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A Standardized Assessment Of Thyroid Nodules In Children Confirms Higher Cancer Prevalence Than In Adults.

Anjuli Gupta, Samantha Ly, Luciana Audi Castroneves, Mary C Frates, Carol B Benson, Henry A. Feldman, Ari J Wassner, Jessica R. Smith, Ellen Marqusee, Erik K. Alexander, Justine A Barletta, Peter M Doubilet, Hope E. Peters, Susan M Webb, Biren P Modi, Harriet J Paltiel, Harry P. W. Kozakewich, Edmund S Cibas, Francis D. Moore, Robert C. Shamberger, P. Reed Larsen, Stephen A. Huang
Published 2013 · Medicine
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CONTEXT Thyroid cancer is the most common endocrine malignancy, but due to its rare occurrence in the pediatric population, the cancer risk of childhood thyroid nodules is incompletely defined, and optimal management of children with suspected nodules is debated. OBJECTIVE The aim was to study the presenting features and cancer risk of sporadic childhood thyroid nodules using a standardized clinical assessment and management plan. DESIGN AND SETTING Boston Children's Hospital and Brigham and Women's Hospital collaborated to create a multidisciplinary pediatric thyroid nodule clinic and implement a standardized assessment plan. Upon referral for a suspected nodule, serum TSH was measured and hypothyrotropinemic patients underwent (123)I scintigraphy. All others underwent thyroid ultrasonography, and if this confirmed nodule(s) ≥ 1 cm, ultrasound-guided fine-needle aspiration was performed. Medical records were retrospectively reviewed and compared to a control population of 2582 adults evaluated by identical methods. PATIENTS AND RESULTS Of 300 consecutive children referred for the initial evaluation of suspected thyroid nodules from 1997 to 2011, 17 were diagnosed with autonomous nodules by scintigraphy. Neck ultrasonography performed in the remainder revealed that biopsy was unnecessary in over half, either by documenting only sub-centimeter nodules or showing that no nodule was present. A total of 125 children met criteria for thyroid biopsy, which was performed without complication. Their rate of cancer was 22%, significantly higher than the adult rate of 14% (P = .02). CONCLUSIONS Neck ultrasonography and biopsy were key to the evaluation of children with suspected thyroid nodules. Although the relative cancer prevalence of sonographically confirmed nodules ≥ 1 cm is higher in pediatric patients than adults, most children referred for suspected nodules have benign conditions, and efforts to avoid unnecessary surgery in this majority are warranted.
This paper references
roid surgery at Children ’ s Hospital Boston : a 35 - year single - institution experience
D Koller (2011)
Distraction techniques for children undergoing procedures: a critical review of pediatric research.
Donna F Koller (2012)
Current controversies in the management of pediatric patients with well-differentiated nonmedullary thyroid cancer: a review.
Wellington Hung (2002)
Diagnostic features of thyroid nodules in pediatrics.
Andrea Corrias (2010)
FNAC is as reliable a method for assessing thyroid nodules in children as in adults. Fine Needle Aspiration Cytology of the Thyroid in Children and Adolescents Experience with 792 Aspirates
Kusum Kapila (2010)
Nodular lesions of the thyroid gland in children.
Alvin B. Hayles (1956)
Fine needle aspiration cytology of the thyroid: a comparison of 5469 cytological and final histological diagnoses.
Gabriele Sangalli (2006)
The Canadian Pediatric Thyroid Nodule Study: an evaluation of current management practices.
Chris Stevens (2008)
Thyroid Fine Needle Aspiration Biopsies in Children: Study of Cytological-Histological Correlation and Immunostaining with Thyroid Peroxidase Monoclonal Antibodies
Victoria Hoperia (2010)
Thyroid fine needle aspiration cytology in children and adolescents.
Sandra Moslavac (2010)
Usefulness of Ultrasonography in the Management of Nodular Thyroid Disease
Ellen Marqusee (2000)
Thyroid Nodules in Children: A Single Institution's Experience
Nini Khozeimeh (2011)
Cancer; a review.
Margaret F. Knapp (1956)
nodules in children and adolescents
N Khozeimeh (2009)
Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer.
David S. Cooper (2009)
Clinical and economic outcomes of thyroid and parathyroid surgery in children.
Julie Ann Sosa (2008)
Predictive factors of malignancy in pediatric thyroid nodules.
Rashmi Roy (2011)
Cold thyroid nodules in childhood: is surgery always necessary?
Guy van Vliet (1987)
Ultrasound-guided fine-needle aspiration in the management of thyroid nodules in children and adolescents.
R. E. Martín Izquierdo (2009)
Thyroid surgery at Children's Hospital Boston: a 35-year single-institution experience.
Stefan Scholz (2011)
Form-based clinical input from a structured vocabulary: initial application in ultrasound reporting.
David S H Bell (1992)
Topical anaesthesia with EMLA, a new lidocaine-prilocaine cream and the Cusum technique for detection of minimal application time.
G Ehrenström-Reiz (1983)
The spectrum of thyroid diseases in childhood and its evolution during transition to adulthood: Natural history, diagnosis, differential diagnosis and management
Christian A. Koch (2001)
Pediatric endocrine surgery: who is operating on our children?
Charles T. Tuggle (2008)
Initial management and follow-up of differentiated thyroid cancer in children.
Steven G. Waguespack (2010)
Fine needle aspiration biopsy: role in diagnosis of pediatric head and neck masses.
Samantha Anne (2008)
The incidence of cancer and rate of false-negative cytology in thyroid nodules greater than or equal to 4 cm in size.
Kelly L. Mccoy (2007)
Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation.
Leila Yassa (2007)
"Atypical" cells in fine-needle aspiration biopsy specimens of benign thyroid cysts.
William C Faquin (2005)
nodules and differentiated thyroid cancer
R Roy (2009)
The treatment of differentiated thyroid cancer in children: emphasis on surgical approach and radioactive iodine therapy.
Scott A. Rivkees (2011)
A novel approach to gathering and acting on relevant clinical information: SCAMPs.
Rahul H Rathod (2010)
Is Ultrasonography Useful in Predicting Thyroid Cancer in Children with Thyroid Nodules and Apparently Benign Cytopathologic Features?
Jannette Saavedra (2011)
High likelihood of malignancy in young patients presenting with a thyroid nodule in Northern England.
Furrukh Jamil (2013)
Research electronic data capture (REDCap) - A metadata-driven methodology and workflow process for providing translational research informatics support
Paul A. Harris (2009)
Thyroid fine-needle aspiration biopsy in children and adolescents: experience with 218 aspirates.
Mojghan Amrikachi (2005)
Accuracy of fine-needle aspiration biopsy for predicting neoplasm or carcinoma in thyroid nodules 4 cm or larger.
Scott N. Pinchot (2009)
Thyroid nodules and cancer in children with PTEN hamartoma tumor syndrome.
Jessica R. Smith (2011)

This paper is referenced by
Surgical Management of Thyroid Disease in Children
Roberto Sobrino Solís (2018)
The role of thyroid FNA cytology in pediatric malignant lesions: An overview of the literature.
Esther Diana Rossi (2017)
Pediatric thyroid surgery and management of thyroid nodules – an institutional experience over a 10-year period
Wen Jiang (2016)
Adolescents with thyroid nodules: retrospective analysis of factors predicting malignancy
Junghwan Suh (2019)
Imaging and Imaging-Based Management of Pediatric Thyroid Nodules
Ioannis Iakovou (2020)
Differentiated Thyroid Cancer in Children: Prevalence and Predictors in a Large Cohort with Thyroid Nodules Followed Prospectively.
Patricia Papendieck (2015)
Noninvasive encapsulated follicular variant of papillary thyroid carcinoma: Should it also be reclassified in children?
Rachel Mariani (2018)
Ultrasonography and the American Thyroid Association Ultrasound-Based Risk Stratification Tool: Utility in Pediatric and Adolescent Thyroid Nodules
Ana L Creo (2018)
A clinical pathway for the postoperative management of hypocalcemia after pediatric thyroidectomy reduces blood draws.
Neha A. Patel (2018)
Thyrotropin serum levels and coexistence with Hashimoto’s thyroiditis as predictors of malignancy in children with thyroid nodules
Giuseppina Zirilli (2019)
Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer.
Gary L. Francis (2015)
Initial and Dynamic Risk Stratification of Pediatric Patients With Differentiated Thyroid Cancer
Tae Yon Sung (2017)
Comprehensive Survey Results of Childhood Thyroid Ultrasound Examinations in Fukushima in the First Four Years After the Fukushima Daiichi Nuclear Power Plant Accident
SuzukiShinichi (2016)
Features and Outcome of Autonomous Thyroid Nodules in Children: 31 Consecutive Patients Seen at a Single Center.
Samantha Ly (2016)
Thyroid Nodules in Children
Siobhan T Pittock (2018)
Comparison of two different standards of care in detecting malignant thyroid nodules using thyroid fine-needle aspiration.
Xiaoyun Liu (2015)
The Thyroid Nodule: Evaluation, Risk of Malignancy, and Management
Léonard Wartofsky (2016)
Management of Childhood Thyroid Nodules: Surgical and Endocrinological Findings in a Large Group of Cases
Emre Divarci (2017)
Differentiated Thyroid Cancer in Children: A UK Multicentre Review and Review of the Literature.
Kyu An Lee (2019)
Evaluation and management of thyroid nodules in children
Andrew J Bauer (2016)
Long- versus short-interval follow-up of cytologically benign thyroid nodules: a prospective cohort study
Marco Medici (2016)
Do Thyroid Nodule Volume and Multicentricity in Childhood Effective on Malignancy
Kemal Ayengin (2020)
The Thyroid Nodules in Kids study (ThyNK study): An evaluation of clinical practice variation.
AlGhalya Al Maawali (2020)
Risk of malignancy for each Bethesda class in pediatric thyroid nodules.
Olov Norlén (2015)
Differentiated thyroid cancer in childhood: a literature update
Olga Karapanou (2017)
Young age is associated with increased rates of residual and recurrent paediatric differentiated thyroid carcinoma
Sarah Cote Hampson (2018)
Best practice for the management of pediatric thyroid cancer
Olov Norlén (2014)
Comments to part of the American thyroid association guidelines for the management of thyroid nodules in children
Alexey Vasil'evich Kiyaev (2016)
Trends in Thyroid Cancer Incidence in Korean Children (1999-2012) Based on Palpation and Nonpalpation Detection Methods
Yoon Young Cho (2015)
Management of Differentiated Thyroid Cancer in Children: Focus on the American Thyroid Association Pediatric Guidelines.
Marguerite T. Parisi (2016)
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