Diagnostic features of thyroid nodules in pediatrics

Area of Science:

• Pediatric Endocrinology
• Oncology
• Radiology

Background:

• Thyroid nodules are common in children, requiring careful evaluation to distinguish benign from malignant conditions.
• Understanding the differences between hyperthyroid and euthyroid patients with thyroid nodules is crucial for diagnosis.

Purpose of the Study:

• To determine the frequency of different histotypes in pediatric thyroid nodules.
• To identify clinical, laboratory, and ultrasonographic differences between hyperthyroid and euthyroid patients.
• To differentiate between benign and malignant nodules in pediatric patients.

Main Methods:

• Retrospective cohort study of 120 pediatric patients with thyroid nodules across 9 Italian centers over 10 years.
• Utilized Doppler ultrasonography, scintiscan, fine-needle aspiration biopsy, and surgicalhistology for data collection.
• Evaluated clinical, laboratory, and ultrasonographic data to identify distinguishing features.

Main Results:

• Hyperthyroid patients presented with more compressive signs, larger nodules, specific vascularization patterns, and increased scintiscan uptake.
• Fine-needle aspiration biopsy revealed 77 benign, 19 malignant, and 8 suspicious lesions.
• Malignant nodules in euthyroid patients were associated with palpable lymph nodes, compressive signs, microcalcifications, and intranodular vascularization.

Conclusions:

• A stepwise diagnostic approach integrating clinical, laboratory, and imaging modalities is essential for pediatric thyroid nodules.
• Ultrasonography aids in identifying nodules and characterizing suspicious lesions.
• Scintiscan is valuable for hyperthyroid patients, while fine-needle aspiration biopsy is key for euthyroid patients.