{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:02:08Z","timestamp":1779840128142,"version":"3.53.1"},"reference-count":43,"publisher":"Georg Thieme Verlag KG","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Magdeburger F\u00f6rderkreis krebskranker Kinder\n                        e.V."},{"DOI":"10.13039\/501100007311","name":"Deutsche Kinderkrebsstiftung","doi-asserted-by":"crossref","award":["DKS 2021.11, DKS 2024.16, DKS 2025.07"],"award-info":[{"award-number":["DKS 2021.11, DKS 2024.16, DKS 2025.07"]}],"id":[{"id":"10.13039\/501100007311","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Mitteldeutsche Kinderkrebsforschung"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Padiatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Differentiated thyroid carcinoma is the most common endocrine malignancy in\n                        children and typically presents as an isolated tumor. The synchronous\n                        occurrence of differentiated thyroid carcinoma with a second, non-thyroid\n                        primary malignancy is exceptionally rare and poorly characterized in\n                        pediatric patients.<\/jats:p>\n                  <jats:p>We reviewed 571 pediatric patients with histologically confirmed\n                        differentiated thyroid carcinoma and enrolled in the national German Society\n                        for Pediatric Oncology and Hematology\u2013malignant endocrine tumor registry\n                        between January 1997 and February 2025. Synchronous tumors were defined as\n                        two distinct malignancies diagnosed within 3 months prior to\n                        disease-specific therapy. Clinical, pathological, and genetic findings were\n                        analyzed descriptively.<\/jats:p>\n                  <jats:p>Five patients (0.9%) were diagnosed with synchronous differentiated thyroid\n                        carcinoma and a second primary malignancy. All thyroid tumors were papillary\n                        thyroid carcinomas, identified in the context of Hodgkin lymphoma\n                        (n=2), pheochromocytoma, synovial sarcoma, and Ewing sarcoma. In four\n                        cases, the thyroid tumor was detected during staging or evaluation for the\n                        primary malignancy. In one patient, the papillary thyroid carcinoma was\n                        diagnosed and treated prior to the identification of Hodgkin lymphoma. One\n                        patient harbored a pathogenic succinate dehydrogenase [ubiquinone]\n                        iron\u2013sulfur subunit variant, and two patients had coexisting Hashimoto\n                        thyroiditis. All patients achieved complete remission.<\/jats:p>\n                  <jats:p>Synchronous presentation of differentiated thyroid carcinoma and other\n                        malignancies in pediatric patients, while rare, poses significant diagnostic\n                        and therapeutic challenges. These cases warrant multidisciplinary evaluation\n                        and may reflect underlying cancer predisposition, immune dysregulation, or\n                        previously unrecognized risk factors.<\/jats:p>","DOI":"10.1055\/a-2863-4534","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T23:03:07Z","timestamp":1779836587000},"source":"Crossref","is-referenced-by-count":0,"title":["Synchronous Differentiated Thyroid Carcinoma and Nonthyroid\n                    Malignancies in Pediatric Patients: A Registry-based Case Series"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2672-4045","authenticated-orcid":false,"given":"Marina","family":"Kunstreich","sequence":"additional","affiliation":[{"name":"Otto von Guericke University Magdeburg Medical\n                    Faculty, ST, Germany","place":["Magdeburg"],"department":["Department of Pediatrics, MET Registry"]},{"name":"University of Augsburg Faculty of\n                    Medicine, BY, Germany","place":["Augsburg"],"department":["Pediatric and Adolescent Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Kn\u00f6fler","sequence":"additional","affiliation":[{"name":"Technische Universit\u00e4t Dresden, SN, Germany","place":["Dresden"],"department":["Department of Pediatric Hematology and Oncology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg Christof","family":"Schwabe","sequence":"additional","affiliation":[{"name":"Medical University of Lausitz\u2014Carl Thiem, BB, Germany","place":["Cottbus"],"department":["Children\u2019s Hospital Cottbus"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Wawer","sequence":"additional","affiliation":[{"name":"Technical University of Munich, BY, Germany","place":["Munich"],"department":["Department of Pediatrics, German Center for Child and Adolescent Health\n                    (DZKJ)"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Henning","family":"Klusmann","sequence":"additional","affiliation":[{"name":"Goethe University Frankfurt, HE, Germany","place":["Frankfurt"],"department":["Department of Pediatrics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Sch\u00f6ndorf","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinikum des Saarlandes, SL, Germany","place":["Homburg"],"department":["Department of Pediatric Hematology & Oncology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antje","family":"Redlich","sequence":"additional","affiliation":[{"name":"Otto von Guericke University Magdeburg Medical\n                    Faculty, ST, Germany","place":["Magdeburg"],"department":["Department of Pediatrics, MET Registry"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4577-0503","authenticated-orcid":false,"given":"Michaela","family":"Kuhlen","sequence":"additional","affiliation":[{"name":"University of Augsburg Faculty of\n                    Medicine, BY, Germany","place":["Augsburg"],"department":["Pediatric and Adolescent Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"914942","DOI":"10.3389\/fped.2022.914942","article-title":"Thyroid cancer in children: A multicenter international study highlighting\n                    clinical features and surgical outcomes of primary and secondary tumors","volume":"10","author":"C Martucci","year":"2022","journal-title":"Front 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american thyroid association guidelines task force on\n                    pediatric thyroid cancer","volume":"25","author":"G L Francis","year":"2015","journal-title":"Thyroid"},{"issue":"05","key":"ref5","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1097\/MED.0000000000000754","article-title":"Differences in the management of thyroid nodules in children and adolescents as\n                    compared to adults","volume":"29","author":"M Goldfarb","year":"2022","journal-title":"Current Opinion in Endocrinology, Diabetes and\n                    Obesity"},{"issue":"04","key":"ref6","doi-asserted-by":"publisher","first-page":"e28171","DOI":"10.1002\/pbc.28171","article-title":"Revisiting the genotype-phenotype correlation in children with medullary thyroid\n                    carcinoma: A report from the GPOH-MET registry","volume":"67","author":"M Kuhlen","year":"2020","journal-title":"Pediatr Blood 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in patients\n                    with thyroid cancer: Systematic review and meta-analysis","volume":"16","author":"D M Berta","year":"2025","journal-title":"Front Endocrinol"},{"issue":"01","key":"ref33","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1002\/ijc.35159","article-title":"Identification of novel candidate predisposing genes in familial nonmedullary\n                    thyroid carcinoma implicating DNA damage repair pathways","volume":"156","author":"C Pires","year":"2025","journal-title":"Int J Cancer"},{"issue":"03","key":"ref34","doi-asserted-by":"publisher","DOI":"10.20452\/pamw.16654","article-title":"Genetic predisposition to differentiated thyroid cancer in the Polish\n                    population","volume":"134","author":"M Borowczyk","year":"2024","journal-title":"Pol Arch Intern Med"},{"issue":"03","key":"ref35","doi-asserted-by":"publisher","first-page":"1481","DOI":"10.21873\/anticanres.15619","article-title":"Thyroid follicular cell-derived 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Endocrinol"},{"issue":"04","key":"ref38","first-page":"303","article-title":"The association between thyroid malignancy and chronic lymphocytic thyroiditis:\n                    Should it alter the surgical approach?","volume":"62","author":"O B\u00fcy\u00fcka\u015f\u0131k","year":"2011","journal-title":"Endokrynol Pol"},{"issue":"06","key":"ref39","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1001\/archpedi.162.6.526","article-title":"Thyroid nodules and cancer in children and adolescents affected by autoimmune\n                    thyroiditis","volume":"162","author":"A Corrias","year":"2008","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"05","key":"ref40","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1111\/j.1365-2265.2009.03699.x","article-title":"The tight relationship between papillary thyroid cancer, autoimmunity and\n                    inflammation: Clinical and molecular studies","volume":"72","author":"M 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