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Management of Thyroid Nodules in Children: A single-center experience
Malika El Omri1, Oumaima Gabsi1, Mouna Bellakhdher1
1Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, University of Sousse, Sousse, 4000, Tunisia.
Insights
Pediatric thyroid nodules are rare but require prompt evaluation due to malignancy risk. This study analyzed 29 pediatric cases, detailing nodule characteristics and surgical outcomes for effective management.
Area of Science:
- Pediatric Endocrinology
- Otolaryngology
- Surgical Oncology
Background:
- Thyroid nodules are infrequent in children, unlike adults.
- Early diagnosis and management are critical due to a higher potential for malignancy in pediatric cases.
- This study focuses on characterizing pediatric thyroid nodules to guide therapeutic strategies.
Purpose of the Study:
- To describe the clinical and pathological characteristics of thyroid nodules in pediatric patients.
- To evaluate the surgical management and outcomes of children with thyroid nodules.
- To inform diagnostic and therapeutic approaches for pediatric thyroid nodules.
Main Methods:
- A retrospective analysis of 29 pediatric patients who underwent surgery for thyroid nodules between 2000 and 2022.
- Review of patient demographics, presenting symptoms, surgical procedures, histological findings, and follow-up data.
- Data collected from the ENT department's surgical records.
Main Results:
- The study included 29 children (average age 14.4 years, predominantly female).
- Anterior cervical swelling was the most common symptom (82.7%).
- Papillary carcinoma was diagnosed in 13.8% of cases; all patients experienced favorable outcomes post-surgery.
Conclusions:
- Thyroid nodules in children necessitate thorough evaluation, including ultrasound and cytology, to assess malignancy risk.
- Appropriate surgical management based on these evaluations is crucial for favorable outcomes.
- Understanding nodule characteristics aids in planning effective therapeutic strategies for pediatric thyroid nodules.
Introduction:
Thyroid nodules are a common diagnosis in adults. However, in children, they are rare, occurring in only 1-5% of cases. Early diagnosis and prompt management are crucial due to the higher likelihood of malignancy. The aim of this study was to describe the characteristics of thyroid nodules in children and plan their therapeutic management.
Materials And Methods:
A retrospective study was conducted on 29 children who underwent surgery for thyroid nodules at our ENT department between 2000 and 2022.
Results:
The average age of the patients was 14.4 years, with a clear predominance of females (sex ratio of 0.16). The primary complaint was the appearance of an anterior cervical swelling in 82.7% of cases. The surgical procedures performed on the thyroid gland included isthmectomy in one patient, lobectomy in 16 patients, and total thyroidectomy in 12 patients. Total thyroidectomy was performed in one step in 10 cases and in two steps in 2 cases where papillary carcinoma was found in the final histological examination of the lobectomy parts. Papillary carcinoma was confirmed in four cases (13.8%) after definitive histological examination. All patients had favourable outcomes. The mean follow-up was 31 months for benign cases and 15 months after the last course of radioactive iodine therapy for malignant cases.
Conclusion:
Thyroid nodules are uncommon in children. To evaluate the risk of malignancy in children with thyroid nodules, ultrasound and cytology should be performed. This will help determine the appropriate surgical management.
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