Evaluation of children with medullary thyroid carcinoma.

Early diagnosis and surgical treatment of medullary thyroid carcinoma (MTC) in children is essential to decrease the likelihood of metastatic spread. From 1981 to 1991, eight children under 18 years of age (five girls and three boys) with MTC were seen and seven underwent total thyroidectomy. Follow-up ranged from 14 months to 10 years after surgery. Four of the seven presented with a neck mass and elevated basal levels of calcitonin (CT). After surgery, three had recurrent disease. In the other three, the diagnosis was made after several years of screening (normal basal values of CT but increased CT levels after calcium/pentagastrin infusion). All had normal stimulated CT values postoperatively. This follow-up showed that the prognosis for MTC in children depends predominantly upon its extent at the time of the diagnosis and treatment.