Thyroid Cancer in Children

What is pediatric thyroid cancer?

The thyroid is a butterfly-shaped gland in the neck that produces hormones that are important for growth and metabolism. Pediatric thyroid cancer (also called thyroid carcinoma) occurs when the cells in the thyroid gland become abnormal and grow out of control.

Thyroid cancer is an uncommon cancer in childhood: Fewer than one in 100,000 children develop thyroid cancer each year. Although it can occur at any age, childhood thyroid cancer is most common in the teenage years, and it is the second most common cancer among adolescents ages 15 to 19.

Thyroid cancer is often detected as a lump in the front of the neck found by the child, a parent, or by a physician during a routine examination. Some thyroid cancers are discovered by chance during medical imaging performed for another reason.

Although thyroid cancer can spread — usually to the lymph nodes in the neck, or less often to the lungs — most children with thyroid cancer respond very well to treatment. Thyroid cancer in children does not behave the same as it does in adult patients, and outcomes in children are generally better than in adults.

There are several types of thyroid cancer:

  • Differentiated thyroid carcinoma includes two different types, papillary thyroid carcinoma and follicular thyroid carcinoma. Both of these types of thyroid cancer develop from the cells of the thyroid gland that normally produce thyroid hormone. Papillary carcinoma is the more common type, accounting for about 90% of thyroid cancers in children. Follicular carcinoma is less common and accounts for about 10% of cases.
  • Medullary thyroid carcinoma is very rare and develops in thyroid cells that do not produce thyroid hormone (called C-cells). Medullary thyroid cancer most often occurs in adults. However, there are familial conditions in which children may develop medullary thyroid carcinoma early in childhood or even in infancy. These familial syndromes are called multiple endocrine neoplasia type 2 (MEN2) or familial medullary thyroid cancer (FMTC).
  • Anaplastic thyroid cancer is an extremely rare and aggressive type of thyroid cancer that occurs almost exclusively in adults.

How we care for thyroid cancer in children

The team of clinicians in the Thyroid Center at Boston Children’s Hospital treats children and adolescents with thyroid cancer. Founded in 2001, the Thyroid Center is the oldest program of its kind in the country, and one of the only centers in the U.S. devoted exclusively to the care of children with thyroid diseases. The specialists in this multidisciplinary program have expertise in thyroid ultrasound, fine needle aspiration, thyroid surgery, nuclear medicine imaging, and radioactive iodine therapy.

Surgical experience is critical to having the best outcomes from thyroid cancer surgery, so it’s important to take the time to choose a surgeon who specializes in thyroid cancer in children. The rate of surgical complications is higher in children with thyroid cancer than in adults, perhaps because few pediatric surgeons are well versed in its treatment. Fortunately, thyroid cancer grows slowly, which gives families the opportunity to find a skilled pediatric thyroid surgeon or to seek a second opinion.

At Boston Children’s Thyroid Center, our pediatric thyroid surgeons specialize in the care of children and adolescents with thyroid disease, making us one of the most experienced centers of its kind in the country. This breadth and depth of knowledge result in exceptional outcomes and a low rate of surgical complications, which means that you can trust that your child is in the best hands.