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Papillary carcinoma masquerading as clinically toxic adenoma in very young children

  • Nishikant Damle EMAIL logo , Santosh Gupta , Praveen Kumar , Sandeep Mathur and Chandrasekhar Bal
Published/Copyright: November 1, 2011
Journal of Pediatric Endocrinology and Metabolism
From the journal Volume 24 Issue 11-12

Abstract

Background: Autonomously functioning thyroid nodules (AFTN) are extremely rare in children. Malignancy may be rarely found in hyperfunctioning ‘hot’ nodules in adults. However, there are limited reports of AFTNs in young children presenting as or developing malignancy in future. We report here two young children aged <6 years old at the time of diagnosis as having an AFTN, which eventually turned out to be papillary carcinoma of thyroid (PTC) on follow-up.

Patient findings: A 2-month-old baby had a right-sided neck swelling since birth. On examination, the baby had clinical and biochemical features of thyrotoxicosis. On sonography, and subsequently on 99mTc-pertechnetate thyroid scan, a hot nodule was found. Patient was treated with carbimazole for 5 years. In spite of euthyroidism achieved, the nodule continuously grew in size. Thyroid cytology was inconclusive, hence hemithyroidectomy was performed and histopathology turned out to be PTC. Another 5-year-old female child had a large right-sided AFTN on thyroid scan. She was treated with radioiodine; however, like the previous case, the nodule started growing in size. She subsequently underwent near total thyroidectomy and histology was reported as PTC.

Conclusion: In the light of this report that shows that solitary hyperfunctioning nodules in very young children have high chance of malignancy, we recommend hemithyroidectomy as the treatment of choice.


Corresponding author: Nishikant Damle, Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi 110029, India Phone: +91-11-26546490, Fax: +91-11-26588993

Received: 2011-03-02
Accepted: 2011-08-05
Published Online: 2011-11-01
Published in Print: 2011-12-01

©2011 by Walter de Gruyter Berlin Boston

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