Akademik Veri Yönetim Sistemi
HONG KONG JOURNAL OF PAEDIATRICS, cilt.22, sa.3, ss.137-143, 2017 (SCI-Expanded)
Objective: To define clinical presentation, surgical complications, characteristics and survival of thyroid carcinoma (TC) and benign masses in children. Methods: Twenty-five paediatric patients underwent thyroid surgery for thyroid masses and TC in 13 years. Retrospectively evaluated medical data included sex, clinicopathologic characteristics, surgery type, postoperative complications, recurrences, and survival rate. Correlations between age, sex, complaint and diagnosis were done using Pearson's t test. Results: The female to male ratio was 3.1:1. The mean age at diagnosis was 16.2 years (range, 5-18 years)(median age=17). A neck mass was the most common complaint (80%). The other patient presented aslymphadenopathy of the supraclavicular region (n=1), neck pain (n=3) and thyroid mass with previous history of exposure to ionising radiation and was receiving chemotherapy for Hodgkin's lymphoma. Seventeen patients were diagnosed with papillary TC, one with follicular TC, four with follicular adenoma, two with thyroiditis, and one with thyroid Burkitt's lymphoma. Surgical treatment consisted of simpletotal thyroidectomy (n=13), total thyroidectomy with modified radical neck node dissection (n=6), and less than total thyroidectomy (n=6). After the total thyroidectomy, surgical resection for recurrence was performed four of the patients with TC. Postoperative radioactive iodine ablation was administered to 15 of the 18 patients with TC (83.3%) after surgical therapy. Mean follow-up duration was 4.2 years (range, 0.5-10 years) and no patients died of TC. Recurrence occurred in five patients (27.7%). Seven patients (38.8%) experienced postoperative hypocalcaemia. One patient who had undergone bilateral neck dissection was found to have a left thoracic duct injury, which was surgically treated. There is no gender differences in complaint and diagnosis (p>0.05). Conclusion: Thyroid carcinoma develops more aggressively and with more recurrences in children. Thus, secondary operations are often required for recurrence and neck dissection. Given the lack of an adequate case load in paediatric clinics, it is vital that surgery be performed by experienced physicians to lessen complications.