Thyroid nodules in children: review of 67 patients

J Mesquita; S Paco Lima; M J Matos; F Neiva; S Pauperio; S Martins; C Costa; C Castro Correia; Davide Carvalho; Manuel Fontoura

Introduction: Thyroid nodules in children and adolescents are less prevalent, but entail greater risk of malignancy than in adults. Most are asymptomatic because they are associated with normal thyroid function, but their prevalence is increasing due to the incidental diagnosis by neck ultrasound.

Aims: To evaluate the characteristics of a pediatric population with thyroid nodules submitted to fine-needle aspiration (FNA) biopsy.

Methods: We evaluated 67 children and adolescents followed in the Pediatric Endocrinology consultation of Hospital de São João-EPE because of thyroid nodules. We determined the demographic parameters of patients, thyroid function, nodules’ size by neck ultrasound, the result of FNA and histology (in patients who underwent surgery).

Results: Fifty-six patients were females (83.6%). Overall they had mean age of 14.6±3.7 years (4–18 years) and thyroid nodules mean size was 11.2±5.2 mm (9–21 mm). Thyroid function was normal in 60 patients (89.55%), with the remaining having hypothyroidism. Mean TSH was 2.3±1.1 μIU/ml (N: 0.35–4.94) and free T₄ was 1.1±0.16 ng/dl (0.7–1.48), after exclusion of patients with hypothyroidism.

FNA revealed lymphocytic thyroiditis in 14 patients (20.9%), papillary carcinoma in 5 patients (7.46%) and follicular tumor in 8 patients (11.94%). In the latter case, histology showed that 4 were follicular adenomas (50.0%), 3 were follicular variant of papillary carcinomas (37.5%) and 1 was follicular carcinoma (12.5%). Two of the patients whose FNA showed benign lesions underwent thyroidectomy for multinodular goiter and its histology showed that they were adenomatous goiters. Malignancy was confirmed in a total of 9 patients (13.4%).

Conclusions: The prevalence of malignancy in our sample was high, which is consistent with previous studies.

Endocrine Abstracts

P403