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Thyroid nodules are lumps of abnormal cells that develop in the thyroid gland. Most thyroid nodules are benign, or not cancerous. Among pediatric patients, approximately 25% of thyroid nodules are malignant, or cancerous. Cancer of the thyroid is called thyroid carcinoma.
The thyroid gland is a butterfly-shaped organ located at the base of the throat in the front of the neck. It is arranged in two lobes, one on the right side and one on the left side. The lobes are connected by a thin piece of tissue called an isthmus. Usually, a healthy thyroid is difficult to feel through the skin. The thyroid gland is part of the body’s endocrine system. The job of the thyroid gland is to produce hormones including thyroxine (T4) and triiodothyronine (T3). Iodine from the diet is used to make thyroid hormones. Thyroid hormones help regulate body functions such as temperature, appetite, growth and energy level. The release of thyroid hormones is controlled by thyroid-stimulating hormone (TSH). Thyroglobulin is a protein produced by healthy thyroid tissue as well as thyroid cancer cells, and can be used in monitoring for thyroid cancer after treatment.
Thyroid cancer in children and teens is very rare. Approximately 2% of all new thyroid cancers diagnosed in the United States occur in people under 20 years of age. It makes up only 1% of childhood cancers. Standard treatment for thyroid carcinoma includes surgery to remove the tumor. This cancer has a very high survival rate in children, typically near 95%.
Risk factors for childhood thyroid cancer include:
There are three main types of thyroid cancer seen in children: papillary thyroid cancer and follicular thyroid cancer (both types of differentiated thyroid cancer) and medullary thyroid cancer. In differentiated thyroid cancer (DTC), cells look more like normal cells and tend to grow more slowly.
Papillary thyroid cancer is the most common type of thyroid cancer in children and adolescents. It makes up approximately 90% of pediatric thyroid carcinomas. The next most common type of thyroid cancer is follicular thyroid cancer. Both papillary and follicular thyroid cancers can generally be treated similarly.
Medullary thyroid cancer (MTC) is often part of an inherited syndrome. Unlike differentiated thyroid tumors, which arise from follicular cells, MTC arises from parafollicular C cells. It is a neurodendocrine tumor, and is treated in a distinct way from differentiated thyroid cancers.
Assessment and treatment of thyroid cancer depends on the specific cancer type.
Reviewed: June 2018