Le cancer différencié de la thyroïde chez l’enfant et l’adolescent: à propos de 22 cas

This study aimed to highlight the features of thyroid cancer in children and adolescents and to evaluate our results compared to the international literature on the basis of the most representative case series in Morocco: 22 cases. We conducted a retrosective study of patients with differentiated thyroid cancer hospitalized in the otorhinolaryngology and cervicofacial surgery department at the Hôpital 20 Août, Casablanca, Morocco over the period January 1995-March 2015. We collected data on 22 cases that met our inclusion criteria. The average age of our patients was 14 years, with a sex-ratio of 3.4; most of our patients presented with thyroid nodule, associated with cervical lymphadenopathy in 22.7% of cases and with signs of compression in 9.1% of cases. All patients underwent total thyroidectomy, followed by lymph node dissection in 31.82% of cases. The diagnosis of thyroid cancer was based on the anatomo-pathological examination of the surgical specimen, that showed papillary carcinoma in 95.4% of cases and vesicular carcinoma in 4.5% of cases. Radioactive iodine-131 treatment was performed in 100% of cases. Subsequently all patients underwent thyroid hormone therapy. Close and regular monitoring allowed the detection of nodal metastases in 3 patients and of distant metastases in 4 patients. Differentiated thyroid cancer in children and adolescents is rare but aggressive. Treatment is based on surgery associated with iratherapy, with excellent prognosis.