Hashimoto thyroiditis and papillary carcinoma of the thyroid in the pediatric patient

An association between Hashimoto thyroiditis and papillary thyroid carcinoma is well described in adults. There are few cases in the pediatric literature. We report 2 cases of papillary carcinoma of the thyroid in pediatric patients with Hashimoto thyroiditis. In both patients, the nodules were not detected by the standard diagnostic approach. In the first patient, delayed diagnosis was the consequence of the failure of ultrasonography to detect the nodule. Since the incidence of malignancy is higher in children with a solitary thyroid nodule, fine-needle-aspiration biopsy should be used to make a definitive diagnosis. Because fine-needle biopsy can yield false-negative results, open biopsy should be considered in children and adolescents. When the diagnosis of papillary thyroid carcinoma is confirmed by histologic examination, total thyroidectomy with radioiodine ablation therapy is the recommended treatment.