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[Solitary solid cold thyroid nodule in children and adolescents]
Archives Francaises De Pediatrie
|April 1, 1985
Summary
In children and adolescents, solid, hypofunctioning thyroid nodules require surgical biopsy for accurate diagnosis. Preoperative clinical and imaging tests cannot reliably predict the final histological outcome, necessitating surgical assessment.
Area of Science:
- Pediatric Endocrinology
- Surgical Pathology
- Thyroid Imaging
Background:
- Solitary hypofunctioning thyroid masses in pediatric patients present a diagnostic challenge.
- Current non-invasive diagnostic methods often lack predictive accuracy for underlying pathology.
Purpose of the Study:
- To evaluate the diagnostic utility of clinical, isotopic, and endocrinological investigations for solitary hypofunctioning thyroid masses in children and adolescents.
- To determine the necessity of surgical biopsy for definitive histological diagnosis in this population.
Main Methods:
- Retrospective analysis of 19 children and adolescents (aged 8-15 years) who underwent surgery for solitary hypofunctioning solid thyroid masses.
- Review of preoperative clinical examinations, isotopic scans (scintigraphy), and endocrinological tests.
- Correlation of preoperative findings with postoperative histopathological diagnoses (adenoma, carcinoma, thyroiditis).
Main Results:
- Histological examination revealed adenoma in 11 cases, carcinoma in 7 cases, and thyroiditis in 1 case.
- Preoperative clinical, isotopic, and endocrinological evaluations were not predictive of the final histological diagnosis.
- Solid nodules identified by ultrasonography and hypofixing on scintiscan did not reliably indicate malignancy.
Conclusions:
- Solitary, solid, hypofunctioning thyroid nodules in children and adolescents require surgical intervention for accurate histological diagnosis.
- Observation for a few months followed by biopsy with intraoperative histological assessment is recommended for these 'cold' nodules.