Stephanie L Samuels1, Lea F Surrey2, Colin P Hawkes1,3, Madeline Amberge4, Sogol Mostoufi-Moab1,3,5, Jill E Langer6, N Scott Adzick3,7, Ken Kazahaya8,9, Tricia Bhatti2, Zubair Baloch2, Virginia A LiVolsi2, Andrew J Bauer1,3. 1. Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 2. Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. 3. Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. 4. Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania. 5. Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 6. Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. 7. Department of Surgery, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 8. Divison of Pediatric Otolaryngology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 9. Department of Otorhinolaryngology/Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
Abstract
Context: In adults, noninvasive follicular variant of papillary thyroid carcinoma (FVPTC) is considered a low risk for metastasis and persistent/recurrent disease. Objective: The goal of this study was to assess the clinical, sonographic, and histopathologic features of FVPTC in a pediatric cohort. Design: A retrospective review of subjects <19 years of age with papillary thyroid carcinoma (PTC) who underwent thyroidectomy between January 2010 and July 2015. Setting: Multidisciplinary academic referral center. Patients: Patients with FVPTC, defined as a tumor ≥1 cm in the largest dimension with predominant follicular growth, complete lack of well-formed papillae, and nuclear features of PTC. Main Outcome Measures: Tumor size and location, presence of a tumor capsule, capsule and vascular invasion, lymph node invasion, and distant metastasis. Results: Eighteen patients with FVPTC were identified from a case cohort of 110 patients with PTC. On histopathology, 13 (72%) had unifocal nodules and 14 (78%) had completely encapsulated FVPTC. Capsule invasion was frequent (nine of 14; 64%), and vascular invasion was found in one-third of patients (six of 18; 33%). No lymph node metastases were found in the 13 patients (72%) who had a central neck lymph node dissection. One patient with vascular invasion had distant metastases. Conclusion: When strictly defined, FVPTC in pediatric patients has a low risk for bilateral disease and metastasis. Prospective studies are needed to confirm whether lobectomy with surveillance is sufficient to achieve remission in pediatric patients with low-risk FVPTC.
Context: In adults, noninvasive follicular variant of papillary thyroid carcinoma (FVPTC) is considered a low risk for metastasis and persistent/recurrent disease. Objective: The goal of this study was to assess the clinical, sonographic, and histopathologic features of FVPTC in a pediatric cohort. Design: A retrospective review of subjects <19 years of age with papillary thyroid carcinoma (PTC) who underwent thyroidectomy between January 2010 and July 2015. Setting: Multidisciplinary academic referral center. Patients: Patients with FVPTC, defined as a tumor ≥1 cm in the largest dimension with predominant follicular growth, complete lack of well-formed papillae, and nuclear features of PTC. Main Outcome Measures: Tumor size and location, presence of a tumor capsule, capsule and vascular invasion, lymph node invasion, and distant metastasis. Results: Eighteen patients with FVPTC were identified from a case cohort of 110 patients with PTC. On histopathology, 13 (72%) had unifocal nodules and 14 (78%) had completely encapsulated FVPTC. Capsule invasion was frequent (nine of 14; 64%), and vascular invasion was found in one-third of patients (six of 18; 33%). No lymph node metastases were found in the 13 patients (72%) who had a central neck lymph node dissection. One patient with vascular invasion had distant metastases. Conclusion: When strictly defined, FVPTC in pediatric patients has a low risk for bilateral disease and metastasis. Prospective studies are needed to confirm whether lobectomy with surveillance is sufficient to achieve remission in pediatric patients with low-risk FVPTC.
Authors: Julia A Baran; Andrew J Bauer; Stephen Halada; Sogol Mostoufi-Moab; Amber Isaza; Stephanie Robbins; Aime T Franco; N Scott Adzick; Tasleema Patel; Ken Kazahaya Journal: Thyroid Date: 2021-12-02 Impact factor: 6.568
Authors: Sasha R Howard; Sarah Freeston; Barney Harrison; Louise Izatt; Sonali Natu; Kate Newbold; Sabine Pomplun; Helen A Spoudeas; Sophie Wilne; Tom R Kurzawinski; Mark N Gaze Journal: Endocr Relat Cancer Date: 2022-09-07 Impact factor: 5.900