Thyroid and parathyroid disease

Abstract

Thyroid disease in children represents a diverse set of diseases including congenital abnormalities, autoimmune conditions, and malignancy. Benign conditions include thyroglossal duct cysts, ectopic thyroid tissue, goiters, Graves disease, acute suppurative thyroiditis, Hashimoto’s disease, congenital hypothyroidism, and subacute thyroiditis. The management of thyroid nodules is more complex and requires an algorithmic approach to evaluate for malignancy. Treatment of thyroid malignancies is either total or subtotal thyroidectomy with or without central lymph node dissection. With parathyroid disease, hyperparathyroidism is the main anomaly encountered in the pediatric population. Hyperparathyroidism in neonates may be relatively benign and self-limiting (neonatal hyperparathyroidism), but neonatal severe hyperparathyroidism can be life-threatening. In older children, primary hyperparathyroidism can be secondary to adenomas, which are usually sporadic, or hyperplasia, which is typically familial. When managing either thyroid or parathyroid disease, a clinician must evaluate for multiple endocrine neoplasia syndromes and be aware of the potential for prophylactic surgeries.