Thyroid carcinomas in children –⁠ current overview in the Czech Republic

Czech version

Authors: R. Katra ¹; L. Fialová ¹; V. Kuklíková ²; B. Peková Bulanová ²; Z. Balatková ¹; Z. Čada ¹
Authors‘ workplace: Klinika ušní, nosní a krční 2. LF UK a FN Motol a Homolka, Praha ¹; Oddělení molekulární endokrinologie, Endokrinologický ústav, Praha ²
Published in: Otorinolaryngol Foniatr, 75, 2026, No. 3, pp. 206-215.
Category: Review Article
doi: https://doi.org/10.48095/ccorl2026206

Overview

Thyroid carcinomas in childhood represent a rare but clinically significant group of malignancies, the incidence of which has been increasing over recent decades, including in the Czech Republic. Although they account for a small proportion of all pediatric cancers, they constitute the most common endocrine malignancy in this age group. Pediatric thyroid carcinomas are characterized by specific biological and clinical features, particularly a higher frequency of multifocal and bilateral disease and an increased incidence of cervical lymph node metastases already present at the time of diagnosis. The most common histological subtype is papillary thyroid carcinoma, which is associated with an excellent long-term prognosis when an appropriate therapeutic strategy is applied. This review summarizes current knowledge on the epidemiology, etiology, diagnosis, and treatment of thyroid carcinomas in childhood, with a focus on specific Czech data and on surgical management from the perspective of pediatric otorhinolaryngology and head and neck surgery.

Keywords:

incidence – karcinom štítné žlázy – dětský věk – chirurgická léčba – krční lymfatické uzliny

Sources

1. Martucci C, Crocoli A, De Pasquale MD et al. Thyroid cancer in children: A multicenter international study highlighting clinical features and surgical outcomes of primary and secondary tumors. Front Pediatr 2022; 10 : 914942. Doi: 10.3389/fped.2022.914942.

2. Kubec V, Riant M, Škopek P et al. Přínos tenkojehlové aspirační biopsie a klasifikace Bethesda v diagnostice tumorů štítné žlázy –⁠ retrospektivní studie. Otorinolaryngol Foniatr 2024; 73 (1): 16–21. Doi: 10.48095/ccorl202416.

3. Katra R, Sýkorová P, Kabelka Z et al. Chirurgická léčba karcinomů štítné žlázy v dětském věku. Otorinolaryngol Foniatr 2011; 60 (4): 204–210.

4. Liu Y, Su L, Xiao H. Review of Factors Related to the Thyroid Cancer Epidemic. Int J Endocrinol 2017 : 5308635. Doi: 10.1155/2017/5308635.

5. Williams D. Radiation carcinogenesis: lessons from Chernobyl. Oncogene 2008; 27 (Suppl 2): S9–S18. Doi: 10.1038/onc.2009.349.

6. Krejčí D, Mužík J, Šnábl I et al. Portál epidemiologie novotvarů v ČR. Brno: Masarykova univerzita 2024. 2024 [online]. Dostupné z: https: //www.svod.cz.

7. Zhang B, Wu W, Shang X et al. Incidence and prognosis of thyroid cancer in children: based on the SEER database. Pediatr Surg Int 2022; 38 (3): 445–456. Doi: 10.1007/s00383-022-05069-3.

8. Bulanova Pekova B, Sykorova V, Mastnikova K et al. RET fusion genes in pediatric and adult thyroid carcinomas: cohort characteristics and prognosis. Endocr Relat Cancer 2023; 30 (12): e230117. Doi: 10.1530/erc-23-0117.

9. Skinner MA, Moley JA, Dilley WG et al. Prophylactic thyroidectomy in multiple endocrine neoplasia type 2A. N Engl J Med 2005; 353 (11): 1105–1113. Doi: 10.1056/NEJMoa043999.

10. Mastnikova K, Bulanova Pekova B, Kuklikova V et al. DICER1 Variants in Pediatric and Young Adult Thyroid Nodules. Thyroid 2024; 34 (10): 1225–1233. Doi: 10.1089/thy.2024.0188.

11. Ushenkova LN, Koterov AN, Biryukov AP. RET/PTC Gene Rearrangements in the Sporadic and Radiogenic Thyroid Tumors: Molecular Genetics, Radiobiology and Molecular Epidemiology. Radiats Biol Radioecol 2015; 55 (3): 229–249.

12. Jitpasutham T, Andrianus S, Gubbiotti M et al. Thyroid nodules with DICER1 mutation or PTEN alteration: A comparative cytologic, clinical, and molecular study of 117 FNA cases. Cancer Cytopathology 2024; 132 (6): 370–385. Doi: 10.1002/cncy.22811.

13. Babala J, Zahradnikova P, Beder I et al. Risk factors of post-surgery complications in children with thyroid cancer. Int J Pediatr Otorhinolaryngol 2019; 127 : 109673. Doi: 10.1016/j.ijporl.2019.109673.

14. Scholfield DW, Lopez J, Badillo ND et al. Complications of Thyroid Cancer Surgery in Pediatric Patients at a Tertiary Cancer Center. Ann Surg Oncol 2023; 30 (12): 7781–7788. Doi: 10.1245/s10434-023-14079-x.

15. Francis GL, Waguespack SG, Bauer AJ et al. Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2015; 25 (7): 716–759. Doi: 10.1089/thy.2014.0460.

16. Rybakov SJ, Komissarenko IV, Tronko ND et al. Thyroid cancer in children of Ukraine after the Chernobyl accident. World J Surg 2000; 24 (11): 1446–1449. Doi: 10.1007/s002680010239.

17. Sadetzki S, Chetrit A, Lubina A et al. Risk of thyroid cancer after childhood exposure to ionizing radiation for tinea capitis. J Clin Endocrinol Metab 2006; 91 (12): 4798–4804. Doi: 10.1210/jc.2006-0743.

18. Romei C, Elisei R. A Narrative Review of Genetic Alterations in Primary Thyroid Epithelial Cancer. Int J Mol Sci 2021; 22 (4). Doi: 10.3390/ijms22041726.

19. Guo K, Qian K, Shi Y et al. Clinical and Molecular Characterizations of Papillary Thyroid Cancer in Children and Young Adults: A Multicenter Retrospective Study. Thyroid 2021; 31 (11): 1693–1706. Doi: 10.1089/thy.2021.0003.

20. Fiore M, Oliveri Conti G, Caltabiano R et al. Role of Emerging Environmental Risk Factors in Thyroid Cancer: A Brief Review. Int J Environ Res Public Health 2019; 16 (7). Doi: 10.3390/ijerph16071185.

21. Derwahl M, Nicula D. Estrogen and its role in thyroid cancer. Endocr Relat Cancer 2014; 21 (5): T273–T283. Doi: 10.1530/ERC-14-0053.

22. Niedziela M. Pathogenesis, diagnosis and management of thyroid nodules in children. Endocr Relat Cancer 2006; 13 (2): 427–453. Doi: 10.1677/erc.1.00882.

23. Norlen O, Charlton A, Sarkis LM et al. Risk of malignancy for each Bethesda class in pediatric thyroid nodules. J Pediatr Surg 2015; 50 (7): 1147–1149. Doi: 10.1016/j.jpedsurg.2014.10.046.

24. Ogle S, Merz A, Parina R et al. Ultrasound and the Evaluation of Pediatric Thyroid Malignancy: Current Recommendations for Diagnosis and Follow-up. J Ultrasound Med 2018; 37 (10): 2311–2324. Doi: 10.1002/jum.14593.

25. Lim-Dunham JE, Erdem Toslak I, Alsabban K et al. Ultrasound risk stratification for malignancy using the 2015 American Thyroid Association Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer. Pediatr Radiol 2017; 47 (4): 429–436. Doi: 10.1007/s00247-017-3780-6.

26. Amin SN, Branson M, Perkins JN et al. TI-RADS and Bethesda Classification System Correlate With Predicting Pediatric Papillary Thyroid Carcinoma. Otolaryngol Head Neck Surg 2025; 173 (4): 985–990. Doi: 10.1002/ohn.1310.

27. Lai SW, Roberts DJ, Rabi DM et al. Diagnostic accuracy of fine needle aspiration biopsy for detection of malignancy in pediatric thyroid nodules: protocol for a systematic review and meta-analysis. Syst Rev 2015; 4 : 120. Doi: 10.1186/s13643-015-0109-0.

28. Heider A, Arnold S, Jing X. Bethesda System for Reporting Thyroid Cytopathology in Pediatric Thyroid Nodules: Experience of a Tertiary Care Referral Center. Arch Pathol Lab Med 2020; 144 (4): 473–477. Doi: 10.5858/arpa.2018-0596-OA.

29. Christison-Lagay ER, Baertschiger RM, Dinauer C et al. Pediatric differentiated thyroid carcinoma: An update from the APSA Cancer Committee. J Pediatr Surg 2020; 55 (11): 2273–2283. Doi: 10.1016/j.jpedsurg.2020.05.003.

30. Pekova B, Sykorova V, Dvorakova S et al. RET, NTRK, ALK, BRAF, and MET Fusions in a Large Cohort of Pediatric Papillary Thyroid Carcinomas. Thyroid 2020; 30 (12): 1771–1780. Doi: 10.1089/ thy.2019.0802.

31. Adam MA, Pura J, Gu L et al. Extent of surgery for papillary thyroid cancer is not associated with survival: an analysis of 61,775 patients. Ann Surg 2014; 260 (4): 601–605; discussion 605-607. Doi: 10.1097/SLA.0000000000000925.

32. Cho JW, Rah CS, Kim WW et al. Concurrent Association of Multifocality, Bilaterality, and Recurrence in Pediatric Papillary Thyroid Cancer Patients. Yonsei Med J 2025; 66 (1): 43–50. Doi: 10.3349/ymj.2023.0582.

33. Cherella CE, Richman DM, Liu E et al. Predictors of Bilateral Disease in Pediatric Differentiated Thyroid Cancer. J Clin Endocrinol Metab 2021; 106 (10): e4242–e4250. Doi: 10.1210/clinem/dgab210.

34. Kumar P, Damle NA, Bal C. Radioiodine Therapy in Pediatric Differentiated Thyroid Cancer: Dosimetry, Clinical Care, and Future Challenges. Clin Nucl Med 2023; 48 (2): 158–167. Doi: 10.1097/RLU.0000000000004431.

35. Cakir AD, Bucak FT, Tarcin G et al. Differentiated Thyroid Cancer in Children and Adolescents: Clinicopathological Characteristics of 32 Patients Followed up in our Pediatric Endocrinology Unit. Sisli Etfal Hastan Tip Bul 2023; 57 (2): 224–231. Doi: 10.14744/semb.2023.09216.

36. Ngo DQ, Le DT, Le Q. Prophylactic Central Neck Dissection to Improve Disease-Free Survival in Pediatric Papillary Thyroid Cancer. Front Oncol 2022; 12 : 935294. Doi: 10.3389/fonc.2022.935294.

37. Hay ID, Gonzalez-Losada T, Reinalda MS et al. Long-term outcome in 215 children and adolescents with papillary thyroid cancer treated during 1940 through 2008. World J Surg 2010; 34 (6): 1192–1202. Doi: 10.1007/s00268-009-0364-0.

38. Rivkees SA, Mazzaferri EL, Verburg FA et al. The treatment of differentiated thyroid cancer in children: emphasis on surgical approach and radioactive iodine therapy. Endocr Rev 2011; 32 (6): 798–826. Doi: 10.1210/er.2011-0011.

39. Bavor P, Pekova B, Sykorova V. Co má vědět chirurg o genetice karcinomů štítné žlázy. Rozhl Chir 2020; 99 (11): 481–486.

40. Bendlova B, Dvorakova S, Sykorova V et al. Nádory štítné žlázy –⁠ molekulárně genetické příčiny a možnosti cílené léčby. Čas Lék čes 2012; (151): 123–127.