McGill Thyroid Nodule Score in Differentiating Benign and Malignant Pediatric Thyroid Nodules: A Pilot Study

Area of Science:

• Pediatric Endocrinology
• Oncology
• Diagnostic Imaging

Background:

• The McGill Thyroid Nodule Score (MTNS) is an established tool for assessing adult thyroid nodule malignancy risk.
• Pediatric thyroid nodules require accurate preoperative risk stratification to guide management.
• Limited data exists on the utility of MTNS in pediatric populations.

Purpose of the Study:

• To evaluate the clinical utility of a modified pediatric McGill Thyroid Nodule Score (MTNS) in children and adolescents.
• To assess the ability of the pediatric MTNS to predict malignancy in pediatric thyroid nodules.
• To determine if the pediatric MTNS can differentiate between benign and malignant nodules with indeterminate cytology.

Main Methods:

• Retrospective chart review of 46 patients ≤18 years with solitary or dominant thyroid nodules.
• Surgical resection and pathological analysis were performed for all nodules.
• The cumulative MTNS was calculated for each nodule and compared with final pathology results.

Main Results:

• 10 out of 46 patients (21.7%) were diagnosed with well-differentiated thyroid cancer.
• Malignant nodules had a significantly higher mean MTNS (16 ± 3.13) compared to benign nodules (5.72 ± 3.03).
• The pediatric MTNS demonstrated high sensitivity (100%) and specificity (94.4%) for malignancy with scores ≥10, and excellent performance (80% sensitivity, 100% specificity) for scores ≥11. It also differentiated indeterminate cytology nodules effectively.

Conclusions:

• A modified pediatric MTNS shows promise as a tool for assessing malignancy risk in pediatric thyroid nodules.
• The scoring system aids in differentiating between benign and malignant thyroid nodules, including those with indeterminate cytology.
• Larger, multi-institutional studies are recommended to validate these findings in a broader pediatric population.