Background: Thyroid nodules are less common in childhood but it has higher risk of malignancy. In this study, we aimed to evaluate children and adolescents with thyroid nodules, clinically, radiologically and histopathologically to determine etiologic distrubution.
Method: Seventy-one patients (46 females) with the mean age of 10.41±5.03 (0.0421) years with thyroid nodules were involved in this study. Patients were evaluated by their complaints at admission, physical examination, thyroid functions and autoantibodies, and thyroid ultrasounds. Fine needle aspiration biopsy (FNAB) was suggested in the patients with nodule size ≥1 cm or 0.51 cm and if there is family history of thyroid ca, increased vascularity in doppler usg or microcalcification.
Results: The most frequent complaint was swelling of neck (n=20.27%). Thyroid nodule was diagnosed incidentally in 16 (22%) patients. In 12 (16.4%) patients, family history of thyroid disease was observed. Hypothyroidism, subclinical hypothyroidism, hyperthyroidism and subclinical hypothyroidism were determined in 6 (8.2%), 3 (4.1%), 1 (1.36%) and 3 (4.1%) of the patients respectively. In the ultrasonographic evaluation, nodule size was ≥1 cm, 0.51 cm, and <0.5 cm in 26 (36.6%), 24 (33.8%), and 21 (29.5%) of the patients. In 18 patients FNAB was performed and in 7 (9.8%) patients carcinoma (papillary (n=3), follicular (n=2), follicular varient papillary (n=1) and hurthle cell (n=1)) was diagnosed. Adenoma and chronic lymphocytic thyroiditis (CLT) were diagnosed in 7 (9.8%) and 4 (5.6%) of the patients. All of the patients with carcinoma had nodule size >1 cm and none of them had thyroid dysfunction at the diagnosis. In two patients with papillary carcinoma there were microcalcifications in the preoperation ultrasound in whom one also had CLT. Three patients with nodule size between 0.5 and 1 cm and had FNAB were diagnosed as CLT. Overall etiological distrubution was as adenoma, carcinoma, CLT, congenital hypothyroidism and nodular goiter in 7 (9.8%), 7 (9.8%), 22 (30.9%), 2 (2.81%), and 33 (46.7%) of the patients.
Conclusion: Although in most of the patients we couldnt identify a specific etiology, significant amount of patients had carcinoma, that should attract attention.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology