Evaluation of children with solid thyroid nodules: a single-center experience

Area of Science:

• Pediatric Endocrinology
• Oncology
• Diagnostic Imaging

Background:

• Thyroid nodules are less common in children than adults but carry a higher risk of malignancy.
• Accurate diagnosis of pediatric thyroid nodules is crucial for appropriate management.

Purpose of the Study:

• To analyze cytopathological and histopathological features of solid thyroid nodules in pediatric patients.
• To assess the diagnostic utility of ultrasonography (US) findings in these nodules.

Main Methods:

• Retrospective review of 53 pediatric patients with solid thyroid nodules undergoing biopsy.
• Classification of biopsy results using the Bethesda System.
• Evaluation of ultrasonographic features suggestive of malignancy.

Main Results:

• The majority of patients were female (81.1%), with a median age of 16.1 years.
• Bethesda categories included benign (47.2%), nondiagnostic (24.5%), and suspicious/malignant (9.4%).
• Papillary thyroid carcinoma (PTC) was diagnosed in 63.2% of surgically treated patients, often with multiple suspicious US findings. PTC was also found in two patients with benign cytology.

Conclusions:

• Thyroid nodule malignancy risk is higher in children, necessitating integrated diagnostic approaches.
• Surgical decisions should combine ultrasonographic risk assessment and Bethesda cytology.
• Consider surgery for nodules with multiple suspicious US features, even with benign or indeterminate cytology.