60th Annual Meeting of the European Society for Paediatric Endocrinology, Rome, İtalya, 15 - 17 Eylül 2022, cilt.95, sa.2, ss.418
Introduction: Although thyroid nodule is seen less frequently
in childhood than in adults, it is more likely to be malignant. The
aim of this study was to examine the characteristics of the patients
followed up for thyroid nodules and to define the patients with
malignant potential by laboratory,radiological and cytological
evaluations.
Method: 100 patients (F/M:63/37) with thyroid nodules followed up in Pediatric Endocrinology Clinic between 2010-2021
were retrospectively reviewed. Clinical, laboratory,imaging
findings,cytology and histological results of the operated patients
were recorded.
Results: The mean age at diagnosis was 12.9 ± 4.1 years.In the
ultrasonographic (USG) evaluation,70% of the patients had a single nodule.The size of the nodules was ≥1 cm in 44% of the
patients.48% of the nodules were solid,58% of them were
hypoechoic.19%(n=9) of 48 patients who underwent fine needle
aspiration biopsy (FNAB) had inadequate/non-diagnostic
cytology,37.5%(n=18) were benign,12.5%(n=6) atypia/undetermined significance (AUS/FLUS),29%(n=14) suspected/malignant.22 patients underwent surgical treatment; total thyroidectomy
was performed in 77%(n=17), lymph node dissection was performed in 68%(n=15) of the patients.The most common papillary
carcinoma (68%,n=15) was detected, while the histology of 3
patients was benign. The histology of 4/6 patients whose cytology
was AUS/FLUS was found to be malignant (Papillary carcinoma).
Due to the suspicion of malignancy in the follow-up of 4 patients
whose cytology was benign, surgery was performed and the histology of 2 of them was found to be compatible with malignancy.Lenf
node metastasis was detected in 66%(n:10/15) patients.Nodules of
17 patients with malignancy were found to be single in
82%(n=14),94%(n=16) ≥1cm in size,76%(n=13) solid,58%(n=10)
hypoechoic and 41%(n=7) of them had microcalcification.
Age,gender,thyroid function tests,autoantibody positivity nodule
size,number of nodules,increased blood supply were not found to
be associated with malignancy,while the presence of microcalcification, solid structure and hypoechoic nodule were associated with
malignancy (p<0.005). Conclusion: Malignancy was detected in 17% of our patients
followed up for thyroid nodules and 37% of those who underwent
FNAB.Although the Bethesda classification of FNAB can be
applied reliably in children,the malignancy rate was found to be
higher in surgically removed nodules,especially in those with
cytology of AUS/FLUS,compared to adults.In addition to the
result of FNAB,it is important to make a careful evaluation in
terms of malignancy in patient of sonographic findings such as
microcalcification of the nodules,solid and hypoechoic structure.