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Related Experiment Videos

Autonomously functioning thyroid nodules in childhood and adolescence.

R D Croom1, C G Thomas, R L Reddick

  • 1Department of Surgery, University of North Carolina School of Medicine, Chapel Hill 27514.

Surgery
|December 1, 1987
PubMed
Summary

Autonomously functioning thyroid nodules (AFTNs) are uncommon in children but pose a higher risk for rapid toxicity and thyroid cancer. Surgery is recommended for all pediatric AFTNs due to these risks.

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Area of Science:

  • Pediatric Endocrinology
  • Surgical Oncology
  • Thyroidology

Background:

  • Autonomously functioning thyroid nodules (AFTNs) are rare in pediatric populations.
  • AFTNs in children exhibit distinct biological behavior compared to adults, with faster progression to toxicity and higher malignancy rates.
  • Previous reports underestimated the incidence of AFTNs in individuals under 18.

Purpose of the Study:

  • To analyze the clinical characteristics and outcomes of AFTNs in children and adolescents.
  • To evaluate the risks associated with AFTNs in this age group, including hyperthyroidism and thyroid carcinoma.
  • To establish optimal management strategies for pediatric AFTNs.

Main Methods:

  • Retrospective review of 12 pediatric patients with AFTNs.

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  • Meta-analysis combining these cases with 49 previously reported pediatric AFTNs, totaling 61 patients.
  • Analysis of surgical outcomes and histopathological findings in 53 operated patients.

    • Main Results:

    • Hyperthyroidism was diagnosed in 15 patients (24.6%).
    • Well-differentiated thyroid carcinoma was identified in 6 patients (11.3%) as the cause of AFTN.
    • Surgical excision, preferably lobectomy, led to rapid euthyroid state restoration and accurate diagnosis.

    Conclusions:

    • Surgical treatment is advised for all pediatric AFTNs due to significant risks of hyperthyroidism and malignancy.
    • Radioiodine therapy is not recommended for pediatric AFTNs.
    • Thyroid-stimulating hormone suppression is indicated for pediatric thyroid carcinoma patients.