소아와 청소년기에 발생한 갑상선 유두암의 임상적 특징
Clinical Characteristics of Papillary Thyroid Carcinoma in Children and Adolescent
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Purpose : Thyroid carcinomas are rare in childhood and adolescence, and the papillary thyroid carcinoma is the most frequent hisotological type. This study was undertaken to investigate clinical characteristics of the papillary thyroid carcinoma developing in childhood and adolescence. Methods : From 1980 to 2006, 53 children and adolescents were treated for the papillary thyroid carcinoma in our department. Clinical characteristics were reviewed retrospectively. The clinical course of 9 patients was not evaluable because of inadequate follow-up and the remaining 44 patients were included in the final survival analysis. Results : The median age at diagnosis was 14.9±3.9 years. There were 9 males and 44 females. There was a significant female preponderance (1:7.8) (P=0.035) in pubertal age group, while there was no sexual difference in prepubertal age group (1:1.25). 33 patients (62.3%) had local invasion to the perithyroidal tissue, 38 patients (71.7%) had regional lymph node metastasis, and 12 patients (22.6%) had pulmonary metastasis. Unilateral lobectomy, subtotal or total thyroidectomy was performed in all patients. 19 patients (35.8%) with local or distant metastasis were additionally treated with radioiodine (131I) ablation therapy. After initial treatment, 41 patients were alive and free of thyroid carcinoma, 3 patients were alive with persistent thyroid carcinoma. At median follow-up of 9.9±5.8 years, 10 patients (24.4%) among 41 patients were recurred but all 44 patients were alive, 5 with disease and 39 disease-free. Conclusion : Childhood Papillary thyroid carcinoma was more frequent in pubertal female. And it was associated with more locally aggressive, more frequent metastasis and had higher recurrence rates.
Abstract
Purpose : Thyroid carcinomas are rare in childhood and adolescence, and the papillary thyroid carcinoma is the most frequent hisotological type. This study was undertaken to investigate clinical characteristics of the papillary thyroid carcinoma developing in childhood and adolescence. Methods : From 1980 to 2006, 53 children and adolescents were treated for the papillary thyroid carcinoma in our department. Clinical characteristics were reviewed retrospectively. The clinical course of 9 patients was not evaluable because of inadequate follow-up and the remaining 44 patients were included in the final survival analysis. Results : The median age at diagnosis was 14.9±3.9 years. There were 9 males and 44 females. There was a significant female preponderance (1:7.8) (P=0.035) in pubertal age group, while there was no sexual difference in prepubertal age group (1:1.25). 33 patients (62.3%) had local invasion to the perithyroidal tissue, 38 patients (71.7%) had regional lymph node metastasis, and 12 patients (22.6%) had pulmonary metastasis. Unilateral lobectomy, subtotal or total thyroidectomy was performed in all patients. 19 patients (35.8%) with local or distant metastasis were additionally treated with radioiodine (131I) ablation therapy. After initial treatment, 41 patients were alive and free of thyroid carcinoma, 3 patients were alive with persistent thyroid carcinoma. At median follow-up of 9.9±5.8 years, 10 patients (24.4%) among 41 patients were recurred but all 44 patients were alive, 5 with disease and 39 disease-free. Conclusion : Childhood Papillary thyroid carcinoma was more frequent in pubertal female. And it was associated with more locally aggressive, more frequent metastasis and had higher recurrence rates.
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