Nodular Thyroid Disease in Children and Adolescents

Area of Science:

• Pediatric Endocrinology
• Surgical Oncology
• Thyroidology

Background:

• Thyroid nodules in children are exceptionally rare.
• While often asymptomatic, pediatric thyroid nodules warrant significant attention due to the elevated risk of malignancy.
• Malignant thyroid nodules in children are a serious concern.

Purpose of the Study:

• To review the diagnostic and surgical management of thyroid nodules in pediatric patients.
• To assess the incidence of benign versus malignant thyroid nodules in surgically managed pediatric cases.
• To provide recommendations for the workup and treatment of pediatric thyroid nodules.

Main Methods:

• Retrospective review of medical records for 71 patients aged 20 years or younger with surgically managed thyroid nodules.
• Evaluation of diagnostic workup including serum thyroid studies, radiologic imaging, and fine-needle aspiration (FNA).
• Analysis of surgical outcomes and pathology reports for benign and malignant lesions.

Main Results:

• Out of 71 pediatric patients, 45 had benign thyroid nodules and 26 had malignant nodules.
• The study discusses the institutional diagnostic approach for these nodules.
• Surgical management strategies for benign and malignant pediatric thyroid nodules were analyzed.

Conclusions:

• Due to the high malignancy potential, surgical excision is recommended for all solitary pediatric thyroid nodules, unless FNA definitively proves benign histology.
• While partial thyroidectomy may suffice for benign conditions, total thyroidectomy is recommended for malignant disease in children.
• The optimal surgical approach for pediatric thyroid nodules remains a subject of ongoing debate.