Evaluation and Management of Pediatric Thyroid Nodules

Abstract

The prevalence of palpable thyroid nodules in patients less than 21 years of age is only .051.8% (American Cancer Society [ACS], 2009; Dinauer & Francis, 2007; Dinauer et al, 2008; Gosepath et al, 2007; Halac & Zimmerman, 2005, Niedziela, 2006; Ortel & Klinck 1965; Rallison et al 1991; Wartofsky, 2000; Wiersinga, 2007). However, the true incidence of incidental nodules may be higher than 13% in the pediatric and adolescent group based on autopsy studies. This is in comparison to the adult population where the rate of palpable thyroid nodules approaches 5% with autopsy studies showing up to 70% of adults harboring incidental thyroid nodules (Ezzat S et al, 1994; Guth et al, 2009). Risk factors for the development of malignant thyroid nodules in pediatric patients include female sex, puberty, family history of thyroid cancer, head and neck radiation exposure, and iodinedeficiency (Crom et al, 1997; Fleming, 1984; Fowler et al, 1989; Josephson & Zimmerman, 2008; Samaan, 1987; Solt et al, 2001).