Pediatric thyroid nodules: A single center experience

1. Analyze our center's experience with thyroid nodules. 2. Evaluate the efficacy of fine needle biopsy. 3. Compare our experience with the 2015 ATA guidelines.

IRB approved retrospective chart review from July 1993-July 2014 at a tertiary pediatric institution. Patients under age 21 with documented thyroid nodules who underwent fine needle aspiration, and/or thyroidectomy were included.

126 patients were identified. 84.1% (n = 106) were female. Age range was 12 months-20 years. The average age was 13.3 ± 4.1 years. The nodules ranged from 0.5 cm to 6 cm 53.9% (n = 68) had a fine needle biopsy done. 42.6% (n = 29) fine needle biopsies were benign, 26.5% (n = 18) were non-diagnostic, 13.2% (n = 9) were classified as "atypia", 0.09% (n = 6) were consistent with thyroiditis, and 0.09% (n = 6) were suspicious for papillary carcinoma. 78.6% (n = 99) underwent surgery. 7 patients with "benign" needle biopsies underwent surgery: all had follicular adenoma. 7 patients with "atypia" needle biopsies underwent surgery: one patient had papillary thyroid cancer. 8 patients with non-diagnostic needle biopsies underwent surgery: one patient had papillary thyroid cancer. All the patients with needle biopsy suspicious for papillary carcinoma had papillary carcinoma on final pathology. 99 patients underwent surgery: 14.1% (n = 14) had papillary carcinoma and 2% (n = 2) had medullary carcinoma.

Our review of pediatric thyroid nodules at our institution supports data previously reported. 84% of identified patients were female, supporting previous data that nodules are more prevalent in the female population. Of the 126 patients identified, 12.7% had thyroid carcinoma, supporting the 7-25% range described in previous literature. Our institution showed a high positive predictive value of FNA for papillary thyroid carcinoma.