Thyroid neoplasia in children

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Abstract
In 1995, the incidence of childhood thyroid cancer in England and Wales was only 0.5 cases per million children per year. Papillary cancers in younger children were histologically distinct from tumors in older individuals. The incidence of thyroid cancer in the vicinity of Chernobyl increased by 62 times within 5 years of the nuclear explosion. Mutations of the RET protooncogene (a growth factor receptor) occur in nearly all familial medullary thyroid carcinomas and may be used for family screening. RET is involved in chromosomal rearrangements in a majority of childhood papillary thyroid cancers. Fine-needle aspiration biopsy identifies the childhood thyroid nodules that are at greatest risk for cancer. It should be noted, however, that approximately 2% of aspirates are falsely negative. The adequacy of unilateral surgery for papillary thyroid cancers is controversial. Aggressive surgery for persistent medullary carcinoma produces remission in one third of patients. Novel radionuclide techniques are useful in detecting and treating metastatic medullary carcinoma.

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