THYROID TUMORS:
The incidence of thyroid cancer under the age of 20 is 4-5 per million. It is mostly seen in the adolescent age group and its incidence is 4 times higher in girls. The greatest risk in thyroid cancer is radiation applied to the neck area. The incidence is 10% in survivors of Hodgkin-type tumors. The reason for this is the radiation and chemotherapy applied.
The majority of thyroid cancers in children are differentiated papillary or follicular types.
Patients apply to the physician with the complaint of a mass in the thyroid gland or enlargement in the neck lymph nodes. The diagnosis of thyroid masses in children can be made by needle biopsy in the adolescent age group. However, surgical resection is recommended for thyroid nodules in the younger age group. Thyroid scintigraphy, thyroid hormone level, chest radiography and CT should be performed preoperatively. It is still controversial whether the thyroid gland should be completely removed in thyroid cancers involving a single lobe. However, total thyroidectomy is recommended in cases involving neck lymph nodes. Neck lymph node dissection should be added to this. Radioactive iodine-131 is also used to eliminate residual thyroid tumors. Total thyroidectomy should be performed in cases where thyroid cancer is thought to be caused by radiation exposure of the neck region.
MELANOM:
The incidence in children under the age of 20 is 4.2 per million, and almost all of them are in the adolescent age group. Its incidence increases rapidly in adults. Although sun exposure in adults is a well-known risk factor, the effect of sun in the childhood age group is uncertain. However, it is recommended that children do not stay in the sun for a long time. Those with fair skin and children with a family history of melanoma are at relatively higher risk. Known risk factors in childhood are hairy moles larger than 20 cm and xeroderma pigmentosum.
Rapidly growing, darkening, irregular borders and easily bleeding moles (nevi) should bring to mind melanoma. Diagnosis is made by pathological examination.
Treatment information is based on adult information. Lymphatic involvement should be investigated with total excision of Diagnosis I and samples taken from neighboring lymph nodes. If there is lymphatic involvement, the adjacent lymph tissues should be surgically removed. Following surgical treatment, chemotherapy with biologic agents and vaccine therapy should be used for possible distant metastases. It is not known whether treatment outcomes in children are better than in adults.
ADENOCARCINOMAS OF THE LARGE BOTTOM AND RECTUM:
They are rarely seen in the childhood age group. It is more common in boys. Even in cases with an increased tendency to cancer such as familial adenomatous polyposis, Peutz-Jeghers syndrome, it is usually absent until adulthood, but they should be checked for possible cancer development in childhood or adolescence. The disease may present with bloody stools or tar-colored poop (melana), abdominal pain, and weight loss. Findings are mostly indistinct and cause delay in diagnosis. The tumor is surgically removed. In cases that cannot be completely removed, chemotherapy is applied. It can be used in radiotherapy in the treatment of rectal carcinomas.
ADENOCORTICAL CARCINOMA:
It is extremely rare. They originate from the adrenal gland and are more common in the first few years of childhood. It is more common in girls. Patients typically present with masculine symptoms. The prognosis depends on the size of the tumor and whether it has been completely removed or not. Chemotherapy should be applied in patients who cannot be completely removed or in cases with metastases, but the prognosis is poor in such cases.
