Safety, Efficacy of Early Thyroidectomy in Pediatric MEN2

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Participants diagnosed with medullary thyroid cancer were diagnosed with early-stage disease. <i> Image credit: ISM / Dr Aubène LEGER</i>
Participants diagnosed with medullary thyroid cancer were diagnosed with early-stage disease. Image credit: ISM / Dr Aubène LEGER

Early thyroidectomy may prevent the development of medullary thyroid cancer in pediatric patients with multiple endocrine neoplasia type 2 (MEN2), according to research presented at the 87th Annual Meeting of the American Thyroid Association, held October 18-22, in Victoria, British Columbia, Canada.

Researchers at the University of Texas MD Anderson Cancer Center in Houston, Texas, conducted an institutional database review of patients with MEN2who underwent thyroidectomy for medullary thyroid cancer prevention before age 18 years.

After applying inclusion criteria, data from 62 patients were analyzed; 93.5% of patients had MEN2A and 6.5% had MEN2B. Age at thyroidectomy was median 7.3 years (range: 3-17.5), with median time between genetic testing and thyroidectomy 0.7 years (range: 0-11.6).

Following thyroidectomy, pathologic review indicated pT1 medullary thyroid cancer in 38.9% of patients, with 37.3% showing signs of C-cell hyperplasia and 23.7% indicating no histologic cancer or precursor lesions. One patient demonstrated locoregional recurrence, resulting in lymphadenectomy within one year. Participants were followed for median 2.4 years (range: 0-19.1).

More than 90% (93.5%) of surgeries were performed by experienced, senior endocrine surgeons.

“Early thyroidectomy for pediatric patients can be safely performed with low morbidity in experienced hands,” the researchers concluded.

Reference

Romero Arenas MA, Bassett RL, Grubbs EG, et al. Small glands in experienced hands: early thyroidectomy in pediatric patients with multiple endocrine neoplasia type 2 (MEN2) over 24 year period. Presented at: 87th Annual Meeting of the American Thyroid Association; October 18-22, 2017; Victoria, BC, Canada. Poster 115.

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