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Thyroid cancer in Sardinian pediatric patients: report of 63 cases and a review of the literature

ABSTRACT
Thyroid cancer is considered uncommon in pediatrics, yet it is the most common endocrine malignancy among them. The aim of this study was to analyze pediatric thyroid carcinomas diagnosed in Sardinian children and adolescents in order to find a possible association with autoimmune diseases.
We studied 63 consecutive 10-20-years-old patients who underwent surgery for thyroid cancer between January 2001 and April 2020 in our hospital.
No evidence of risk factors including external radiation was found. All cases were follicular-derived neoplasms: 45 PTCs (72%), 9 FTCs (14%), 2 well differentiated carcinomas not otherwise specified (3%), 2 poorly differentiated carcinomas (3%), 5 cases of encapsulated PTC-FV were re-diagnosed as NIFTP (8%), according to the last WHO classification. Autoimmune thyroid diseases were detected in the 29 PTCs (64% of PTCs). BRAF V600E mutation was found in 21 PTCs (47% of PTCs). Our study shows that thyroid cancer in Sardinian children and adolescents is characterized by peculiar features: our cohort is composed only by Follicular-derived differentiated thyroid cancer without medullary carcinomas; PTC seems to be more frequent and strongly associated with autoimmune thyroid diseases in our population. Those evidences, together with the absence of any exposure to radiation in our patients, support the possibility that autoimmune diseases became an important event to be considered also in the evolution of pediatric thyroid carcinogenesis.

IMPACT STATEMENT

A twenty-year study with a large number of cases of thyroid cancer in pediatric patients in the particular genetic scenario of Sardinia.

Table of Content: Vol. 1 (No. 3) 2021 September

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