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Published on: April 21, 2023
Evaluation and management of thyroid nodules in children
Andrew J Bauer1, Gary L Francis
1aDivision of Endocrinology and Diabetes, Children's Hospital of Philadelphia bDepartment of Pediatrics, The University of Pennsylvania, The Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Insights
This review covers new findings on thyroid nodules in children and adolescents. Evaluation and management strategies are updated for pediatric thyroid cancer risk assessment.
Area of Science:
- Pediatric Endocrinology
- Thyroidology
- Oncology
Background:
- Thyroid nodules are rare but increasingly detected in pediatric populations via imaging.
- Current management guidelines exist but require updates due to recent advancements.
- Evaluating pediatric thyroid nodules involves assessing cancer risk and appropriate follow-up.
Purpose of the Study:
- To review recent advancements in the presentation and management of thyroid nodules in children and adolescents.
- To provide updated information beyond existing American Thyroid Association guidelines.
Main Methods:
- Literature review of recent studies on pediatric thyroid nodules.
- Analysis of diagnostic criteria and risk stratification tools.
- Synthesis of current management and follow-up strategies.
Main Results:
- Thyroid nodules are often found incidentally in children through imaging.
- Risk stratification for malignancy utilizes personal/family history, ultrasound, and fine-needle aspiration.
- Management decisions are guided by the assessed cancer risk of the nodule.
Conclusions:
- Updated approaches are crucial for the accurate diagnosis and management of pediatric thyroid nodules.
- Integrating new data ensures optimal care for children with thyroid nodules.
- Continued research is needed to refine risk assessment and treatment protocols.
Purpose Of Review:
The review is focused on new information about the presentation and management of thyroid nodules in children and adolescents.
Recent Findings:
Palpable thyroid nodules are uncommon in children but many children have nodules detected by radiologic imaging. How to evaluate them, when to suspect thyroid cancer, and how best to follow apparently benign nodules has become an area of great interest. The American Thyroid Association recently published treatment guidelines for children with thyroid nodules and cancers but much has been learned since that publication.
Summary:
Personal and family history, ultrasound features, and fine needle aspiration cytology are used to determine the risk of cancer in thyroid nodules, which are then managed according to cancer risk.
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