We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Natural History and Outcomes of Cytologically Benign Thyroid Nodules in Children.
- Authors
Cherella, Christine E; Feldman, Henry A; Hollowell, Monica; Richman, Danielle M; Cibas, Edmund S; Smith, Jessica R; Angell, Trevor; Wang, Zhihong; Alexander, Erik K; Wassner, Ari J; Angell, Trevor E
- Abstract
<bold>Context: </bold>Most pediatric thyroid nodules are cytologically benign, but few data exist to guide treatment.<bold>Objective: </bold>To describe the natural history and outcomes of cytologically benign, pediatric thyroid nodules.<bold>Design: </bold>Cohort study.<bold>Setting: </bold>Multidisciplinary thyroid clinic at an academic medical center.<bold>Patients: </bold>Consecutive pediatric patients (≤18 years old) with cytologically benign thyroid nodules evaluated between 1998 and 2016.<bold>Results: </bold>Cytologically benign nodules (N = 237) in 181 patients were followed by ultrasound (median follow-up, 3.4 years; range, 0.5 to 13.9 years) or to resection. Thyroid cancer was diagnosed in six nodules (2.5%), and all six patients were disease free after median follow-up of 4.9 years. Malignancy was more common in nodules >4 cm (15.4%; P = 0.037) or that grew during follow-up (6.0%; P = 0.048). The likelihood of nodule growth (±SE) was 15% ± 3%, 24% ± 4%, and 49% ± 10% at 6, 12, and 24 months, respectively. Among nodules >2 cm, those with ≥25% cystic content grew more slowly than nodules <25% cystic; nodules <2 cm grew similarly regardless of cystic content.<bold>Conclusion: </bold>Benign cytology in pediatric thyroid nodules has a low false-negative rate similar to that in adults, and prognosis is excellent in the rare cases of malignancy. Resection of nodules >4 cm, combined with surveillance of smaller nodules and repeated aspiration for growth, detects most false-negative results. Follow-up ultrasound in 12 months is appropriate for most cytologically benign pediatric nodules, but delaying surveillance up to 24 months may be reasonable in large, predominantly cystic nodules.
- Publication
Journal of Clinical Endocrinology & Metabolism, 2018, pN.PAG
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/jc.2018-00895