ESPE2015 Poster Category 3 Thyroid (64 abstracts)
Thyroid Nodules in Children and Adolescents
Gema Grau Bolado a , Maite Perez de Ciriza Cordeu b , Andrea Cerezo Aguirre c , Javier Nuñez Rodriguez c, , Amaia Vela Sojo a, , Amaia Rodriguez Estevez a , Itxaso Rica Echevarria a & Concepcion Fernandez Ramos c,
aPediatric Endocrinology Unit, Cruces University Hospital, Biocruces, Barakaldo, Vizcaya, Spain; bEndocrinology, Basurto University Hospital, Bilbao, Vizcaya, Spain; cPediatric Endocrinology Unit, Basurto University Hospital, Bilbao, Vizcaya, Spain; dEHU/UPV, Basque Country, Spain
Background: The presence of a thyroid nodule (TN) is a rare clinical condition during childhood and adolescence. In children, classically was considered malignant and total thyroidectomy was recommended whenever a TN was detected or in the case of cold nodules. There are not long time series in children, but recent clinical guidelines recommend an initial management as in adults.
Objective and hypotheses: Review TN in children in our area.
Method: Retrospective study (1999–2014) of TN >1 cm in children (0–15 years) in our area (138 000 pediatric population).
Results: We found 15 TN, determining an incidence of 0.7/100 000 per year. Diagnostic was done by palpation in 40%. Mean age was 12.6 years and 80% were girls. Thyroiditis was associated in a 26.7%. Radiation history was related in a 13.3% and a 46% had familiar history of non-malignant thyroid disease. Thyroid function was normal in all cases. Long diameter in US was 2.6±1.6 cm. Only in six cases scintingraphy was performed, being three cold nodules. Fine needle aspiration biopsy (FNAB) and/or guided aspiration biopsy (GAB) was done in all nodules. Five of them were considered ‘non benign’ and surgery was indicated. Malignant diagnostic in macroscopic study was confirmed in four TN.
| US (cm) | Scint | PAAF | GAB | Surgery | Diagnostic | Follow-up | |
| Case 1 | 7.5 | No | Papillary | No | Total | C. papillary | NR |
| Case 2 | 5 | Cold | Follicular | No | Total | C. follicular | NR |
| Case 3 | 3 | Cold | No | Follicular | Hemi | A. follicular | Benign |
| Case 4 | 2.5 | Hot | Follicular | Benign | Total | C. papillary | NR |
| Case 5 | 2 | No | No | Papillary | Total | C. papillary | NR |
| NR, no recurrence; C, cancer; A, adenoma. | |||||||
Conclusion: TN >1 cm is a rare and a serious clinical condition in children. In this study, 26.6% of TN were malignant. In children, as in adults, we consider the use of PAAF and/or GAB always necessary to a correct management of TN.
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