ES14P THYROID CANCERS IN CHILDHOOD – A PROSPECTIVE REVIEW OF THE MALAYSIAN POPULATION

Objective  The aim of this study was to review the incidence and pattern of childhood thyroid cancers at our center. We also evaluate the possible risk factors and the outcome of treatment. Methodology  Prospective review of all childhood thyroid cancers operated at Putrajaya Hospital from Jan 2002 to Dec 2006. All data was prospectively reviewed and analyzed. Results  A total number of 20 patients (58.8% of the total number of paediatric goiters) were accrued in this study. The Male : Female ratio was 1 : 4. The mean age was 16.1 (ranged 6–21 years). All patients were euthyroid on presentation. 13 presented with a solitary nodule, 6 with a multinodular disease, 1 thyroglossal cyst and 6 with associated palpable lymph nodes. All were differentiated thyroid cancers; 18 were papillary thyroid cancer (14.1% of total adult population, 18/127) and 2 were follicular (10.5%, 2/17).Total thyroidectomy was done in 12 patients, completion surgery in 8. 9 patients required additional modified radical neck dissection. There was no history of previous irradiation to neck. All patients received radioiodine ablation (RAI) postoperatively. Average weight of gland was 3.2 g and the average size was 3.5 cm. 2(10%) patients developed nodal recurrence. There was no morbidity or mortality in this series. 1 patient had recurrent laryngeal nerve paresis preoperatively. All 20 patients are still alive on a mean follow up of 22 months. Conclusions  Our study showed that the incidence of malignancy in childhood goiters is significantly high and best option of treatment is total thyroidectomy with or without neck dissection.