Thyroid nodules in childhood and adolescence

Thyroid nodules are uncommon in the paediatric age group. One hundred and twenty-two children and adolescents underwent thyroidectomy for nodular thyroid disease in the Endocrine Surgical Unit at the Royal North Shore Hospital over a 37 year period. In the adolescent age group (13-18 years) 99 thyroidectomies were performed and the pattern of thyroid disease was similar to that seen in adults. In the prepubertal are group (0-12 years), the major difference was the high incidence of thyroid malignancy, especially in males. Of 23 prepubertal children undergoing thyroidectomy for nodular disease, malignancy was found in 38% of boys and 13% of girls. Multicentric papillary cancer (66%) and cervical lymph node metastases (80%) were very common, despite which the long-term survival was excellent.