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Pediatric follicular thyroid cancer (FTC)
What is pediatric follicular thyroid cancer (FTC)?
El carcinoma folicular tiroideo es el segundo tipo de cáncer más frecuente de la glándula tiroidea. Representing about 5-10% of all pediatric thyroid cancer diagnoses, it is much less common than papillary thyroid carcinoma. Typically there is a nodule that does not invade any of the blood vessels. Partial removal of the thyroid can lean to remission.
Factores de riesgo
While some risk factors have been identified, the majority of patients will not have any risk factors. While there is ongoing research into possible genetic causes of papillary thyroid carcinoma, the primary known risk factors for the disease include:
- Antecedentes de exposición a la radiación en la cabeza y el cuello
- Antecedentes de enfermedad tiroidea del paciente
- Tratamiento para el cáncer infantil previo (particularmente linfoma de Hodgkin)
- Antecedentes familiares de cáncer tiroideo
Se produce con más frecuencia en las mujeres y, entre la población pediátrica, las adolescentes corren un riesgo mayor.
What are the signs and symptoms of pediatric follicular thyroid cancer (FTC)?
Muchos niños no tienen ningún síntoma cuando reciben el diagnóstico o a medida que la enfermedad avanza. Por lo general, el carcinoma folicular tiroideo se detecta como un bulto o una inflamación en el cuello.
Los padres pueden notar lo siguiente:
- Un cambio en la voz del niño.
- El niño puede quejarse de dolor de cuello o garganta, dificultad para respirar o un “bulto” en la garganta al tragar.
A veces, se identifica solo de manera incidental después de que se indica un estudio radiológico del cuello por otro motivo y se observa una lesión en la glándula tiroidea.
How is pediatric follicular thyroid cancer (FTC) diagnosed?
La evaluación central del carcinoma folicular tiroideo incluye una visita inicial integral con un miembro del equipo de Enfermedades Tiroideas, así como una extracción de sangre para evaluar la función de la glándula tiroidea, una ecografía de la glándula y el cuello, y una biopsia por AAF (aspiración con aguja fina) del bulto tiroideo.
Imágenes ecográficas
A non-invasive test that uses sound waves to develop pictures of the thyroid gland.
Aspiración con aguja fina
Involves a very small needle that is used to remove a sample of thyroid tissue that will then be analyzed by an expert pathologist who will assess for the presence of any cancer.
En función de los resultados de estos y de posibles estudios adicionales, se recomendará un plan de tratamiento.
What are the causes of pediatric follicular thyroid cancer (FTC)?
Al igual que con todos los tipos de cáncer, la causa del carcinoma folicular tiroideo es la reproducción de células anómalas que forman lo que se conoce como “tumor”. Se desconoce el desencadenante exacto de este crecimiento.
How is pediatric follicular thyroid cancer (FTC) treated?
El alcance del tratamiento quirúrgico y médico dependerá del alcance de la enfermedad.
Cirugía
Initial treatment consists of surgical excision of all or part of the thyroid gland. Follicular thyroid carcinoma has a tendency to spread through blood vessels and therefore is less likely to spread into lymph nodes in the neck than papillary thyroid carcinoma and more likely to spread into other sites such as the lungs, liver, and bones. Surgical or other additional treatment may be required to treat any disease that has spread beyond the thyroid gland.
Tratamiento con yodo radiactivo
Once surgical management is complete, radioactive iodine treatment will be administered. Radioactive iodine treatment involves taking a pill that targets and kills any remaining thyroid tissue left after surgery.
In rare cases chemotherapy or external radiation may be required to treat extensive or residual disease.
Pediatric follicular thyroid cancer (FTC) doctors and providers
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Perrin White, MD Endocrinología pediátrica -
Soumya Adhikari, MD Endocrinología pediátrica -
Abha Choudhary, MD Endocrinología pediátrica -
Melissa Ham, MD Endocrinología pediátrica -
Muniza Mogri, MD Endocrinología pediátrica -
Sudha Mootha, MD Endocrinología pediátrica -
Nivedita Patni, MD Endocrinología pediátrica -
Amanda Shaw, MD Endocrinología pediátrica -
Ming Yang, MD Endocrinología pediátrica -
Huay-Lin Lo, MD Endocrinología pediátrica
Preguntas frecuentes
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¿Cuál es el pronóstico de un paciente que recibe un diagnóstico de carcinoma folicular tiroideo?
Follicular thyroid carcinoma tends to grow slowly and generally responds well to treatment. The overall prognosis for pediatric patients with follicular thyroid carcinoma is very good. An individual’s prognosis depends on a number of factors, including whether the cancer appears to have spread into blood vessels or outside of the thyroid gland.
While the disease itself is very treatable, persistent and recurrent disease is more common in the pediatric population and may present even decades after initial treatment and a long period during which there was no evidence of disease. For this reason, multiple procedures and multiple radioactive iodine treatments may be required and long-term follow-up is critical.
While recurrent disease is actually more common in children than in adults, the outcomes in pediatric patients with recurrence are actually better. With appropriate treatment most patients with follicular thyroid carcinoma can expect to lead a long and fulfilling life.
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¿Qué puede esperar un paciente después del tratamiento para el carcinoma folicular tiroideo?
Patients will need close follow-up to monitor for disease recurrence after surgery.
Thyroid hormone replacement therapy is generally taken by mouth for the rest of the patient’s life to replace the hormone that the body needs but can no longer produce once the gland has been removed.
