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Cancer in thyroid nodules with fine-needle aspiration in Korean pediatric populations

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Purpose: To determine the prevalence and clinical findings of benign thyroid nodules and cancer in Korean pediatric patients with thyroid nodules. Methods: We investigated the medical records of 134 patients aged younger than 18 years who had a goiter, thyroid nodule, thyroid mass, or thyroid cancer who underwent fine needle aspiration biopsy (FNAB). Results: The study population included 113 females (84.3%) and 21 males (13.7%); the mean patient age was 16.1±2.3 years (range, 8–18 years). Of the 134 patients, 24 (18.0%) were finally diagnosed with thyroid cancer, of which 20 (83.3%) were papillary cancer and 4 (16.7%) were follicular cancer. No patient was exposed to radiation. FNAB revealed malignant cancer in 21 of the patients; 3 were initially reported as having benign tumors by FNAB, but were later diagnosed with follicular cancer. An additional 13 patients were suspected to have malignant tumors by FNAB, with a final diagnosis of nodular hyperplasia. Cystic nodules were more common in the benign group. The percentages of cervical lymphadenopathy and irregular nodular margins were higher in the malignant group compared to the benign group. Cervical lymphadenopathy and FNAB malignant findings were highly suggestive of malignant nodules. Conclusion: Thyroid cancer prevalence in a Korean pediatric population is comparable to reported estimates of worldwide thyroid cancer prevalence. In this population, cancer predominates on the right thyroid lobe. Papillary thyroid cancers are dominant in the Korean pediatric population but are less prevalent than in Korean adults. As expected, FNAB was highly accurate in predicting malignant nodules.

Abstract

Purpose: To determine the prevalence and clinical findings of benign thyroid nodules and cancer in Korean pediatric patients with thyroid nodules. Methods: We investigated the medical records of 134 patients aged younger than 18 years who had a goiter, thyroid nodule, thyroid mass, or thyroid cancer who underwent fine needle aspiration biopsy (FNAB). Results: The study population included 113 females (84.3%) and 21 males (13.7%); the mean patient age was 16.1±2.3 years (range, 8–18 years). Of the 134 patients, 24 (18.0%) were finally diagnosed with thyroid cancer, of which 20 (83.3%) were papillary cancer and 4 (16.7%) were follicular cancer. No patient was exposed to radiation. FNAB revealed malignant cancer in 21 of the patients; 3 were initially reported as having benign tumors by FNAB, but were later diagnosed with follicular cancer. An additional 13 patients were suspected to have malignant tumors by FNAB, with a final diagnosis of nodular hyperplasia. Cystic nodules were more common in the benign group. The percentages of cervical lymphadenopathy and irregular nodular margins were higher in the malignant group compared to the benign group. Cervical lymphadenopathy and FNAB malignant findings were highly suggestive of malignant nodules. Conclusion: Thyroid cancer prevalence in a Korean pediatric population is comparable to reported estimates of worldwide thyroid cancer prevalence. In this population, cancer predominates on the right thyroid lobe. Papillary thyroid cancers are dominant in the Korean pediatric population but are less prevalent than in Korean adults. As expected, FNAB was highly accurate in predicting malignant nodules.

참고문헌 (30)

  1. Ahn HS, "Thyroid cancer screening in South Korea increases detection of papillary cancers with no impact on other subtypes or thyroid cancer mortality", Thyroi, 26, pp.1535~1540 (2016)[DOI]
  2. 정규원, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2008", Cancer Research and Treatment, 43(1), pp.1~11 (2011), 대한암학회
  3. Pandeya N, "Increasing thyroid cancer incidence in Queensland, Australia 1982-2008 - true increase or overdiagnosis?", Clin Endocrinol (Oxf) (2015)
  4. Davies L, "Increasing incidence of thyroid cancer in the United States, 1973-2002", JAMA, 295, pp.2164~2167 (2006)[DOI]
  5. American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules, "Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer", Thyroid, 19, pp.1167~1214 (2009)[DOI]
  6. "The NCCN Clinical Practice Guidelines in Oncology, Thyroid Carcinoma (Version 2, 2013)" (2017)
  7. Guidelines for the management of thyroid cancer (Perros P, ed) 2nd ed. Report of the Thyroid Cancer Guidelines Update Group, "British Thyroid Association", Royal College of Physicians, ~ (2007)
  8. Mussa A, "Predictors of malignancy in children with thyroid nodules", J Pediatr, 167, pp.886~892 (2015)[DOI]
  9. Guille JT, "Evaluation and management of the pediatric thyroid nodule", Oncologist, 20, pp.19~27 (2015)[DOI]
  10. Vergamini LB, "Increase in the incidence of differentiated thyroid carcinoma in children, adolescents, and young adults: a population-based study", J Pediatr, 164, pp.1481~1485 (2014)[DOI]
  11. Lee SJ, "Diagnostic performance of thyroid ultrasonography screening in pediatric patients with a hypothyroid, hyperthyroid or euthyroid goiter", Pediatr Radiol, 46, pp.104~111 (2016)[DOI]
  12. Lee YA, "Pediatric patients with multifocal papillary thyroid cancer have higher recurrence rates than adult patients: a retrospective analysis of a large pediatric thyroid cancer cohort over 33 years", J Clin Endocrinol Metab, 100, pp.1619~1629 (2015)[DOI]
  13. Cho YY, "Trends in thyroid cancer incidence in Korean children (1999-2012) based on palpation and nonpalpation detection methods", Eur Thyroid J, 4, pp.252~259 (2015)[DOI]
  14. Norlen O, "Risk of malignancy for each Bethesda class in pediatric thyroid nodules", J Pediatr Surg, 50, pp.1147~1149 (2015)[DOI]
  15. Siegel DA, "Cancer incidence rates and trends among children and adolescents in the United States, 2001-2009", Pediatrics, 134, pp.e945~e955 (2014)[DOI]
  16. Sklar C, "Abnormalities of the thyroid in survivors of Hodgkin's disease: data from the Childhood Cancer Survivor Study", J Clin Endocrinol Metab, 85, pp.3227~3232 (2000)
  17. Tucker MA, "Therapeutic radiation at a young age is linked to secondary thyroid cancer. The Late Effects Study Group", Cancer Res, 51, pp.2885~2888 (1991)
  18. Sinnott B, "Exposing the thyroid to radiation: a review of its current extent, risks, and implications", Endocr Rev, 31, pp.756~773 (2010)[DOI]
  19. Williams ED, "Thyroid cancer in an iodide rich area: a histopathological study", Cancer, 39, pp.215~222 (1977)[DOI]
  20. Czene K, "Environmental and heritable causes of cancer among 9.6 million individuals in the Swedish Family-Cancer Database", Int J Cancer, 99, pp.260~266 (2002)[DOI]
  21. Park YJ, "The long-term outcomes of the second generation of familial nonmedullary thyroid carcinoma are more aggressive than sporadic cases", Thyroid, 22, pp.356~362 (2012)[DOI]
  22. Demidchik YE, "Comprehensive clinical assessment of 740 cases of surgically treated thyroid cancer in children of Belarus", Ann Surg, 243, pp.525~532 (2006)[DOI]
  23. Monaco SE, "Cytomorphological and molecular genetic findings in pediatric thyroid fine-needle aspiration", Cancer Cytopathol, 120, pp.342~350 (2012)[DOI]
  24. Demidchik YE, "Childhood thyroid cancer in Belarus, Russia, and Ukraine after Chernobyl and at present", Arq Bras Endocrinol Metabol, 51, pp.748~762 (2007)[DOI]
  25. Gharib H, "American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: executive summary of recommendations", Endocr Pract, 16, pp.468~475 (2010)[DOI]
  26. Haugen BR, "2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer", Thyroid, 26, pp.1~133 (2016)[DOI]
  27. Lyshchik A, "Diagnosis of thyroid cancer in children: value of gray-scale and power doppler US", Radiology, 235, pp.604~613 (2005)[DOI]
  28. Francis GL, "Management guidelines for children with thyroid nodules and differentiated thyroid cancer", Thyroid., 25, pp.716~759 (2015)[DOI]
  29. Leboulleux S, "Ultrasound criteria of malignancy for cervical lymph nodes in patients followed up for differentiated thyroid cancer", J Clin Endocrinol Metab, 92, pp.3590~3594 (2007)[DOI]
  30. McLeod DS, "Thyrotropin and thyroid cancer diagnosis: a systematic review and dose-response metaanalysis", J Clin Endocrinol Metab, 97, pp.2682~2692 (2012)[DOI]

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