New insights into the management of differentiated thyroid carcinoma in children and adolescents (Review)

Zanella,André B.; Scheffel,Rafael Selbach; Weinert,Letícia; Dora,José Miguel; Maia,Ana Luiza

doi:10.3892/ijo.2021.5193

New insights into the management of differentiated thyroid carcinoma in children and adolescents (Review)

Authors:
- André B. Zanella
- Rafael Selbach Scheffel
- Letícia Weinert
- José Miguel Dora
- Ana Luiza Maia
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Affiliations: Thyroid Unit, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul 90035-003, Brazil, Endocrine Division, Hospital Escola, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul 96160-000, Brazil
Published online on: March 1, 2021 https://doi.org/10.3892/ijo.2021.5193
Article Number: 13

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Abstract

Differentiated thyroid carcinoma (DTC) is the most common malignant neoplasm of the endocrine system. In children and adolescents, DTC usually presents as a more aggressive disease than in the adult population, but patients often have a favourable prognosis, even in cases of advanced disease. Nevertheless, certain patients have persistent or recurrent disease leading to increased morbidity. A significant challenge in the management of DTC is identifying the subgroup of patients with a high risk of unfavourable outcomes. Prognostic factors related to the patient, tumour, and stratification systems (Tumor‑Node‑Metastasis/American Joint Committee on Cancer, American Thyroid Association risk classification and dynamic risk stratification) are used in an attempt to identify the individuals at increased risk. In the present review, the current risk classification systems applied for paediatric thyroid cancer are discussed, highlighting the major differences between paediatric and adult DTC in pathophysiology, clinical presentation and long‑term outcomes. In recent years, genetic markers have also been proposed as prognostic factors for children and adolescents with DTC. Advances in the understanding of the molecular profile of paediatric DTC may aid individualized management, potentially improving diagnosis and treatment. This review article aims to critically review and update the current concepts on DTC management in children and adolescents, with an emphasis on clinical presentation, treatment, risk assessment, follow‑up and future perspectives.

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