• Thyroid Carcinoma Overview

    Thyroid carcinoma is an uncommon cancer in children that forms in the thyroid gland, the butterfly shaped gland at the base of the neck, which produces hormones that play a critical role in a child’s growth and metabolism. Unusually high exposure to radiation can cause children to develop thyroid carcinoma, which is one reason radiation is no longer used to treat benign conditions.

    There are two main types of thyroid carcinoma:

    • Differentiated thyroid carcinoma, which includes papillary thyroid carcinoma and follicular thyroid carcinoma, both of which develop in cells that produce thyroid hormone. The papillary form is the most common, while follicular disease is more aggressive.
    • Medullary thyroid carcinoma, which is very rare, develops in cells that do not produce thyroid hormone and typically affects those over age 20. However, there is a familial form in which children may develop the tumor very early in life.

    At diagnosis, about 70 percent of children have disease that has spread to the lymph nodes. Of these, 20 percent have disease that has spread to more distant sites, especially the lungs.

    Thyroid Carcinoma Treatment at Dana-Farber/Boston Children’s

    Children with thyroid carcinoma are treated at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center through our Solid Tumor Center. Continue reading to learn more about thyroid carcinoma or visit the Rare Tumors Treatment Program homepage to learn about our expertise and treatment options.

    Symptoms & Diagnosis

    Most children feel well when they are diagnosed with thyroid carcinoma. The most common symptoms of the disease include:

    • A lump in the neck
    • Swollen lymph nodes
    • Unexplained hoarseness
    • Trouble with breathing or swallowing

    In addition to a complete medical history and physical examination, thyroid carcinoma is diagnosed with:

    • Blood tests—to determine if the thyroid gland is working properly
    • Ultrasound—to confirm the presence of a thyroid mass
    • Computerized tomography (CT or CAT) scan
    • Biopsy

    After all tests are completed, doctors will be able to outline the best treatment options.

    Treatment & Care

    The most common treatments for thyroid carcinoma are:

    • Surgery—to remove as much of the tumor as possible; if necessary, the entire thyroid gland is removed
    • Radioactive iodine therapy—to destroy any remaining cancer cells after surgery
    • Molecular therapies—for patients with advanced differentiated thyroid carcinoma that do not respond to radioactive iodine therapy and for patients with advanced medullary thyroid carcinoma
    • Hormone therapy—to replace normal hormones and slow the growth of cancer cells
    • TSH suppression—a medication, called levothryoxine, or T4, to suppress thyroid-stimulating hormone blood levels, which helps to prevent tumor growth and recurrence

    Long-term Outlook

    The prognosis for children with thyroid carcinoma is excellent, with a survival rate of greater than 90 percent. Outcomes are best with early detection and treatment. Children treated for thyroid carcinoma seem to have higher recurrence rates than adults, especially children under age 10, boys, and those with large tumors or cancer that has spread to the lymph nodes. Postoperative suppression of TSH may decrease recurrence. Outcomes for children with recurrent disease are better than they are for adults.