Solitary thyroid nodules in 93 children and adolescents. a 35-years experience

Over a period of 35 years from 1963 to 1998, 93 patients under the age of 18 years, 74 girls and 19 boys, were seen for evaluation of a solitary nodule of the thyroid gland. All patients had preoperative scintiscans of the thyroid gland and had their solitary nodule excised. Seventy-seven of the patients had a cold nodule on scintiscanning. The most common cause of solitary thyroid nodules was follicuar adenoma (68.9%). Fifteen of the 77 cold nodules were malignant (19.9%). The frequency of carcinoma in males was 26.3%, while in females it was 13.5%. Our experience suggests that the incidence of thyroid carcinoma may be decreasing in pediatric patients not exposed to known risk factors. Available diagnostic methods for attempting differentiation of benign from malignant solitary nodules are reviewed and recommendations to the clinical management are presented.