ISSN: 1308-5727 | E-ISSN: 1308-5735
Volume : 9 Issue : 3 Year : 2024
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Turkish Society for Pediatric Endocrinology and Diabetes
Management of Childhood Thyroid Nodules: Surgical and Endocrinological Findings in a Large Group of Cases [J Clin Res Pediatr Endocrinol]
J Clin Res Pediatr Endocrinol. 2017; 9(3): 222-228 | DOI: 10.4274/jcrpe.4272

Management of Childhood Thyroid Nodules: Surgical and Endocrinological Findings in a Large Group of Cases

Emre Divarcı1, Ülgen Çeltik1, Zafer Dökümcü1, Orkan Ergün1, Geylani Özok1, Samim Özen2, Damla Gökşen Şimşek2, Şükran Darcan2, Nazan Çetingül3, Aylin Oral4, Yeşim Ertan5, Bengü Demirağ6, Ahmet Çelik1
1Ege University Faculty Of Medicine, Department Of Pediatric Surgery, İzmir, Turkey
2Ege University Faculty Of Medicine, Division Of Pediatric Endocrinology, İzmir, Turkey
3Ege University Faculty Of Medicine, Division Of Pediatric Oncology, İzmir, Turkey
4Ege University Faculty Of Medicine, Department Of Nuclear Medicine, İzmir, Turkey
5Ege University Faculty Of Medicine, Department Of Pathology, İzmir, Turkey
6Dr. Behçet Uz Children’S Hospital, Division Of Pediatric Oncology, İzmir, Turkey

Objective: The management of childhood thyroid nodules is still a big challenge for clinicians. In this study, we aimed to present our surgical and endocrinological experience in more than one hundred pediatric cases.
Methods: A retrospective analysis of patients admitted with a thyroid nodule between 2006 and 2014 was performed. Detailed ultrasonography and fine-needle aspiration biopsy (FNAB) were the cornerstones of the diagnostic approach.
Results: One hundred-three children (72 female, 31 male) with a mean age of 13.1±3.6 years (3-18 years) were admitted to our center. Management strategy was surgery in 58 patients and follow-up in 45 patients. Mean nodule size was 17±12.7 mm (2-45 mm). The diagnoses were listed as benign solitary nodule (48 patients), thyroid carcinoma (26 patients), multinodular goiter (23 patients), Hashimoto thyroiditis (4 patients), and Graves’ disease (2 patients). Surgical procedures were nodulectomy/lobectomy (32 patients), total thyroidectomy (TT) (13 patients), or TT+ neck dissection (13 patients). The rate of malignancy was 25% in the total group and 44% in the surgery group. The malignancy rate was higher in patients younger than 12 years compared to older children (41% vs. 17%, p=0.040). Metastasis was seen in 38% of the malignant nodules. Postoperative complications were transient hypocalcemia (8%), permanent hypocalcemia (1.7%), and unilateral vocal cord paralysis (1.7%). Recurrence or mortality was not encountered in the 5.4±1.2-year follow-up period.
Conclusion: Thyroid nodule in a child requires an aggressive diagnostic approach due to increased risk of malignancy and metastasis. Intraoperative frozen section examination must be done as a useful adjunct to determine the surgical strategy. Incidence of complications is small in thyroid surgery when performed by experienced surgeons.

Keywords: Thyroid nodule,thyroidectomy,papillary carcinoma,frozen section,fine-needle aspiration biopsy

Emre Divarcı, Ülgen Çeltik, Zafer Dökümcü, Orkan Ergün, Geylani Özok, Samim Özen, Damla Gökşen Şimşek, Şükran Darcan, Nazan Çetingül, Aylin Oral, Yeşim Ertan, Bengü Demirağ, Ahmet Çelik. Management of Childhood Thyroid Nodules: Surgical and Endocrinological Findings in a Large Group of Cases. J Clin Res Pediatr Endocrinol. 2017; 9(3): 222-228
Manuscript Language: English
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