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Follicular adenoma of the thyroid gland in children: a clinical spectrum
Sylwester Gerus1, Marcin Rasiewicz1, Maciej Baglaj1
1Department of Pediatric Surgery and Urology, Wroclaw Medical University, Wroclaw, Poland.
Insights
Thyroid follicular adenoma is uncommon in children, presenting diverse clinical features. This study analyzed 56 pediatric cases, highlighting the need for a tailored management algorithm for this rare thyroid condition.
Area of Science:
- Pediatric Surgery
- Endocrinology
- Oncology
Background:
- Thyroid diseases in children are rare compared to adults.
- Follicular adenoma represents a significant portion of pediatric thyroid pathology.
- Understanding its clinical spectrum is crucial for effective management.
Purpose of the Study:
- To assess the clinical characteristics of thyroid follicular adenoma in pediatric patients.
- To develop a practical management algorithm for pediatric follicular adenoma.
- To analyze surgical outcomes and recurrence rates in children.
Main Methods:
- Retrospective review of pediatric patients operated for thyroid disease (1993-2018).
- Detailed analysis of medical files for 56 children diagnosed with follicular adenoma post-surgery.
- Assessment of clinical presentation, imaging, surgical procedures, and outcomes.
Main Results:
- Follicular adenoma was found in 30.6% of 183 pediatric thyroid surgery cases.
- Patients ranged from 7 to 18 years, with initial hypo- or hyperthyroidism in some.
- Ultrasound revealed solitary nodules in 66.1%, with suspicious cytology in 21.4%; 75% underwent lobectomy with no recurrences.
Conclusions:
- Pediatric follicular adenoma exhibits a broad clinical and morphological range.
- Associated systemic diseases and congenital anomalies suggest complex etiologies.
- Further research into endogenic factors influencing pediatric follicular adenoma is warranted.
Introduction:
Surgical diseases of the thyroid gland in children are rare in comparison with those in the adult population. The aim of the study was to assess clinical aspects of thyroid follicular adenoma in children and attempt to develop a management algorithm that is useful in clinical practice.
Material And Methods:
The clinical database of all children operated on due to thyroid disease in the years 1993-2018 at the university pediatric surgical center was reviewed. The children in whom the postoperative histology report showed follicular adenoma were selected and their medical files were analyzed in detail. Clinical course of the disease, medical and family history, results of imaging studies, details of surgical management and final outcome were assessed in each case.
Results:
Among 183 children operated on for thyroid pathology in the study period there were 56 patients with follicular adenoma (30.6%). Their age ranged from 7 to 18 years. Seven patients were found to be hypothyroid and a further seven showed hyperthyroid status initially. Ultrasound scan showed a solitary nodule in 37 (66.1%) children. Multiple nodules in one lobe were detected in 5 patients, while a further 14 children showed bilateral thyroid pathology. The result of preoperative cytologic examination was suspicious in 12 (21.4%) children. All children were subjected to operative management. Forty-two (75%) children underwent at least unilateral total lobectomy. No patient showed a recurrent thyroid disease.
Conclusions:
Follicular adenoma in children presents a wide clinical and morphological spectrum. High incidence of associated diseases of other systems and congenital anomalies of the thyroid gland may indicate a complex etiology of follicular adenoma with participation of still unknown endogenic factors in children.
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