Post-Chernobyl thyroid carcinoma in children

The dramatic increase in childhood thyroid carcinoma observed in Belarus and Ukraine as early as 4 years after the Chernobyl nuclear accident, is well recognized as being a consequence of exposure to radioactive iodine fallout. Uncertainties persist concerning the contamination and the dosimetric data. Thyroid nodule, cervical lymph nodes or systematic ultrasound thyroid screening in exposed children led to the diagnosis. The carcinomas affected younger subjects, were less influenced by gender, and were more aggressive at clinical and histological presentation than in the case with naturally occurring carcinoma. Total thyroidectomy and radioiodine treatment remain the treatment of choice. The prognosis is good but further studies are needed to evaluate the prognosis of children presenting with pulmonary metastasis. The project of the Newly Independent States Chernobyl Tissue Bank will facilitate molecular genetic research into this important public health issue. Nevertheless, clinicians must keep in mind the simplicity and the effectiveness of iodine prophylaxis.