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Thyroid nodules in children.

A K White, R J Smith

    Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
    |July 1, 1986
    PubMed
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    Pediatric thyroid nodules are rarely malignant, with benign conditions like hyperplasia being more common. This study reviewed 38 children, finding only 29% had thyroid cancer, suggesting a low incidence of malignancy in childhood thyroid lesions.

    Area of Science:

    • Pediatric Endocrinology
    • Surgical Pathology
    • Oncology

    Background:

    • Thyroid nodules in children are uncommon but historically associated with high malignancy rates (40-70%) after low-dose irradiation.
    • Recent trends indicate a decrease in malignancy incidence, with a relative increase in benign thyroid conditions.
    • There's growing concern about secondary thyroid neoplasms in pediatric cancer survivors.

    Purpose of the Study:

    • To determine the incidence of benign versus malignant thyroid pathology in children undergoing surgery.
    • To investigate the role of prior irradiation or chemotherapy in the development of pediatric thyroid disease.
    • To review clinical presentation, diagnostic evaluation, and surgical management of pediatric thyroid nodules.

    Main Methods:

    • Retrospective review of 38 children treated surgically for thyroid nodules at Texas Children's Hospital (1972-1984).

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  • Analysis of pathological diagnoses (benign vs. malignant).
  • Assessment of patient history for prior irradiation or chemotherapy.

    • Main Results:

    • Benign conditions were diagnosed in 27 children (71%), most commonly diffuse hyperplasia (26%) and follicular adenoma (21%).
    • Thyroid carcinoma was diagnosed in 11 children (29%).
    • No patients received multimodal therapy for prior malignancy; only one had prior irradiation for a benign condition.

    Conclusions:

    • Benign thyroid conditions are more frequent than malignant ones in surgically treated pediatric patients.
    • The study did not find a link between prior multimodal therapy and thyroid neoplasia, suggesting a very low incidence.
    • Clinical and surgical management parallels findings in other pediatric thyroid nodule series.