ABSTRACT

Metastatic Papillary Thyroid Cancer in a Pediatric Patient. A Rare Case Report

Muhammad Dhanny Irawan, Artanto Wahyono
Division of Surgical Oncology, Department of Surgery
Gadjah Mada University / RSUP Dr. Sardjito

Background: Pediatric thyroid cancer are rare endocrine cancers, majority of which are comprised
of papillary thyroid carcinoma (PTC) with an incidence of 4% of all cancers. Pediatric thyroid
cancer resulting in distant metastases is rare, and previous studies have been limited by small
numbers of patients. The aim of this case report is to present rare cases and their comprehensive
management
Case illustration: A 10 years old girl have typical sign and symptoms of thyroid disease. The
patient underwent physical examination, laboratory, thorax x-ray, MRI, and biopsy. The result of
thorax x-ray is milliary type pulmonary metastases. The result of MRI is inhomogeneous mass
(predominantly solid) in the left thyroid and multiple bilateral cervical lymphadenopathies. The
result of the biopsy was carcinoma of the thyroid. The patient then underwent total thyroidectomy
and bilateral radical neck dissection surgery with histopathological results papillary carcinoma
(follicular variant) and continued with radioactivity iodine therapy (RAI)
Discussion: The latest American Thyroid Association (ATA) children’s guidelines recommend
radioactive iodine therapy (RAI) after total thyroidectomy for intermediate and highrisk groups
who have extensive cervical lymph node involvement. However, owing to its rare occurrence, the
data for pediatric PTC are deficient, and many of the recommendations of these guidelines were
extrapolated from data for adult PTC
Conclusion: Thyroid cancer in pediatrics is a very rare case and the guidelines are still based on
adult data, therefore more data on pediatric TC are needed to guide evidence-based clinical practice
and management.
References:
Alzahrani et al. Lung Metastasis in Pediatric Thyroid Cancer: Radiological Pattern, Molecular
Genetics, Response to Therapy, and Outcome. J Clin Endocrinol Metab 104: 103–110, 2019
Nies M et al. Distant Metastases From Childhood Differentiated Thyroid Carcinoma: Clinical
Course and Mutational Landscape. The J Clin Endoc & Met, 2021, Vol. 106, No. 4
Mothata et al. Metastatic Papillary Thyroid Carcinoma in a Paediatric Patient. Case Reports in
Endocrinology Volume 2021, Article ID 6655491, 4 pages
Kim et al. Aggressiveness of Differentiated Thyroid Carcinoma in Pediatric Patients Younger
Than 16 years: A Propensity Score-Matched Analysis. Front. Oncol. 12:872130. doi:
10.3389/fonc.2022.872130