Diagnosis and treatment strategies for distant metastasis of thyroid carcinoma in children and young adolescents

WANG Zhuo-ying; QIU Ming; QIAN Kai

doi:10.19538/j.cjps.issn1005-2208.2024.06.13

Abstract：The incidence of thyroid carcinoma in children and adolescents has been on the rise in recent years.Compared to adults,children and adolescent patients with thyroid carcinoma have a higher degree of malignancy as well as increased risks of distant metastasis and recurrence.Diagnosing and treating distant metastases are crucial aspects of clinical medical care.Risk factors for distant metastasis in pediatric and adolescent thyroid carcinoma include radiation exposure,age,genetic alterations,and pathological types.Diagnosing distant metastasis requires an accurate diagnosis of the primary disease,including clinical staging pathological type and molecular diagnosis.For high-risk patients with a history of radiation exposure,family history of genetic susceptibility,and genetic alterations,screening for distant metastases should be emphasized.Thyroglobulin(Tg)testing and radioisotope nucleotide scanning are important for assessing presence and recurrence of tumors.Treatment strategies include surgical treatment,radioactive iodine(RAI)therapy,thyroid-stimulating hormone(TSH)suppression therapy,Tg level monitoring targeted therapy,and long-term management.Compared to adults,children and adolescent thyroid carcinoma patients have a better long-term prognosis,even in the case of distant metastases with more extended survival periods.Hence,improving the diagnosis and treatment strategies for pediatric and adolescent thyroid carcinoma to enhance patients'quality of life is particularly important.Dynamic risk stratification plays a significant role in the disease's long-term management and prognosis assessment.Furthermore,attention should also be given to the prevention and treatment of postoperative hypoparathyroidism patients'mental health and quality of life.