MON-092 Clinical Characteristics and Management of Thyroid Cancer in Pediatrics: Results from the Mexican Population Registry Between 2010-2019
Authors: Galán Isabel B , Barreto Thelma G , Reyes Lucia , Calzada Raùl , Arguinzoniz Lissette , Ruiz Maria de la Luz , Altamirano Nelly , Diaz Luisa G , Bonilla Paola Sophia , Robles Carlos 
Published: May 2020

METHODS

Study: Analytical and retrospective

Patients files diagnosed with Thyroid Cancer treated during January 2010 to May 2019, who underwent surgical intervention and histopathological study were reviewed. Chi Square test were used as statistical analysis. A level of significance p &lt;0.001 was established.

INTRODUCTION: Cancer thyroid in pediatrics is characterized by advanced presentation, coupled with frequent lymph nodal metastases and often pulmonary metastases. There are few reports on the rate of cancer and hypoparathyroidism in children.

OBJECTIVE: Describe of pediatric thyroid cancer with particular emphasis on the clinical characteristics, risk factors associated and with treatment outcomes

RESULTS

43 patients were included in the study 69.8% were female. Average age of 12 years (range 5 to 17 years). Association of cancer and thyroiditis 25% and Cancer with Graves Disease 2.3%.

Histopathological diagnoses of thyroid cancer: 86% papillary, 2.3% follicular, 11.6% medullary, 69.8% patients presented with metastases, most often lymph node (46.5%), pulmonary (2.3%) and pulmonary plus lymph node (23.3%), 11.6% patients do not present metastasis and 16.3% without data.

Surgical interventions: only thyroidectomy 16.3%, Hemitiroidectomy 4.7%, total thyroidectomy with lymph node emptying 74% and modified radical neck dissection 5%.In 16% of the patients, second surgery was required after the histopathological report. Post-surgical hypoparathyroidism was recorded in 27 patients (62%): transitory in 11 (25%) and 16 (37%) permanent.

Biochemical variables: (N /%/ Hypoparathyroidism /NO hypoparathyroidism) of 18 patients with post-surgical PTH &lt;10 pg/ml (18/42%/17/1) 17 of them presented post-surgical hypoparathyroidism (P &lt;0.001), PTH &gt;10 pg/ml (13/30%/9/4), and without post-surgical measurement of PTH (12/28% / 6/6). Post-surgical ionized calcium &lt;4mg/dl in 29 patients of which 22 had hypoparathyroidism (P &lt;0.001) (29 / 67.4% / 22/7), with calcium &gt;4 mg/dL (14 / 32.6% / 9/5). 21 patients with seric calcium &lt;8mg/dl 20 with hypoparathyroidism. (21/48%/ 20/1) (P &lt;0.001). Seric calcium &gt;8 (16/37%/9/7) without measurement data. Serial calcium in 6 patients (6/15% / 3/3). Postoperative positive thyroglobulin parameter was presented as an risk factor for complication and metastases OR 1.42 (1-1.6)

Regarding iodine treatment, 29 patients received an average dose of 200 (range 100- 720 milicuries mCi).

CONCLUSIONS

Papillary cancer is the most common type in pediatric patients, evidence of metastases find in 69.8% most frequent lymph node, postoperative thyroglobulin OR 1.42. They should always be considered in the management of these patients. As a post-surgical complication, there is an increased risk to present hypoparathyroidism when PTH less &lt; 10 pg / ml, post-surgical ionized calcium &lt; 4 mg/dl and serum calcium &lt;8 mg/dl.