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Related Experiment Videos

Pediatric thyroid nodules: insights in management

H Lugo-Vicente1, V N Ortíz

  • 1Department of Surgery, UPR School of Medicine, Rio Piedras, PR. titolugo@coqui.net

Boletin De La Asociacion Medica De Puerto Rico
|December 29, 1998
PubMed
Summary

Clinical judgment remains key in managing pediatric thyroid nodules, as current diagnostic tools like ultrasonography (US), radionuclear scans (RNS), and fine needle aspiration biopsy (FNAB) have limited impact on surgical decisions.

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Area of Science:

  • Pediatric Endocrinology
  • Oncology
  • Diagnostic Imaging

Background:

  • Pediatric thyroid nodules require multiple diagnostic studies to assess malignancy and surgical necessity.
  • Current diagnostic modalities include ultrasonography (US), radionuclear scans (RNS), and fine needle aspiration biopsy (FNAB).

Purpose of the Study:

  • To evaluate changes in the management of pediatric thyroid nodules with the use of current diagnostic tools.
  • To assess the effectiveness of US, RNS, and FNAB in guiding treatment decisions for pediatric thyroid nodules.

Main Methods:

  • Retrospective review of 24 children with thyroid nodules over a ten-year period.
  • Analysis of demographic data, clinical presentation, imaging findings (US, RNS), FNAB results, surgical outcomes, and pathology.

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  • Categorization of US, RNS, and FNAB results as benign, malignant, suspicious, or insufficient.

    • Main Results:

    • The study included 24 children (mean age 14.9 years), with a 5:1 female to male ratio. 79% of nodules were benign, and 21% were malignant.
    • Ultrasonography (US) showed 86% accuracy, 80% sensitivity, and 88% specificity. Radionuclear scans (RNS) had 26% accuracy, 80% sensitivity, and 11% specificity. Fine needle aspiration biopsy (FNAB) achieved 80% accuracy, 60% sensitivity, and 90% specificity.
    • Clinical findings such as nodule persistence, growth, and cosmetic concerns were primary surgical indications, not imaging results.

    Conclusions:

    • Diagnostic modalities like US, RNS, and FNAB played a minor role in surgical decisions for pediatric thyroid nodules.
    • US aided in aspirating cystic nodules, while RNS assessed functionality but lacked ideal accuracy. FNAB was valuable for suspicious or malignant cytology.
    • Clinical judgment, based on serial physical examinations and suspicion, remains the most critical factor in managing pediatric thyroid nodules.