Unusual Cancers of Childhood (PDQ®): Treatment - Patient Information [NCI] - Unusual Cancers of the Head and Neck
Thyroid tumors may cause any of the following symptoms. Check with your child's doctor if you see any of the following problems in your child:
- A lump in the neck or near the collarbone.
- Trouble breathing.
- Trouble swallowing.
- Hoarseness or a change in the voice.
Other conditions that are not thyroid tumors may cause these same symptoms.
Tests to diagnose and stage thyroid tumors may include the following:
- Physical exam and history.
- Fine-needle aspiration (FNA) biopsy.
- Open biopsy or surgery to remove all or part of the thyroid.
See the General Information section for a description of these tests and procedures.
Other tests used to diagnose and stage thyroid tumors include the following:
- Ultrasound: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later. This procedure can show the size of a thyroid tumor and whether it is solid or a fluid -filled cyst. Ultrasound may be used to guide a fine-needle aspiration (FNA) biopsy.
- Thyroid function test: The blood is checked for abnormal levels of thyroid-stimulating hormone (TSH). TSH is made by the pituitary gland in the brain. It stimulates the release of thyroid hormone and controls how fast follicular thyroid cells grow. The blood may also be checked for high levels of the hormone calcitonin.
- Thyroglobulin test: The blood is checked for the amount of thyroglobulin, a protein made by the thyroid gland. Thyroglobulin levels are low or absent with normal thyroid function but may be higher with thyroid cancer or other conditions.
The prognosis (chance of recovery) depends on the following:
- Whether the tumor has spread to other parts of the body at diagnosis.
- The size of the tumor.
Treatment of thyroid tumors in children may include the following:
- Surgery to remove most or all of the thyroid gland and lymph nodes with cancer, followed by radioactive iodine (RAI) to kill any thyroid cancer cells that are left. Hormone replacement therapy (HRT) is given to make up for the lost thyroid hormone.
- Surgery to remove the lobe in which thyroid cancer is found, followed by HRT to make up for the lost thyroid hormone.
- Radioactive iodine (RAI) for cancer that has recurred (come back).
- Targeted therapy with tyrosine kinase inhibitors (TKIs) or vascular endothelial growth factor inhibitors (VEGFs) for cancer that has spread to other parts of the body or that has recurred.
- A clinical trial of targeted therapy.
Four to six weeks after surgery a radioactive iodine scan (RAI scan) is done to find areas in the body where thyroid cancer cells that were not removed during surgery may be dividing quickly. RAI is used because only thyroid cells take up iodine. A very small amount of RAI is swallowed, travels through the blood, and collects in thyroid tissue and thyroid cancer cells anywhere in the body. If no cancer cells are found, a larger dose of RAI is given to destroy any remaining thyroid tissue. If cancer remains in the lymph nodes or has spread to other parts of the body, an even larger dose of RAI is given to destroy any remaining thyroid tissue and thyroid cancer cells.