Evolving approaches in paediatric thyroid cytopathology: A review

Area of Science:

• Endocrinology
• Paediatric Oncology
• Cytopathology

Background:

• Thyroid nodule workup guidelines are primarily based on adult data and applied to children.
• The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is widely used for both adult and paediatric thyroid nodules.
• Paediatric thyroid nodules exhibit distinct molecular characteristics and behaviours compared to adult nodules.

Purpose of the Study:

• To review the key differences between paediatric and adult thyroid cancer.
• To evaluate the recent literature on the application of TBSRTC in paediatric populations.
• To emphasize the need for paediatric-specific diagnostic and management strategies for thyroid nodules.

Main Methods:

• Literature review of studies comparing paediatric and adult thyroid cancer.
• Analysis of recent research on the performance of TBSRTC in paediatric thyroid nodules.
• Synthesis of findings regarding molecular drivers and clinical trajectories in paediatric thyroid cancer.

Main Results:

• Paediatric thyroid nodules possess unique molecular drivers and behavioural patterns.
• Existing literature suggests variability in the direct applicability of TBSRTC to paediatric cases.
• There is a growing body of evidence supporting the need for tailored paediatric approaches.

Conclusions:

• Paediatric thyroid nodules require specific diagnostic and management considerations distinct from adults.
• Further research is needed to refine TBSRTC or develop paediatric-specific systems for thyroid nodule evaluation.
• Optimizing the workup of paediatric thyroid nodules can lead to improved patient outcomes.