Four cases of thyroid carcinoma presenting in childhood: 15 years experience in a National Tertiary Referral Centre

Thyroid cancer has an annual incidence of 0.2–5 per million children representing 3% of all childhood tumours. We describe the presentation, histopathology and treatment of four patients in a regional paediatric surgical and endocrine unit over the past 15 years.

Three of four cases are female with 1 male. Age of diagnosis ranged from 6 to 15 years. All had an elevated thyroglobulin at presentation with normal thyroid function tests. Three underwent FNA and progressed to total thyroidectomy. Two presented with a simple thyroid lump. One had an incidental finding of a neck mass during work-up for renal transplant. The remaining case presented with a neck swelling treated as an inflammatory mass. She later presented with stridor and hoarseness, necessitating urgent operative intervention. One patient had metastases (pulmonary) at presentation. Histology showed one follicular carcinoma and three papillary carcinoma tumours (one follicular variant). All had post-operative radio-iodine (range 1–10 doses) and are disease free at present. We describe follow-up over a range of 18 months to 14 years.

Thyroid carcinoma is a rare diagnosis in children, with limited studies to guide optimum management. We recommend a high index of suspicion when a child presents with a neck lump. Regular follow-up is important especially through teenage years as compliance with thyroxine treatment can be varied. We report remission in all 4 of our cases, highlighting the potential good clinical outcome in this age group.