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Pediatric thyroid nodules: management in the era of fine needle aspiration.

Abstract：

BACKGROUND/PURPOSE:Thyroid nodules are rare in children. The need to uncover malignancy is the most challenging dilemma in management. The aim of this report was to determine whether management of pediatric thyroid nodules has changed in the era of fine-needle aspiration (FNA) cytology. METHODS:Twenty-four children with thyroid nodules comprised the study group. Demographic characteristics, clinical manifestations, imaging results, FNA cytology results, surgical therapy, complications, and pathological reports were reviewed retrospectively. FNA cytology results were categorized as either benign, malignant, suspicious, or insufficient. RESULTS:Girls outnumbered boys (five to one) with a mean age of 14.9 years. Nineteen nodules were benign and five malignant. Malignancy was characterized by localized tenderness, multiglandular appearance, and fixation to adjacent tissues. Ultrasound scans and nuclear scans gave no clue toward management because cystic, hot, and warm nodules figured among malignant cases. FNA in 18 children achieved 80% accuracy, 60% sensitivity, 90% specificity, 75% positive, and 81% negative predictive value. Physical examination findings, persistence of the nodule, and progressive growth decided for surgery in most children. CONCLUSIONS:FNA is a safe adjunctive test that plays a minor role in the decision to withhold surgery. Its greatest strength is to resolve, in case of suspicious or malignant cytology, that a more radical procedure will be needed. Clinical judgement as determined by serial physical findings continues to be the most important factor in the management of thyroid nodules in children.

journal_name

J Pediatr Surg

journal_title

Journal of pediatric surgery

authors

Lugo-Vicente H,Ortíz VN,Irizarry H,Camps JI,Pagán V

doi

10.1016/s0022-3468(98)90174-9

subject

Has Abstract

pub_date

1998-08-01 00:00:00

pages

1302-5

issue

8

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(98)90174-9

journal_volume

33

pub_type

临床试验,杂志文章

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