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Hyperfunctioning thyroid nodules in children and adolescents.

F de Luca, J L Chaussain, J C Job

    Acta Paediatrica Scandinavica
    |January 1, 1986
    PubMed
    Summary
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    Solitary hyperfunctioning thyroid nodules in children and adolescents can present as subclinical hyperthyroidism. Surgical removal is recommended for thyrotoxic, enlarged, or growing nodules.

    Area of Science:

    • Pediatric Endocrinology
    • Thyroidology
    • Nuclear Medicine

    Background:

    • Solitary thyroid nodules are common in children, but hyperfunctioning nodules are rare.
    • Thyroid scintigraphy is crucial for evaluating nodule function and surrounding tissue activity.

    Purpose of the Study:

    • To investigate the clinical presentation, hormonal status, and outcomes of pediatric patients with solitary hyperfunctioning thyroid nodules.
    • To assess the potential for malignancy in these nodules and determine appropriate management strategies.

    Main Methods:

    • Retrospective analysis of eight pediatric patients with solitary hyperfunctioning thyroid nodules over a 12-year period.
    • Thyroid scintigraphy, thyroid function tests (T4, T3, TSH), TRH stimulation tests, and surgical histopathology were reviewed.

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    Main Results:

    • Seven female and one male patient (aged 7.1–15.0 years) presented with hyperfunctioning nodules.
    • One patient had overt hyperthyroidism; three had subclinical hyperthyroidism, with one progressing over time.
    • A significant negative correlation was observed between serum T3 levels and TRH-stimulated TSH peak (r = -0.829, p < 0.02).
    • Seven nodules were benign adenomas; one was a papillary adenocarcinoma.

    Conclusions:

    • Solitary hyperfunctioning thyroid nodules in pediatric patients can cause thyrotoxicosis, ranging from subclinical to overt.
    • While malignancy is uncommon, surgical intervention is advised for thyrotoxic, enlarged, or progressively growing nodules.
    • Histopathological evaluation is essential to rule out malignancy, even in hyperfunctioning nodules.