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[Thyroid tumors in childhood].

J Cerdá1, A Rodríguez, E Molina

  • 1Servicio de Cirugía Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid.

Cirugia Pediatrica : Organo Oficial De La Sociedad Espanola De Cirugia Pediatrica
|November 26, 1999
PubMed
Summary

Pediatric thyroid nodules are rare, with most being benign. However, careful evaluation is crucial to rule out rare cancers like papillary and medullary thyroid carcinoma, especially with a family history of endocrine neoplasia.

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Area of Science:

  • Pediatric Endocrinology
  • Surgical Oncology
  • Thyroid Pathology

Background:

  • Thyroid pathology accounts for 5% of pediatric conditions, with infantile solitary thyroid nodules representing 1.2% of these cases.
  • Thyroid tumors constitute 0.5% of all childhood tumors, with 10% occurring in individuals under 21 years old.
  • Most infantile thyroid nodules are asymptomatic, presenting only as neck swelling, but family history is vital for investigating potential medullary carcinoma linked to multiple endocrine neoplasias.

Purpose of the Study:

  • To present a series of pediatric patients with thyroid pathology requiring surgical intervention.
  • To analyze the types of thyroid pathologies encountered, treatment strategies, and outcomes in children.
  • To highlight the importance of a thorough diagnostic workup for pediatric thyroid nodules.

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Main Methods:

  • Retrospective review of 13 pediatric patients who underwent surgical treatment for thyroid pathology between 1983 and 1997.
  • Diagnostic workup included thyroid gammagraphy, cervical ultrasound, and fine-needle aspiration (FNA) cytology.
  • Surgical strategies were tailored based on diagnostic findings, ranging from total thyroidectomy to nodule excision.

Main Results:

  • Five cases of papillary thyroid carcinoma (ages 7-14) and one case of medullary thyroid carcinoma associated with multiple endocrine neoplasia (MEN II 2A) were diagnosed.
  • Papillary thyroid carcinoma cases were treated with total thyroidectomy followed by radioactive iodine (131I) ablation.
  • Seven patients had benign thyroid nodules, including six adenomas and one colloid cyst (ages 8-15), treated with surgical excision.

Conclusions:

  • While rare, thyroid cancer in children necessitates prompt diagnosis and appropriate surgical management.
  • A comprehensive diagnostic protocol involving imaging and cytology is essential for guiding surgical strategy in pediatric thyroid nodules.
  • Early detection and treatment are crucial for favorable outcomes in pediatric thyroid malignancies and benign conditions.