Management of Childhood Thyroid Nodules: Surgical and Endocrinological Findings in a Large Group of Cases
| Autor: | Orkan Ergün, Zafer Dokumcu, Geylani Özok, Samim Özen, Şükran Darcan, Yeşim Ertan, Ahmet Çelik, Bengü Demirağ, Emre Divarci, Nazan Çetingül, Damla Gökşen Şimşek, Aylin Oral, Ulgen Celtik |
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| Přispěvatelé: | Ege Üniversitesi |
| Rok vydání: | 2017 |
| Předmět: |
Thyroid nodules
Male medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism medicine.medical_treatment surgical experience 030209 endocrinology & metabolism Malignancy Thyroid carcinoma 03 medical and health sciences 0302 clinical medicine Endocrinology fine-needle aspiration biopsy medicine Humans Thyroid Nodule Child Letter to the Editor Retrospective Studies Solitary pulmonary nodule business.industry Incidence (epidemiology) Thyroid Neck dissection Nodule (medicine) medicine.disease frozen section Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis Child Preschool Pediatrics Perinatology and Child Health thyroidectomy Female medicine.symptom business papillary carcinoma pediatric surgeon |
| Zdroj: | Journal of Clinical Research in Pediatric Endocrinology |
| ISSN: | 1308-5735 |
| Popis: | WOS: 000410406300006 PubMed ID: 28387647 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. |
| Databáze: | OpenAIRE |
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