When and how to suspect thyroid cancer in children and adolescents
DOI:
https://doi.org/10.13112/pc.1159Keywords:
Thyroid Neoplasms; Thyroid Nodule; Adolescent; Child; UltrasonographyAbstract
Thyroid cancer, although rare, is the most common endocrine malignancy in children and adolescents. Its biological behavior in this population differs from that observed in adults. Pediatric thyroid cancers are often larger at diagnosis, demonstrate a higher frequency of local invasion, and exhibit a greater propensity for metastasis to cervical lymph nodes and distant organs. Despite their more aggressive initial presentation and an increased risk of recurrence, long-term outcomes in children and adolescents remain excellent. Over recent decades, a notable rise in the incidence of thyroid cancers has been reported. The most prevalent histological subtype is papillary thyroid carcinoma, whereas other variants are considerably less common. Thyroid cancer is most frequently diagnosed during adolescence and typically presents as an asymptomatic thyroid nodule. Although thyroid nodules are uncommon in children, their malignant potential is significantly higher than in adults, warranting careful diagnostic evaluation. Key risk factors include exposure to ionizing radiation, hereditary syndromes, a family history of thyroid malignancy, and certain autoimmune thyroid disorders. Ultrasonography constitutes the cornerstone of diagnostic assessment, with specific sonographic features substantially increasing the suspicion of malignancy. Fine-needle aspiration biopsy remains the gold standard for suspicious nodules. Early identification of high-risk clinical and imaging features is essential for timely diagnosis, optimal therapeutic intervention, and the maintenance of the excellent prognosis observed in pediatric thyroid cancer.
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