Pediatric Thyroid Cancer

Childhood thyroid cancer is a rare disease. Providers caring for children with thyroid disease must be knowledgeable about the unique pathology and behavior of pediatric thyroid cancers, including diffuse sclerosing variant papillary thyroid cancer (DSVPTC), as well as the American Thyroid Association (ATA) Guidelines for the treatment of pediatric differentiated thyroid cancer (DTC) and medullary thyroid cancer (MTC). Treatment of most childhood papillary thyroid cancers (PTCs) should entail total or near-total thyroidectomy and appropriate nodal resection (not “berry picking”). Every effort should be made to preserve parathyroid and recurrent laryngeal nerve (RLN) function. Surgery should be performed by high-volume, experienced endocrine, pediatric, and head and neck surgeons familiar with the ATA pediatric thyroid DTC guidelines to minimize surgical and adjuvant treatment morbidity. Radioactive iodine (RAI) benefits children in intermediate and high-risk categories and those with more aggressive tumor variants. More work is needed to better understand pediatric tumor genetics and outcomes to further individualize treatment plans and optimize long-term outcomes.