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Open Access 01-12-2014 | Commentary

Thyroid nodules in childhood: indications for biopsy and surgery

Authors: Filippo De Luca, Tommaso Aversa, Luca Alessi, Valeria Cama, Daria Costanzo, Cristina Genovese, Veronica Scuderi, Roberta Vadalà, Giuseppe Zoccali

Published in: Italian Journal of Pediatrics | Issue 1/2014

Abstract

Aims of this commentary is to report the most recent views about epidemiology, diagnostic procedures, malignancy risk factors and clinical management of thyroid nodules in children. On the basis of our personal experiences and recent literature evidences, we conclude that: a) if nodule is accompanied by lymphadenopathy and/or other alert findings, fine-needle aspiration biopsy (FNAB) should be recommended; b) if no lymphadenopathy and no other clinical and ultrasonographic alert signs are observed, work-up can progress to FNAB only if nodule persists or grows over time, even under levo-thyroxine therapy.

National Institutes of Health: National Cancer Institute. Cancer statistics. 2012, Bethesda: Cancer statistics

SEER Cancer Statistics Review. Edited by: Howlader N, Noone AM, Krapcho M, Garshell J, Neyman N, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA. 1975, Bethesda, MD: National Cancer Institute,http://seer.cancer.gov/csr/1975_2010/, –2010,

Dean DS, Gharib H: Epidemiology of thyroid nodules. Best Pract Res Clin Endocrinol Metab. 2008, 22: 901-911. 10.1016/j.beem.2008.09.019.CrossRefPubMed

Niedzela M: Pathogenesis, diagnosis and management of thyroid nodules in children. Endocr Relat Cancer. 2006, 13: 427-453. 10.1677/erc.1.00882.CrossRef

Aghini-Lombardi F, Antonangeli L, Martino E, Vitti P, Maccherini D, Leoli F, Rago T, Grasso L, Valeriano R, Balestrieri A, Pinchera A: The spectrum of thyroid disorders in an iodine-deficient community: the Pescopagano survey. J Clin Endocrinol Metab. 1999, 84: 561-566.PubMed

Gupta A, Ly S, Castroneves LA, Frates MC, Benson CB, Feldman HA, Wassner AJ, Smith JR, Marqusee E, Alexander EK, Barletta J, Doubilet PM, Peters HE, Webb S, Modi BP, Paltiel HJ, Kozakewich H, Cibas ES, Moore FD, Shamberger RC, Larsen PR, Huang SA: A standardized assessment of thyroid nodules in children confirms higher cancer prevalence than in adults. J Clin Endocrinol Metab. 2013, 98: 3238-3245. 10.1210/jc.2013-1796.PubMedCentralCrossRefPubMed

Waguespack SG, Francis G: Initial management and follow-up of differentiated thyroid cancer in children. J Natl Compr Canc Netw. 2010, 8: 1289-1300.PubMed

Hung W, Sarlis NJ: Current controversies in the management of pediatric patients with well-differentiated nonmedullary thyroid cancer: a review. Thyroid. 2002, 12: 683-702. 10.1089/105072502760258668.CrossRefPubMed

Attie JA: Carcinoma of the thyroid in children and adolescents. Pediatric Endocrinology. Edited by: Lifshitz F. 1996, New York: Marcel Dekker, 423-432. 3

10.

Corrias A, Cassio A, Weber G, Mussa A, Wasniewska M, Rapa A, Gastaldi R, Einaudi S, Baronio F, Vigone MC, Messina MF, Bal M, Bona G, de Sanctis C: Study Group for Thyroid Diseases of Italian Society for Pediatric Endocrinology and Diabetology (SIEDP/ISPED): Thyroid nodules and cancer in children and adolescents affected by autoimmune thyroiditis. Arch Pediatr Adolesc Med. 2008, 162: 526-531. 10.1001/archpedi.162.6.526.CrossRefPubMed

11.

Mehta RS, Carty SE, Ohori NP, Hodak SP, Coyne C, LeBeau SO, Tublin ME, Stang MT, Johnson JT, McCoy KL, Nikiforova MN, Nikiforov YE, Yip L: Nodule size is an independent predictor of malignancy in mutation-negative nodules with follicular lesion of undetermined significance cytology. Surgery. 2013, 154: 730-736. 10.1016/j.surg.2013.05.015.CrossRefPubMed

12.

Gupta A, Ly S, Castroneves LA, Frates MC, Benson CB, Feldman HA, Wassner AJ, Smith JR, Marqusee E, Alexander EK, Barletta J, Muyide F, Doubilet PM, Peters HE, Webb S, Modi BP, Paltiel HJ, Martins Y, Burmeister K, Kozakewich H, Hollowell M, Cibas ES, Moore FD, Shamberger RC, Larsen PR, Huang SA: How are childhood thyroid nodules discovered: opportunities for improving early detection. J Pediatr. in press

13.

Corrias A, Mussa A: Thyroid nodules in pediatrics: which ones can be left alone, which ones must be investigated, when and how. J Clin Res Pediatr Endocrinol. 2013, 5 (Suppl 1): 57-69.PubMedCentralPubMed

14.

Corrias A, Mussa A, Baronio F, Arrigo T, Salerno M, Segni M, Vigone MC, Gastaldi R, Zirilli G, Tuli G, Beccaria L, Iughetti L, Einaudi S, Weber G, De Luca F, Cassio A: Study Group for Thyroid Diseases of Italian Society for Pediatric Endocrinology and Diabetology (SIEDP/ISPED): Diagnostic features of thyroid nodules in pediatrics. Arch Pediatr Adolesc Med. 2010, 164: 714-719. 10.1001/archpediatrics.2010.114.CrossRefPubMed

15.

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, American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer: Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009, 19: 1167-1214. 10.1089/thy.2009.0110.CrossRefPubMed

16.

Corrias A, Mussa A, Wasniewska M, Segni M, Cassio A, Salerno M, Gastaldi R, Vigone MC, Bal M, Matarazzo P, Weber G, De Luca F: Levothyroxine treatment in pediatric benign thyroid nodules. Horm Res Paediatr. 2011, 75: 246-251. 10.1159/000321841.CrossRefPubMed

17.

Corrias A, Einaudi S, Chiorboli E, Weber G, Crinò A, Andreo M, Cesaretti G, de Sanctis L, Messina MF, Segni M, Cicchetti M, Vigone M, Pasquino AM, Spera S, De Luca F, Mussa GC, Bona G: Accuracy of fine needle aspiration biopsy of thyroid nodules in detecting malignancy in childhood: comparison with conventional clinical, laboratory, and imaging approaches. J Clin Endocrinol Metab. 2001, 86: 4644-4648. 10.1210/jcem.86.10.7950.CrossRefPubMed

18.

Castro MR, Gharib H: Continuing controversies in the management of thyroid nodules. Ann Intern Med. 2005, 142: 926-931. 10.7326/0003-4819-142-11-200506070-00011.CrossRefPubMed

19.

Lewis CM, Chang KP, Pitman M, Faquin WC, Randolph GW: Thyroid fine-needle aspiration biopsy: variability in reporting. Thyroid. 2009, 19: 717-723. 10.1089/thy.2008.0425.CrossRefPubMed

20.

Mussa A, Salerno MC, Bona G, Wasniewska M, Segni M, Cassio A, Vigone MC, Gastaldi R, Iughetti L, Santanera A, Capalbo D, Matarazzo P, De Luca F, Weber G, Corrias A: Serum thyrotropin concentration in children with isolated thyroid nodules. J Pediatr. 2013, 163: 1465-1470. 10.1016/j.jpeds.2013.07.003.CrossRefPubMed

21.

Lugo-Vicente H, Romero-Estremera NJ: Thyroid nodules in children: what should be a minimal work-up preceding surgery?. Bol Asoc Med P R. 2012, 104: 33-36.PubMed

22.

Saavedra J, Deladoëy J, Saint-Vil D, Boivin Y, Alos N, Deal C, Van Vliet G, Huot C: Is ultrasonography useful in predicting thyroid cancer in children with thyroid nodules and apparently benign cytopathologic features?. Horm Res Paediatr. 2011, 75: 269-275. 10.1159/000322877.CrossRefPubMed

23.

Roy R, Kouniavsky G, Schneider E, Allendorf JD, Chabot JA, Logerfo P, Dackiw AP, Colombani P, Zeiger MA, Lee JA: Predictive factors of malignancy in pediatric thyroid nodules. Surgery. 2011, 150: 1228-1233. 10.1016/j.surg.2011.09.023.CrossRefPubMed

Title: Thyroid nodules in childhood: indications for biopsy and surgery
Authors: Filippo De Luca
Tommaso Aversa
Luca Alessi
Valeria Cama
Daria Costanzo
Cristina Genovese
Veronica Scuderi
Roberta Vadalà
Giuseppe Zoccali
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: Italian Journal of Pediatrics / Issue 1/2014
Electronic ISSN: 1824-7288
DOI: https://doi.org/10.1186/1824-7288-40-48

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Thyroid nodules in childhood: indications for biopsy and surgery

Abstract

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