Pediatric Thyroid Nodules: Ultrasound Characteristics as Indicators of Malignancy

Title

Pediatric Thyroid Nodules: Ultrasound Characteristics as Indicators of Malignancy

Creator

Brandon Fornwalt
Manasa Melachuri
Matthew Kubina
Janice McDaniel
Anita Jeyakumar

Date

2022

Description

Objective: Pediatric thyroid nodules are uncommon but carry a 25% malignancy risk. Adult patients have well-established ultrasound characteristics that are predictive of malignancy, but these are not clearly defined in pediatric patients. We reviewed a case series of pediatric thyroid nodules.

Study design: Retrospective chart review.

Setting: Tertiary children's hospital.

Method: Institutional review board approval was obtained. This case series with chart review includes all pediatric thyroid nodules with ultrasounds from 2006 to 2016 at 2 pediatric tertiary care centers.

Results: An overall 112 pediatric thyroid nodules were analyzed. The mean patient age was 14.3 years; there was a female:male ratio of 4:1; and 94% were Caucasian. Seventeen percent (20/112) of nodules were malignant. In patients with malignant nodules, the average presenting age was 15.5 years, with a female:male ratio of 5.6:1. Seventy percent of malignant nodules had accompanying microcalcifications, 55% had abnormal lymph nodes, and 45% had irregular margins. In the benign nodules, 11% had microcalcifications, 12% had abnormal lymph nodes, and 26% had irregular margins. The presence of microcalcifications (odds ratio, 19.1 [95% CI, 6.0-61.0]; P < .0001), abnormal lymph nodes (odds ratio, 9.0 [95% CI, 3.0-26.6]; P = .0001), and size >3.5 cm (odds ratio, 5.8 [95% CI, 1.5-22.5]; P = .01) was associated with thyroid cancer. Irregular margins were not statistically significant (odds ratio, 2.3 [95% CI, 0.86-6.3]; P = .9).

Conclusions: Our data suggest that abnormal lymph nodes, microcalcifications, and size >3.5 cm could be predictors of malignancy in the pediatric population and influence clinical decision making.

Source

OTO Open
. 2022 Mar 8;6(1):2473974X211073702. doi: 10.1177/2473974X211073702. eCollection 2022 Jan-Mar.

Language

English

Citation

Brandon Fornwalt et al., “Pediatric Thyroid Nodules: Ultrasound Characteristics as Indicators of Malignancy,” NEOMED Bibliography Database, accessed March 29, 2024, https://neomed.omeka.net/items/show/12034.