PEDIATRICS Vol. 98 No. 3 September 1996, pp. 464-466
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Papillary Thyroid Cancer: A Pediatric Perspective

Timothy K. Flannery MD1, John L. Kirkland MD1, Kenneth C. Copeland MD1, Alison A. Bertuch MD, PhD2, Lefkothea P. Karaviti MD, PhD3, and Mary L. Brandt MD4

1 Endocrinology and Metabolism, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030
2 Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030
3 Endocrinology and Metabolism, Department of Pediatrics, Department of Cell Biology, Baylor College of Medicine, Houston, TX 77030
4 Department of Surgery and Pediatrics, Baylor College of Medicine, Houston, TX 77030

A less-invasive approach to the evaluation of papillary carcinoma in children and adolescents recently has been proposed, based on reports of the accuracy and reliability of fine-needle aspiration biopsy (FNAB) in this population.1-4 Such confidence may be ill-founded, as the following clinical histories will illustrate. Functioning nodules, Hashimoto's thyroiditis (HT), and goiter-associated lymphadenopathy are unusual but significant presentations of papillary carcinoma in children and young adults, likely to be missed by the standard diagnostic approach in adults, which is reliant on FNAB, 123I scintiscans, or clinical response to suppressive doses of L-thyroxine (T4).

CASE REPORTS

Case 1

A thyroid nodule developed in a 12-year-old girl, first observed 1 month before evaluation in an endocrine clinic.

Submitted on August 15, 1995
Accepted on October 30, 1995