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Related Concept Videos

Goiter01:27

Goiter

Goiter refers to an abnormal enlargement of the thyroid gland that may appear as a diffuse goiter (uniform enlargement) or nodular (single or multiple nodules). Functionally, it is classified as nontoxic (normal/low hormone levels) or toxic (excess hormone production).PathophysiologyDiffuse thyroid enlargement typically results from prolonged stimulation by thyroid-stimulating hormone (TSH) or TSH-like agents, commonly seen in hypothyroidism or iodine deficiency. In contrast, in hyperthyroid...
The Thyroid Gland01:23

The Thyroid Gland

The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...
Hyperthyroidism I: Introduction01:25

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
Graves' Disease I: Introduction01:28

Graves' Disease I: Introduction

Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence in...
Graves Disease II: Pathophysiology01:24

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...

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Related Experiment Video

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"Sun's Seven-Step Technique" for Endoscopic En-Bloc Resection of Thyroid Cancer via the Chest-Breast Approach
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Consultation with the specialist: thyroid nodules.

Jennifer N Osipoff1, Thomas A Wilson

  • 1Division of Pediatric Endocrinology, Department of Pediatrics, Stony Brook Children's Hospital, State University of New York, Stony Brook, NY, USA.

Pediatrics in Review
|February 4, 2012
PubMed
Summary

Pediatric thyroid nodules are more often malignant than in adults, with radiation exposure being a key risk factor. Fine-needle aspiration biopsy is recommended for evaluation, and while management is debated, young patients show higher survival rates for thyroid cancer.

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Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration
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Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration

Published on: November 10, 2014

Area of Science:

  • Pediatric Endocrinology
  • Oncology
  • Surgical Oncology

Background:

  • Thyroid nodules in children and adolescents exhibit a higher likelihood of malignancy compared to adults.
  • A history of ionizing radiation to the head or neck is a significant independent risk factor for developing thyroid malignancies.
  • Pediatric thyroid carcinoma, despite often presenting at a more advanced stage, is associated with superior survival rates compared to adult cases.

Purpose of the Study:

  • To review the current evidence regarding the evaluation and management of thyroid nodules and carcinomas in pediatric and adolescent populations.
  • To highlight the importance of fine-needle aspiration biopsy in the diagnostic workup of pediatric thyroid nodules.
  • To discuss the controversies in surgical management and postoperative care for well-differentiated thyroid carcinomas in young patients.

Main Methods:

  • Review of existing research evidence, including meta-analyses.
  • Analysis of risk factors, diagnostic modalities, and treatment outcomes for pediatric thyroid cancer.
  • Examination of evidence-based recommendations from organizations like the American Thyroid Association.

Main Results:

  • Fine-needle aspiration biopsy is strongly supported for evaluating all pediatric thyroid nodules.
  • Pediatric patients with thyroid carcinoma demonstrate higher survival rates than adults, even with more advanced initial disease.
  • The American Thyroid Association provides recommendations for medullary thyroid carcinoma management, including genetic testing and prophylactic thyroidectomy for high-risk mutations.

Conclusions:

  • Thyroid nodules in the pediatric population warrant thorough evaluation due to their higher malignant potential.
  • Early diagnosis and appropriate management, guided by evidence-based recommendations, are crucial for improving outcomes in pediatric thyroid cancer.
  • Ongoing research is needed to address controversies in the surgical and postoperative management of well-differentiated thyroid carcinomas in children and adolescents.