Characteristics of Follicular Variant Papillary Thyroid Carcinoma in a Pediatric Cohort.

Characteristics of Follicular Variant Papillary Thyroid Carcinoma in a Pediatric Cohort.

J Clin Endocrinol Metab. 2018 Feb 08;:

Authors: Samuels SL, Surrey LF, Hawkes CP, Amberge M, Mostoufi-Moab S, Langer JE, Adzick NS, Kazahaya K, Bhatti T, Baloch Z, LiVolsi VA, Bauer AJ

Abstract
Context: In adults, non-invasive follicular variant papillary thyroid carcinoma (FVPTC) is considered low risk for metastasis and persistent/recurrent disease.
Objective: The goal of this study was to assess the clinical, sonographic, and histopathological features of FVPTC in a pediatric cohort.
Design: A retrospective review of subjects < 19 years of age with papillary thyroid carcinoma (PTC) who underwent thyroidectomy between January 2010 and July 2015.
Setting: Multidisciplinary, academic referral center.
Patients: Patients with FVPTC, defined as a tumor ≥1.0 cm in largest dimension with predominant follicular growth, complete lack of well-formed papillae, and nuclear features of PTC.
Main Outcome Measure: Tumor size and location, presence of a tumor capsule, capsule and vascular invasion, lymph node and distant metastasis.
Results: Eighteen patients with FVPTC were identified from a case cohort of 110 patients with PTC. On histopathology, 13 (72%) had unifocal nodules and 14 (78%) were completely encapsulated. Capsule invasion was frequent (9/14; 64%) and vascular invasion was found in one third of patients (6/18; 33%). No lymph node metastases were found in the 13 (72%) patients who had a central neck lymph node dissection. One patient with vascular invasion had distant metastases.
Conclusion: When strictly defined, FVPTC in pediatric patients has a low risk for bilateral disease and metastasis. Prospective studies are needed to confirm whether lobectomy with surveillance is sufficient to achieve remission in pediatric patients with low risk FVPTC.

PMID: 29438531 [PubMed - as supplied by publisher]

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