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Differentiated thyroid cancer in adolescents – does extent of disease at presentation differ with age?

  • Priya Arya ORCID logo , Emily A. Wright , Eric K. Shaw , Daniel J. Lubin and Kara K. Prickett EMAIL logo
Published/Copyright: December 31, 2024
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 38 Issue 3

Abstract

Objectives

The authors sought to assess whether the age of 18 reflects a true pathological inflection point that justifies transitioning between pediatric and adult paradigms of care with differentiated thyroid cancer (DTC).

Methods

A retrospective chart review was conducted for patients aged 12–24 undergoing hemithyroidectomy or total thyroidectomy for papillary or follicular thyroid carcinoma from 2010 to 2020.

Results

A total of 153 patients receiving surgery for DTC were assessed for pathological stage, nodal metastasis, and thyroid neoplasm characteristics. When comparing pathologic tumor staging of patients <18 vs. ≥18 years old, there was a significant relationship between age and pT stage (p=0.009), but not between age and pN stage (p=0.319). However, when comparing patients ≤15 vs. >15 years, there was a significant relationship between age and pT stage (p=0.015) and age and pN stage (p=0.016). Patients ≤15 years of age most commonly had stage pT2 tumors (48.9 %, n=22), whereas most >15 years had stage pT1 tumors (37.9 %, n=41). Of patients whose lymph nodes were analyzed, patients ≤15 years were most likely to have pN1b disease (31.1 %, n=14), while patients >15 years were most likely to have pN0 disease (33.3 %, n=36).

Conclusions

In this sample, separating children and adults at an age of 15, rather than 18, yielded more significant differences in risk of nodal involvement. Markers of invasive histology were more common in patients older than 15, while nodal involvement was more common in patients 15 and under.

Keywords: thyroid cancer; papillary thyroid cancer; well-differentiated thyroid cancer; adolescent; pediatric
Corresponding author: Kara K. Prickett, MD, Department of Otolaryngology, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA; Children’s Healthcare of Atlanta, 1405 Clifton Rd NE, Atlanta, GA 30322, USA; and Center for Advanced Pediatrics, 1400 Tullie Rd NE, Atlanta, GA 30329, USA, E-mail:
This study was presented as an oral presentation at the American Head and Neck Society (AHNS) 11th International Conference on Head and Neck Cancer; Montréal, QC, Canada; July 11–12, 2023.

  1. Research ethics: The local Institutional Review Board deemed the study exempt from review. IRB approval was obtained from Emory University (STUDY00004844), Children’s Healthcare of Atlanta, and Grady Memorial Hospital.

  2. Informed consent: Informed consent was obtained from all individuals included in this study.

  3. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Use of Large Language Models, AI and Machine Learning Tools: None declared.

  5. Conflict of interest: The authors state no conflict of interest.

  6. Research funding: None declared.

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Supplementary Material

This article contains supplementary material (https://doi.org/10.1515/jpem-2024-0289).

Received: 2024-06-16
Accepted: 2024-11-28
Published Online: 2024-12-31
Published in Print: 2025-03-26

© 2024 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Original Articles
  3. Thyroid surgery in pediatric age: a 10-year experience at a single center and literature review
  4. Differentiated thyroid cancer in adolescents – does extent of disease at presentation differ with age?
  5. Evaluation of iodine and selenium level and thyroid functions in patients with cystic fibrosis
  6. Interpreting positive celiac serology in children with new-onset type 1 diabetes
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  10. Development of a disease diagnostic model to predict the occurrence of central precocious puberty of female
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  12. The clinical presentation and genetic diagnosis of Tangier disease in the pediatric age group
  13. Clinical and genetic diagnosis of first cohort of differences of sexual development in the Iranian population
  14. Short Communication
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  16. Case Reports
  17. Coexistence of phenylketonuria and tyrosinemia type 3: challenges in the dietary management
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https://doi.org/10.1515/jpem-2024-0289
Keywords for this article
thyroid cancer; papillary thyroid cancer; well-differentiated thyroid cancer; adolescent; pediatric

Articles in the same Issue

  1. Frontmatter
  2. Original Articles
  3. Thyroid surgery in pediatric age: a 10-year experience at a single center and literature review
  4. Differentiated thyroid cancer in adolescents – does extent of disease at presentation differ with age?
  5. Evaluation of iodine and selenium level and thyroid functions in patients with cystic fibrosis
  6. Interpreting positive celiac serology in children with new-onset type 1 diabetes
  7. Elastographic evaluation for fatty liver disease in north Indian children and adolescents with type 1 diabetes
  8. Diagnostic value of fasting insulin and insulin-like growth factor-1 levels in girls with central precocious puberty
  9. Clinical outcomes of switching to lonapegsomatropin from somatropin for treatment of pediatric growth hormone deficiency
  10. Development of a disease diagnostic model to predict the occurrence of central precocious puberty of female
  11. Adrenal hypoandrogenism in adolescents with premature ovarian insufficiency
  12. The clinical presentation and genetic diagnosis of Tangier disease in the pediatric age group
  13. Clinical and genetic diagnosis of first cohort of differences of sexual development in the Iranian population
  14. Short Communication
  15. Effect of a GnRH injection on kisspeptin levels in girls with suspected precocious puberty: a randomized-controlled pilot study
  16. Case Reports
  17. Coexistence of phenylketonuria and tyrosinemia type 3: challenges in the dietary management
  18. Acrodermatitis dysmetabolica: lessons from two pediatric cases
  19. Dramatic response to Evinacumab in a North Indian girl with homozygous familial hypercholesterolemia
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