[Benign thyroid gland diseases in childhood and adolescence--early indications for surgical therapy]

Thyroid diseases in childhood and adolescence are mainly diffuse goiters due to iodine deficiency, which should be treated conservatively. Thyrotoxicosis, in the majority due to Graves' disease, is usually treated conservatively, and remissions can be expected in only 20%. Our prospective data from 21 patients under 20 years of age show that primary surgery is favored in young patients because of its prompt and permanent success. Minimal postoperative morbidity is the precondition for this approach. Preoperative conservative treatment for more than 2 years causes a significantly higher incidence of persistent ophthalmopathy postoperatively. Thyroid nodes in children are malignant in 20-30%. Consequently, all children and adolescents with nodular thyroid disease should have a primary lobectomy.