Pediatric Thyroidectomy: Experience From a Portuguese Hospital

Abstract

Background and objectivePediatric thyroid disease requiring surgery is rare. Thyroid nodules are a frequent indication for surgery and are mostly benign. However, up to 25% of cases can be malignant. In this study, we aimed to describe our center's experience with regard to pediatric thyroid surgery. MethodsThis was a retrospective transverse study involving pediatric patients who underwent thyroid surgery at a tertiary hospital between January 2010 and December 2021. ResultsA total of 14 patients underwent 15 surgeries. The main reason for referral to pediatric endocrinology was thyroid nodules (n=10). Thirteen fine needle aspirations (FNAs) were performed, with follicular tumor (n=6) being the most common finding. The median age of patients at surgery was 15.9 years [interquartile range (IQR): 14.0-16.8]. The most common surgical indications were the presence of a follicular tumor on FNA (n=5) and thyroid nodule size causing symptoms (n=5). There was one case of prophylactic thyroidectomy due to the identification of a multiple endocrine neoplasia type 2A (MEN2A) mutation. The most frequently described histopathology results were follicular adenoma (n=6) and colloid nodular goiter (n=6). Three postoperative complications were observed in three different patients: bilateral lesion of the recurrent laryngeal nerve, cervical hematoma, and transient hypoparathyroidism with hypocalcemia. ConclusionIn our study, the most frequent surgical indication was a follicular tumor. A good correlation was found between FNA cytology and final histopathology results, which is in accordance with previous studies. This reinforces the importance of FNA in diagnosis and surgical planning. The rate of complications in our study is comparable to that in larger single-center series in the literature.

Thyroid surgery in children: a single-center experience of 20 years

“…Thyroid nodules are usually present as an asymptomatic neck mass, cervical lymphadenopathy, or compression symptoms may accompany 9 . On ultrasonographic imaging, irregular shape and margins, microcalcifications, marked hypoechogenicity, intranodular hypervascularization, enlargement of the nodule over time, invasion of extra thyroid tissues, anteroposterior diameter larger than the transverse diameter, and the presence of cervical lymphadenopathies suggest malignancy 9 , 14 . Ultrasound-guided fine needle aspiration (FNA) biopsy can be performed on hypofunctioning thyroid nodules, and histopathological evaluation according to the Bethesda classification can be evaluated to predict the risk of malignancy 9 .…”