RADIOIODINE AND THE CHILD WITH THYROID CANCER

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Abstract
Thyroid cancer occurs more commonly in females than in males, and has been thought to be increasing in incidence in young people. Its cause is unknown, but one of the contributing factors may be exposure of the neck to ionizing radiation in infancy, childhood or later. Differentiated carcinoma is the commonest form of thyroid cancer in childhood. Mortality from thyroid cancer is approximately 15% of all patients, with 2/3 dying of the differentiated carcinomas. Forty per cent of those who die of the disease do so more than 5 years after discovery. Complication due to local recurrence and direct extension is the commonest mode of death. The prognosis for survival in patients with thyroid carcinoma is good, and has led to misunderstandings about the real nature of the disease. General diagnostic and therapeutic approaches for various types and distributions of thyroid cancer in children are described. Representative situations in management of childhood thyroid cancer are illustrated from our own clinical experience. A diagnostic and therapeutic regimen for children with thyroid cancer is outlined in detail. The role of radioiodine in the management of thyroid carcinoma in children is explored at length.

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