Clinical and histopathological characteristics of thyroid gland diseases requiring surgical treatment in children and adolescents

[V. D. Pantelić]

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Operacije dobrodiferentovanih karcinoma štitaste žlezde kod dece i adolescenata su retke u praksi i oskudno dokumentovane u literaturi. Cilj ovog istraživanja bio je da se utvrde kliničke i patohistološke karakteristike oboljenja štitaste žlezde kod dece i adolescenata koji su prethodno bili hirurški lečeni u Centru za endokrinu hirurgiju Univerzitetskog kliničkog centra Srbije od 01.01.2001. do 01.01.2011. Studijom je obuhvaćeno 170 pacijenata oba pola iz populacije dece i adolescenata (uzrasta od 16 do 20 godina) sa različitim malignim i benignim oboljenjima štitaste žlezde. Podaci za ovu studiju su dobijeni iz istorija bolesti i elektronske baze podataka Centra za endokrinu hirurgiju. Detaljna analiza podataka obuhvatila je dijagnozu, simptomatologiju, vrstu hirurške intervencije i stadijum bolesti. Iz preoperativnih podataka analizirani su sledeći parametri tireoidnog statusa: T4 (tiroksin), FT4 (slobodna frakcija tiroksina), T3 (trijodtironin), FT3 (slobodna frakcija trijodtironina) i TSH (tireostimulišući hormon). Osim toga, utvrđene su i patohistološke karakteristike dijagnostikovanih bolesti štitaste žlezde, sa posebnim osvrtom na prisustvo dobro diferentovanih karcinoma. Papilarni karcinomi su bili najčešći od dobro diferentovanih karcinoma kod dece i adolescenata tokom desetogodišnjeg perioda praćenja. Na osnovu ispitivanih podataka, totalna tiroidektomija je bila najčešće korišćeni vid hirurške intervencije kod ovih pacijenata. Sprovedeno istraživanje pruža suštinske informacije koje se odnose kako na biološke karakteristike i dijagnostiku ovih karcinoma, tako i na njihovo hirurško lečenje u ovoj osetljivoj populaciji. Štaviše, istraživanjem je pokazano da je klinička slika kancera štitaste žlezde kod dece i adolescenata skoro identična onoj kod odraslih.

Operations for well-differentiated thyroid cancer in children and adolescents are rare in practice and there is insufficient data on this topic in the literature. The present research aimed to determine the clinical and pathohistological characteristics of thyroid gland diseases in children and adolescents who were previously surgically treated at the Endocrine Surgery Center of the University Medical Center of Serbia from 01/01/2001 to 01/01/2011. The study covered 170 patients of both sexes from the population of children and adolescents (aged 16 to 20 years) with various malignant and benign thyroid gland diseases. The data for this study were extracted from the medical histories and the electronic database of the Center for Endocrine Surgery. Detailed data analysis included diagnosis, symptomatology, surgical intervention type, and disease stage. The following thyroid status parameters were analyzed from preoperative data: T4 (thyroxine), FT4 (thyroxine free fraction), T3 (triiodothyronine), FT3 (triiodothyronine free fraction), and TSH (thyroid stimulating hormone). In addition, the pathohistological features of diagnosed thyroid diseases were also determined, with a special focus on the presence of well-differentiated cancers. Papillary carcinomas were the most common of well-differentiated cancers in adolescents over the ten-year follow-up period. Based on the assessed data, total thyroidectomy was the most commonly used type of surgical intervention in these patients. The conducted research provides essential information related to both the biological characteristics and diagnostics of these cancers and their surgical treatment in such a sensitive population. Moreover, research showed that the clinical presentation of thyroid cancer in children and adolescents is almost identical to that in adults.

štitasta žlezda, hirurško lečenje, patohistologija, deca, adolescenti

thyroid gland, surgical treatment, pathohistology, children, adolescents

616.441-089:616-091.8(043.3)

Endokrina hirurgija

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