Papillary thyroid cancer with pulmonary metastases in children: Long-term prognosis

Jeromy S. Brink, Jon A. Van Heerden, Bryan McIver, Diva R. Salomao, David R. Farley, Clive S. Grant, Geoffrey B. Thompson, Donald Zimmerman, Ian D. Hay

Research output: Contribution to journalArticlepeer-review

94 Scopus citations


Background. Papillary thyroid cancer (PTC) in young patients may rarely be encountered with pulmonary metastases. Previous studies have suggested that, in the pediatric population, this may not portend a lethal outcome. Our present study, children with pulmonary metastases, was designed to clarify this issue. Methods. Fourteen children and young adolescents (mean age, 13.5 years; range, 9.8-17 years) with PTC and pulmonary metastases were treated at our institution between 1937 and 1998. Surgical treatment consisted of total thyroidectomy (n = 10 patients), subtotal thyroidectomy (n = 3 patients), and a biopsy only procedure (n = 1 patient). All patients who underwent thyroidectomy also underwent a variety of cervical lymph node dissections, and all patients proved to have regional nodal disease. After the operation, 12 patients were treated with ablative doses of 131I, 1 patient was treated with external beam irradiation, and all patients were placed on suppressive thyroid hormone therapy. The mean length of follow-up was 19.3 years (range, 1-45 years). Results. Regional recurrent disease developed in 2 patients (15 %). No patient experienced the development of worsening pulmonary disease or extra-pulmonary metastases. All patients with recurrent disease underwent selective nodal resections. No patient died of metastatic PTC. Seven patients (50%) remain completely free of disease and are probably cured; 7 patients (50 %) are asymptomatic with residual pulmonary disease. Conclusions. A stepwise treatment approach allows long-term survival and frequent cure for young patients with PTC and concomitant pulmonary metastases.

Original languageEnglish (US)
Pages (from-to)881-887
Number of pages7
Issue number6
StatePublished - Dec 2000

ASJC Scopus subject areas

  • Surgery


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