IMPE Abstracts

Papillary thyroid carcinoma (PC) is rare in the pediatric age group. Diffuse sclerosing papillary carcinoma (DSPC) is a multifocal, less frequent variant associated with worse prognosis, recurrence, and higher mortality. We present a 5-year follow up of a child with DSPC, treated in our institution. Due to goiter, hypothyroidism, and elevated thyroid antibodies at 8.5-years, our patient was diagnosed with Hashimoto's thyroiditis (HT) and started treatment with L-thyroxine 75 mg/day. Initial thyroid ultrasound (US) showed diffuse parenchymal disease without nodules. At 9.4 years old and being euthyroid, a new US showed multiple diffuse punctate microcalcifications in both lobes and bilateral anterior cervical lymphadenopathy. A fine needle aspiration biopsy was performed and showed PC (Bethesda V). No evidence of long-distance metastasis was found. Total thyroidectomy and resection of cervical lymphadenopathy were performed and pathology specimen showed DSPC. Postoperative systemic exploration with I131 by TSH stimulated with Thyrogen showed only uptake in thyroid remnant and 0.18 ng/ml thyroglobulin. Based on the biopsy and local extension of the tumor, 83 mci of I123 was applied. After the surgery, she presented transient paralysis of the left vocal cord. For 5 years, supplemented with LT4, she has remained euthyroid with low TSH, periodic neck US controls without recurrence, and undetectable ultrasensitive TG (Table 1). She has presented normal pubertal growth and development, and has no evidence of disease recurrence.