Thyroid nodules in children are less common than adults. However, pediatric thyroid nodules have higher rate of malignancy compared with adults, and also have increased risk of metastasis and recurrence. In this study, we analyzed clinical features, laboratory findings, and thyroid ultrasound (US) of children with thyroid nodules to determine predictive factors of thyroid cancer. Total 268 patients under 18 years of age with thyroid nodule whom visited Severance Childrens Hospital from January 2005 to May 2017 were retrospectively reviewed. Patients were divided into thyroid cancer group and benign nodule group, and clinical, laboratory, US data had been compared. Variables with statistical significance were used to analyze predictive factors of thyroid cancer. Among the 268 patients, 101 patients were diagnosed with thyroid cancer, and the remainder of 167 patients were set to be benign nodule group. Thyroid mass was more often palpated in thyroid cancer group, whereas grade 2 goiter was more often seen in benign nodule group. The size of thyroid nodule was larger in thyroid cancer group. Nodule with microcalcifications, regional lymph node alterations, irregular margins, and intranodular blood flow on US were significantly related to thyroid cancer. Palpable thyroid nodule, nodule with microcalcifications, and lymph node alterations showed statistical significance in predicting thyroid cancer, while mixed echogenicity on US suggested benign nodule. In conclusion, palpable thyroid nodule, nodule with microcalcifications, and lymph node alterations are predictive factors of thyroid cancer, so further evaluation including fine needle aspiration biopsy should be considered in patients with these findings.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology