Intrathyroidal thymic tissue in children: Avoiding unnecessary surgery.

Abstract:

BACKGROUND/PURPOSE:Intrathyroidal thymic tissue may be misinterpreted as a thyroid lesion in children, leading to invasive tests or resection. We sought to describe the characteristic imaging features of these lesions and to evaluate the safety of non-operative management. METHODS:A retrospective review of all patients less than 18years old with intrathyroidal thymic tissue from 2000 to 2016 was performed. Data collection included patient demographics, imaging results, interventions, and outcomes. RESULTS:Eleven patients were identified using institutional radiology and pathology databases. Median patient age and lesion size at presentation were 5years old (range 2 to 8years old) and 0.9cm (range 0.4 to 9.2cm), respectively. Six lesions were incidentally identified, six were left-sided, and the most common location was the lower pole. Ultrasonographic features were reproducible and included well demarcated (10/11), hypoechoic lesions (11/11), containing punctate/linear internal echoes (11/11), and occasional mild hypervascularity (6/11). All cases demonstrated interval size and echotexture stability over a median surveillance period of 3years (range 1 to 8years). While 9 patients were simply observed, the first patient in this series underwent excision, while another had a fine needle aspiration to confirm pathology. LEVEL OF EVIDENCE:Study of diagnostic test, Level IV. CONCLUSION:Intrathyroidal thymic tissue has typical clinical and sonographic characteristics which allow for appropriate diagnosis and avoids thyroid resection.

journal_name

J Pediatr Surg

authors

Kay-Rivest E,Mascarella MA,Puligandla P,Emil S,Saint-Martin C,Nguyen LHP,Daniel SJ,Baird R

doi

10.1016/j.jpedsurg.2018.02.011

subject

Has Abstract

pub_date

2018-05-01 00:00:00

pages

1010-1013

issue

5

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(18)30065-4

journal_volume

53

pub_type

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