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Thyroid carcinoma in children and adolescents.

OBJECTIVES
To categorize the clinical presentation of thyroid carcinoma in the pediatric and adolescent population and to present a philosophy of surgical management based on oncologic principles.


RESULTS
Over half these children with thyroid carcinoma (55%) presented with an asymptomatic thyroid mass. Twelve of 26 patients presented with lymphatic metastasis. There were no recurrences in any patient when the neck disease was treated with cervical lymphadenectomy or when the patient received postoperative radioablative therapy.


CONCLUSIONS
The prognosis is excellent even with more extensive disease in children. Total thyroidectomy along with selective neck dissection for regional metastatic disease is recommended for thyroid carcinoma. This is followed by nuclear scintigraphy with subsequent radioablation for residual or recurrent disease and thyroid suppression and/or replacement.