The Etiology, Diagnosis and Treatment of Differentiated Thyroid Carcinoma in Children and Adolescents

Differentiated thyroid carcinoma (DTC) of epithelium origin in children and adolescents is an uncommon malignancy with an excellent prognosis. However, pediatric DTC always presents at advanced stages and with higher rates of recurrence. This review aims at the current findings of etiology, diagnosis and therapeutic approach for pediatric DTC. Radiation exposure is the only established risk of pediatric DTC, which was first discovered more than half a century ago. Research uncovers family history of thyroid carcinoma and nonthyroid malignant tumors may also be a risk factor in children DTC. Conventional diagnostic methods including palpation, ultrasonography and fine needle aspiration cytology (FNAC), may provide definitive diagnoses for many patients. For patients cannot be confirmed, molecular markers such as BRAF V600E and RAS mutations as well as RET-PTC rearrangements maybe improved diagnosis of thyroid nodules. Although recurrence is common, the outcome is favorable when appropriately treated. To minimize the risk of recurrence, total thyroidectomy, central compartment dissection, with or without lateral compartment dissection should be the surgical procedure for most pediatric DTC. Furthermore, suppression of serum thyroid stimulating hormone, radioactive iodine therapy for remnant ablation and a long-term follow-up should be done for most pediatric DTC.