Thyroid Tumors in Children

The following are the different types of thyroid tumors seen in children:

• Adenomas: These are large benign growth that secretes hormones and rarely become malignant (cancerous) that spread to the lungs and lymph nodes of the neck.
• Carcinomas: There are three different types of thyroid carcinomas in children.
  1. Papillary thyroid carcinoma: The most common type of thyroid cancer in children and progresses slowly. This type of thyroid cancer is mostly seen in teenagers. Papillary thyroid cancers are made of one or more nodules on both sides of the thyroid gland. Cancerous cells spread to the lymph nodes in the neck and the lungs. The prognosis is quite good when treated properly.
  2. Follicular thyroid carcinoma: Is made of one nodule and spreads to distant organs (such as bone and lungs) but rarely, spreads to lymph nodes of the neck.
  3. Medullary thyroid carcinoma: Usually forms from the parafollicular cells of the thyroid gland and is linked to genetic mutation of the RET and MEN 2 genes.

The exact cause of thyroid cancer is unknown. However, a few factors, such as genetics and radiation, increase the risk of thyroid tumors in children.

• Administration of radiation therapy for any previous childhood cancers.
• Thyroid tumors in children could be inherited from the parents. A few genetic syndromes that increase the risk of thyroid tumors in children are:
  • PTEN hamartoma tumor syndrome
  • DICER1 syndrome
  • Familial adenomatous polyposis
  • MEN 2
  • Familial medullary thyroid carcinoma

The symptoms may vary among children. The common symptoms of thyroid tumors in children are:

• Swollen lymph nodes
• Lump in the neck
• Difficulty swallowing
• Difficulty breathing
• Voice hoarseness

The following are the different methods to diagnose thyroid cancers:

• Physical examination and general health examination
• Ultrasound: Sound waves produce images of structures inside the body. The doctor uses this method to get clear images of the internal tissues.
• CT: Takes pictures of internal organs from different angles using X-rays.
• MRI: Magnetic and radio waves help take images of cancer.
• Thyroid function test: The blood is checked to determine abnormal levels of the thyroid-stimulating hormone secreted by the brain's pituitary gland. This thyroid-stimulating hormone controls the growth of follicular thyroid cells.
• RET gene test: Done in children who have medullary thyroid carcinoma. A sample of blood or tissue is taken to check for changes in the RET gene.

The following are the different treatment options for thyroid tumors in children:

• Surgery: Removes tumors and if the tumors spread to the nearby lymph nodes, the lymph nodes are surgically resected.
• Chemotherapy: Powerful medications are used to kill cancer cells. Chemotherapy is administered orally or intravenously.
• Radiotherapy: High-power X-rays or other radiations are used to kill cancer cells.
• Targeted therapy: A drug therapy that targets only cancer cells and will not affect the other healthy cells in the body.