THYROID DISEASE / CLINICAL RESEARCH
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Surgical diseases of the thyroid gland in children are rare in comparison with those in the adult population. The aim of the study was to assess clinical aspects of thyroid follicular adenoma in children and attempt to develop a management algorithm that is useful in clinical practice.

Material and methods:
The clinical database of all children operated on due to thyroid disease in the years 1993–2018 at the university pediatric surgical center was reviewed. The children in whom the postoperative histology report showed follicular adenoma were selected and their medical files were analyzed in detail. Clinical course of the disease, medical and family history, results of imaging studies, details of surgical management and final outcome were assessed in each case.

Results:
Among 183 children operated on for thyroid pathology in the study period there were 56 patients with follicular adenoma (30.6%). Their age ranged from 7 to 18 years. Seven patients were found to be hypothyroid and a further seven showed hyperthyroid status initially. Ultrasound scan showed a solitary nodule in 37 children (66.1%). Multiple nodules in one lobe were detected in 5 patients, while a further 14 children showed bilateral thyroid pathology. The result of preoperative cytologic examination was suspicious in 12 children (21.4%). All children were subjected to operative management. Forty-two children (75%) underwent at least unilateral total lobectomy. No patient showed a recurrent thyroid disease.

Conclusions:
Follicular adenoma in children presents a wide clinical and morphological spectrum. High incidence of associated diseases of other systems and congenital anomalies of the thyroid gland may indicate a complex etiology of follicular adenoma with participation of still unknown endogenic factors in children.
REFERENCES (14)
1.
Ledbetter DJ. Thyroid surgery in children. Semin Pediatr Surg 2014; 23: 60-5.
 
2.
Festen C, Otten BJ, van de Kaa CA. Follicular adenoma of the thyroid gland in children. Eur J Pediatr Surg 1995; 5: 262-4.
 
3.
Hung W, Anderson KD, Chandra RS, et al. Solitary thyroid nodules in 71 children and adolescents. J Pediatr Surg 1992; 27: 1407-9.
 
4.
Mirshemirani A, Rozhanzamir F, Tabari AK, et al. Thyroid nodules in childhood: a single institute experience. Iran J Pediatr 2010; 20: 91-6.
 
5.
Meissner WA. Follicular carcinoma of the thyroid. Am J Surg Pathol 1977; 1: 171-3.
 
6.
Angerpointner TA, Britsch E, Knorr D, et al. Surgery for benign and malignant diseases of the thyroid gland in childhood. Prog Pediatr Surg 1991; 26: 21-7.
 
7.
Baglaj M, Gerus S, Dorobisz U, et al. Thyroidectomy in children: changing trends and surgical strategies. Adv Clin Exp Med 2013; 22: 387-93.
 
8.
Yoskovitsch A, Laberge JM, Rodd C, et al. Cystic thyroid lesions in children. J Pediatr Surg 1998; 33: 866-70.
 
9.
Scholz S, Smith JR, Chaignaud B, Shamberger RC, Huang SA. Thyroid surgery at Children’s Hospital Boston: a 35-year single-institution experience. J Pediatr Surg 2011; 46: 437-42.
 
10.
Lugo-Vicente H, Ortiz VN. Pediatric thyroid nodules: insights in management. Bol Asoc Med P R 1998; 90: 74-8.
 
11.
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.
 
12.
Breuer C, Tuggle C, Solomon D, et al. Pediatric thyroid disease: when is surgery necessary, and who should be operating on our children? J Clin Res Pediatr Endocrinol 2013; 5 (Suppl 1): 79-85.
 
13.
Burke JF, Sippel RS, Chen H. Evolution of pediatric thyroid surgery at a tertiary medical center. J Surg Res 2012; 177: 268-274.
 
14.
Raval MV, Browne M, Chin AC, et al. Total thyroidectomy for benign disease in the pediatric patient – feasible and safe. J Pediatr Surg 2009; 44: 1529-33.
 
eISSN:1896-9151
ISSN:1734-1922
Journals System - logo
Scroll to top