Thyroid nodules in children and adolescents.

Area of Science:

• Endocrinology
• Pediatric Oncology
• Diagnostic Imaging

Background:

• Pediatric thyroid nodules carry a 2-3 times higher risk of malignancy compared to adults.
• The American Thyroid Association (ATA) released guidelines in 2015 for pediatric thyroid nodule and differentiated thyroid cancer management.
• Clinical practice requires updates to reflect recent advancements in the field.

Purpose of the Study:

• To review recent literature on pediatric thyroid nodule evaluation and management.
• To propose integration of new findings into clinical practice.
• To enhance the care of pediatric patients with thyroid nodules.

Main Methods:

• Literature review of recent additions to the scientific and clinical landscape.
• Analysis of updated diagnostic tools and risk stratification methods.
• Synthesis of findings for clinical application.

Main Results:

• Ultrasound-based scoring systems are refined for better fine needle aspiration selection.
• Pediatric-specific malignancy risks within The Bethesda System for Reporting Thyroid Cytopathology are better defined.
• Oncogene landscape research supports adjunct testing for indeterminate nodules.

Conclusions:

• Significant literature updates exist since the 2015 ATA guidelines.
• Integrating these advancements in multidisciplinary, pediatric-specific centers is crucial.
• Improved care for pediatric thyroid nodules is achievable through updated clinical practice.