermine yanit alindi. Sonuc: PTK cocukluk ve ergenlik doneminde daha ileri evrede ortaya ciksa da uygun hastalik yonetimiyle tedaviye yanit oldukca iyiydi. Anahtar Kelimeler: Papiller tiroid kanseri, tiroid, pediatrik, radyoaktif iyot