Advertisement

Thyroid Nodules in Children

  • Geoffrey K. BlairEmail author
  • Daniel J. LedbetterEmail author
Chapter

Abstract

Nodular disease of the thyroid, as with other thyroid disorders, is much less common in children than in adults but it is a regular occurrence in regional centers that provide comprehensive care for children and adolescents. The major clinical concern of thyroid nodules in both children and adults is the risk of malignancy. Since the risk of a thyroid nodule being malignant seems to be higher in children than adults, children presenting with thyroid nodules deserve the same organized approach to their evaluation that adults receive. This chapter will present one approach to the evaluation and management of thyroid nodules in children.

Keywords

Thyroid nodules Incidentalomas Thyroid mass Thyroid lesions Thyroid neoplasms 

References

  1. 1.
    Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, Evans JG, Young E, Bird T, Smith PA. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol. 1977;7:481–93.CrossRefGoogle Scholar
  2. 2.
    Tan GH, Gharib H. Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Ann Intern Med. 1997;126:226–31.CrossRefPubMedGoogle Scholar
  3. 3.
    Hagag P, Strauss S, Weiss M. Role of ultrasound-guided fine-needle aspiration biopsy in evaluation of nonpalpable thyroid nodules. Thyroid (official journal of the American Thyroid Association). 1998;8:989–95.CrossRefGoogle Scholar
  4. 4.
    Marqusee E, Benson CB, Frates MC, Doubilet PM, Larsen PR, Cibas ES, Mandel SJ. Usefulness of ultrasonography in the management of nodular thyroid disease. Ann Intern Med. 2000;133:696–700.CrossRefPubMedGoogle Scholar
  5. 5.
    American Thyroid Association Guidelines Taskforce on Thyroid N, Differentiated Thyroid C, Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, McIver B, Pacini F, Schlumberger M, Sherman SI, Steward DL, Tuttle RM. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid (official journal of the American Thyroid Association). 2009;19:1167–1214.Google Scholar
  6. 6.
    Rallison ML, Dobyns BM, Keating FR Jr, Rall JE, Tyler FH. Thyroid nodularity in children. Jama. 1975;233:1069–72.CrossRefPubMedGoogle Scholar
  7. 7.
    Rallison ML, Dobyns BM, Meikle AW, Bishop M, Lyon JL, Stevens W. Natural history of thyroid abnormalities: prevalence, incidence, and regression of thyroid diseases in adolescents and young adults. Am J Med. 1991;91:363–70.CrossRefPubMedGoogle Scholar
  8. 8.
    Josefson J, Zimmerman D. Thyroid nodules and cancers in children. Pediatr Endocrinol Rev PER. 2008;6:14–23.PubMedGoogle Scholar
  9. 9.
    Hegedus L. Clinical practice. The thyroid nodule. New Engl J Med. 2004;351:1764–71.CrossRefPubMedGoogle Scholar
  10. 10.
    Farahati J, Bucsky P, Parlowsky T, Mader U, Reiners C. Characteristics of differentiated thyroid carcinoma in children and adolescents with respect to age, gender, and histology. Cancer. 1997;80:2156–62.CrossRefPubMedGoogle Scholar
  11. 11.
    Harach HR, Williams ED. Childhood thyroid cancer in England and Wales. Br J Cancer. 1995;72:777–83.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Canadian Pediatric Thyroid Nodule Study G. The Canadian Pediatric Thyroid Nodule Study: an evaluation of current management practices. J Pediatr Surg. 2008;43:826–30.CrossRefGoogle Scholar
  13. 13.
    Wiersinga WM. Management of thyroid nodules in children and adolescents. Hormones. 2007;6:194–9.PubMedGoogle Scholar
  14. 14.
    Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedus L, Vitti P, Nodules AAETFoT. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. J Endocrinol Inv. 2010;33:1–50.Google Scholar
  15. 15.
    Niedziela M. Pathogenesis, diagnosis and management of thyroid nodules in children. Endocr Relat Cancer. 2006;13:427–53.CrossRefPubMedGoogle Scholar
  16. 16.
    Francis GL, Waguespack SG, Bauer AJ, Angelos P, Benvenga S, Cerutti JM, Dinauer CA, Hamilton J, Hay ID, Luster M, Parisi MT, Rachmiel M, Thompson GB, Yamashita S. Management guidelines for children with thyroid nodules and differentiated thyroid cancer. Thyroid (official journal of the American Thyroid Association). 2015;25:716–59.CrossRefGoogle Scholar
  17. 17.
    Boelaert K, Horacek J, Holder RL, Watkinson JC, Sheppard MC, Franklyn JA. Serum thyrotropin concentration as a novel predictor of malignancy in thyroid nodules investigated by fine-needle aspiration. J Clin Endocrinol Metab. 2006;91:4295–301.CrossRefPubMedGoogle Scholar
  18. 18.
    Pacini F, Pinchera A, Giani C, Grasso L, Doveri F, Baschieri L. Serum thyroglobulin in thyroid carcinoma and other thyroid disorders. J Endocrinol Invest. 1980;3:283–92.CrossRefPubMedGoogle Scholar
  19. 19.
    Cheung K, Roman SA, Wang TS, Walker HD, Sosa JA. Calcitonin measurement in the evaluation of thyroid nodules in the United States: a cost-effectiveness and decision analysis. J Clin Endocrinol Metab. 2008;93:2173–80.CrossRefPubMedGoogle Scholar
  20. 20.
    Costante G, Meringolo D, Durante C, Bianchi D, Nocera M, Tumino S, Crocetti U, Attard M, Maranghi M, Torlontano M, Filetti S. Predictive value of serum calcitonin levels for preoperative diagnosis of medullary thyroid carcinoma in a cohort of 5817 consecutive patients with thyroid nodules. J Clin Endocrinol Metab. 2007;92:450–5.CrossRefPubMedGoogle Scholar
  21. 21.
    Elisei R, Bottici V, Luchetti F, Di Coscio G, Romei C, Grasso L, Miccoli P, Iacconi P, Basolo F, Pinchera A, Pacini F. Impact of routine measurement of serum calcitonin on the diagnosis and outcome of medullary thyroid cancer: experience in 10,864 patients with nodular thyroid disorders. J Clin Endocrinol Metab. 2004;89:163–8.CrossRefPubMedGoogle Scholar
  22. 22.
    Hegedus L. Thyroid ultrasonography as a screening tool for thyroid disease. Thyroid (official journal of the American Thyroid Association). 2004;14:879–80.CrossRefGoogle Scholar
  23. 23.
    Papini E, Guglielmi R, Bianchini A, Crescenzi A, Taccogna S, Nardi F, Panunzi C, Rinaldi R, Toscano V, Pacella CM. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab. 2002;87:1941–6.CrossRefPubMedGoogle Scholar
  24. 24.
    Cappelli C, Castellano M, Pirola I, Cumetti D, Agosti B, Gandossi E, Agabiti Rosei E. The predictive value of ultrasound findings in the management of thyroid nodules. QJM (monthly journal of the Association of Physicians). 2007;100:29–35.CrossRefGoogle Scholar
  25. 25.
    Moon WJ, Jung SL, Lee JH, Na DG, Baek JH, Lee YH, Kim J, Kim HS, Byun JS, Lee DH, Thyroid Study Group KSoN, Head, Neck R. Benign and malignant thyroid nodules: US differentiation-multicenter retrospective study. Radiology. 2008;247:762–70Google Scholar
  26. 26.
    Frates MC, Benson CB, Doubilet PM, Kunreuther E, Contreras M, Cibas ES, Orcutt J, Moore FD Jr, Larsen PR, Marqusee E, Alexander EK. Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J Clin Endocrinol Metab. 2006;91:3411–7.CrossRefPubMedGoogle Scholar
  27. 27.
    Schneider AB, Ron E, Lubin J, Stovall M, Gierlowski TC. Dose-response relationships for radiation-induced thyroid cancer and thyroid nodules: evidence for the prolonged effects of radiation on the thyroid. J Clin Endocrinol Metab. 1993;77:362–9.PubMedGoogle Scholar
  28. 28.
    Hemminki K, Eng C, Chen B. Familial risks for nonmedullary thyroid cancer. J Clin Endocrinol Metab. 2005;90:5747–53.CrossRefPubMedGoogle Scholar
  29. 29.
    Pitman MB, Abele J, Ali SZ, Duick D, Elsheikh TM, Jeffrey RB, Powers CN, Randolph G, Renshaw A, Scoutt L. Techniques for thyroid FNA: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn Cytopathol. 2008;36:407–24.CrossRefPubMedGoogle Scholar
  30. 30.
    Stevens C, Lee JK, Sadatsafavi M, Blair GK. Pediatric thyroid fine-needle aspiration cytology: a meta-analysis. J Pediatr Surg. 2009;44:2184–91.CrossRefPubMedGoogle Scholar
  31. 31.
    Izquierdo R, Arekat MR, Knudson PE, Kartun KF, Khurana K, Kort K, Numann PJ. Comparison of palpation-guided versus ultrasound-guided fine-needle aspiration biopsies of thyroid nodules in an outpatient endocrinology practice. Endocrine Pract (official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists). 2006;12:609–14.CrossRefGoogle Scholar
  32. 32.
    Baloch ZW, LiVolsi VA, Asa SL, Rosai J, Merino MJ, Randolph G, Vielh P, DeMay RM, Sidawy MK, Frable WJ. Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn Cytopathol. 2008;36:425–37.CrossRefPubMedGoogle Scholar
  33. 33.
    Alexander EK, Heering JP, Benson CB, Frates MC, Doubilet PM, Cibas ES, Marqusee E. Assessment of nondiagnostic ultrasound-guided fine needle aspirations of thyroid nodules. J Clin Endocrinol Metab. 2002;87:4924–7.CrossRefPubMedGoogle Scholar
  34. 34.
    Braga M, Cavalcanti TC, Collaco LM, Graf H. Efficacy of ultrasound-guided fine-needle aspiration biopsy in the diagnosis of complex thyroid nodules. J Clin Endocrinol Metab. 2001;86:4089–91.CrossRefPubMedGoogle Scholar
  35. 35.
    de los Santos ET, Keyhani-Rofagha S, Cunningham JJ, Mazzaferri EL. Cystic thyroid nodules. Dilemma Malignant Lesions Arch Intern Med. 1990;150:1422–7.Google Scholar
  36. 36.
    Carmeci C, Jeffrey RB, McDougall IR, Nowels KW, Weigel RJ. Ultrasound-guided fine-needle aspiration biopsy of thyroid masses. Thyroid (official journal of the American Thyroid Association). 1998;8:283–9.CrossRefGoogle Scholar
  37. 37.
    Ylagan LR, Farkas T, Dehner LP. Fine needle aspiration of the thyroid: a cytohistologic correlation and study of discrepant cases. Thyroid (official journal of the American Thyroid Association). 2004;14:35–41.CrossRefGoogle Scholar
  38. 38.
    Bennedbaek FN, Hegedus L. Treatment of recurrent thyroid cysts with ethanol: a randomized double-blind controlled trial. J Clin Endocrinol Metab. 2003;88:5773–7.CrossRefPubMedGoogle Scholar
  39. 39.
    Norlen O, Charlton A, Sarkis LM, Henwood T, Shun A, Gill AJ, Delbridge L. Risk of malignancy for each Bethesda class in pediatric thyroid nodules. J Pediatr Surg. 2015;50:1147–9.CrossRefPubMedGoogle Scholar
  40. 40.
    Gharib H, Goellner JR, Johnson DA. Fine-needle aspiration cytology of the thyroid. A 12-year experience with 11,000 biopsies. Clin Lab Med. 1993;13:699–709.PubMedGoogle Scholar
  41. 41.
    Raval MV, Bentrem DJ, Stewart AK, Ko CY, Reynolds M. Utilization of total thyroidectomy for differentiated thyroid cancer in children. Ann Surg Oncol. 2010;17:2545–53.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2018

Authors and Affiliations

  1. 1.Division of Pediatric SurgeryBritish Columbia’s Children’s HospitalVancouverCanada
  2. 2.Seattle Children’s HospitalSeattleUSA

Personalised recommendations