Jaromír Astl1, Martin Chovanec2, Petr Lukeš3, Rami Katra4, Marcela Dvořáková5, Petr Vlček6, Pavla Sýkorová6, Jan Betka3. 1. Department of Otorhinolaryngology and Head and Neck Surgery, IPVZ, 1st Faculty, Charles University Hospital, Motol, Prague, Czech Republic; Department of Otorinolaryngology, 3rd Faculty of Medicine, Charles University, Motol, Prague, Czech Republic; Military Faculty Hospital, Motol, Prague, Czech Republic. Electronic address: jaromir.astl@seznam.cz. 2. Department of Otorhinolaryngology and Head and Neck Surgery, IPVZ, 1st Faculty, Charles University Hospital, Motol, Prague, Czech Republic; Institute of Anatomy (M.C.), 1st Faculty of Medicine, Charles University, Motol, Prague, Czech Republic; Center for Cell Therapy and Tissue Repair (M.C.), Faculty Hospital Motol, 2nd Faculty of Medicine, Charles University, Motol, Prague, Czech Republic. 3. Department of Otorhinolaryngology and Head and Neck Surgery, IPVZ, 1st Faculty, Charles University Hospital, Motol, Prague, Czech Republic. 4. Department of Otorhinolaryngology and Head and Neck Surgery, 2nd Faculty, Charles University Prague, Motol, Prague, Czech Republic. 5. Institute of Endocrinology (M.D.), Charles University, Motol, Prague, Czech Republic. 6. Department of Nuclear Medicine (P.V., V.S.), Charles University, Motol, Prague, Czech Republic.
Abstract
OBJECTIVES: The purpose of this study is to evaluate the characteristics of thyroid gland surgery focusing on malignancies at the pediatric age with the main concern on treatment results and complications in extensive primary treatment. METHODS: The records of all patients 18 years and younger with surgically treated thyroid diseases in the Prague Hospital, Motol, between 1991 and 2006 were retrospectively reviewed. RESULTS: Thyroid surgery was performed on 148 pediatric patients (including 56 carcinomas). The youngest patient involved in the study was seven years old, the oldest patient 18 years old (mean 13.7 years). Most frequent histological cancer type was PTC (42 cases, 75%). Follicular cancer was diagnosed in five cases (8.9%) and medullar cancer in nine cases (16.1%). A prophylactic thyroidectomy was performed in three cases (5.4%) without clinical signs of thyroid tumor with diagnosed RET gene mutation. CONCLUSIONS: We consider total thyroidectomy with subsequent radioiodine ablation and TSH suppression as the basic approach in the treatment protocol of pediatric WDTC. The observed 100% recurrence-free and overall survival together with a low incidence of postoperative complications strongly supports the idea of a total thyroidectomy with selective neck dissection in the treatment of metastases of WDTC and MTC.
OBJECTIVES: The purpose of this study is to evaluate the characteristics of thyroid gland surgery focusing on malignancies at the pediatric age with the main concern on treatment results and complications in extensive primary treatment. METHODS: The records of all patients 18 years and younger with surgically treated thyroid diseases in the Prague Hospital, Motol, between 1991 and 2006 were retrospectively reviewed. RESULTS: Thyroid surgery was performed on 148 pediatric patients (including 56 carcinomas). The youngest patient involved in the study was seven years old, the oldest patient 18 years old (mean 13.7 years). Most frequent histological cancer type was PTC (42 cases, 75%). Follicular cancer was diagnosed in five cases (8.9%) and medullar cancer in nine cases (16.1%). A prophylactic thyroidectomy was performed in three cases (5.4%) without clinical signs of thyroid tumor with diagnosed RET gene mutation. CONCLUSIONS: We consider total thyroidectomy with subsequent radioiodine ablation and TSH suppression as the basic approach in the treatment protocol of pediatric WDTC. The observed 100% recurrence-free and overall survival together with a low incidence of postoperative complications strongly supports the idea of a total thyroidectomy with selective neck dissection in the treatment of metastases of WDTC and MTC.
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