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VII съезд онкологов и радиологов стран СНГ
№987 Pathological characteristics of sporadic pediatric thyroid cancer in Belarus
Fridman M.1, Mankovskaya S.2,
Demidchik Y.I IRepublic Centre
for Thyroid Tumors, Minsk, Belarus;
2Institute of Physiology NASB,
This was a retrospective analysis of clinical and histological information of children and adolescents of Belarus with sporadic papillary thyroid carcinoma (PTC).
The entire series included 94 patients (76 girls and 18 boys; sex ratio 4.2:1; the mean age was 15.2±2.6 years) who were born one year after the Chernobyl accident and therefore were not exposed to radioactive fallouts. All the patients underwent surgery in Republic Centre for Thyroid Tumors.
In accordance with criteria of AJCC/UICC TNM, 7th edition, most patients were diagnosed as having pT3NlbM0-stage. Tumor size varied from 1 to 100 mm (mean 15.0±14.2 mm). Tumors were less than 10 mm in 43.6% of patients (less than 5 mm in 12.7%). Mean tumor size was 10.9±5.1 mm for intrathyroidal and 21.4±20.6 mm for extrathyroidal papillary carcinoma. In 43 of 94 cases (45.7%) was registered classical variant of PTC, in 20 cases (21.3%) - follicular, in 10 (10.7%) - tall cell. Lymph nodes involvement was detected in the majority of incidences (Nla - 19/94 (20.2%), Nib - 48/94 (51.1%)) and nine patients got bilateral involvement (9.6%). Papillary structures (p=0.001), nodular type of lymphoid infiltration (p=0.012), lymph vessels invasion (pO.0001) and intrathyroidal tumor emboli and psammoma bodies within lymph vessels (pO.0001) were associated with lymph nodes metastases.
Small tumor size itself does not preclude neither lymph nodes and/or inner organs metastases nor extrathyroidal extension but minimal extrathyroidal invasion in children and adolescents with papillary thyroid microcarcinoma could be provocative for a more extensive initial surgical approach because of high risk of recurrence. Thus, we suggest a more extensive surgical approach in the initial treatment of PTC in children and adolescents never minding a size of the tumor - total thyroidectomy with routine selective bilateral lymph node dissection (levels VI and II-IV).
№988 The risks of childhood malignancies in children born after assisted reproductive technology
Sadiyeva N.A., Huseynova S.A.
Department of Pediatrics of Azerbaijan
Medical University, Baku, Azerbaijan