Nodular goiter and thyroid carcinoma in children and adolescents in a moderate endemic area (Lower Silesia-Sudeten endemia) in the last twelve years

Although thyroid carcinoma is more common in the adult population, the risk of a nodule being malignant is greater in children. The aim of our present investigation was to ascertain the percentage of malignancy in nodular goi ter observed in patients from the Lower Silesia region in the last 12 years . The examination included 60 children (12 boys and 48 girls) treated in ou r clinic from 1987 to June 1998, Age varied from 7 to 18 years (mean 14.8 /- 2.4), most of them in the age group between 13 and 18 years. The followi ng investigations were performed: TSH, T-3, T-4, thyroid ultrasonography, f ine needle aspiration biopsy and Tc-99 scintigraphy of the thyroid. Most of the patients were euthyroid; two children demonstrated pressure symptoms. All the patients were treated by operation. Histological examinations revea led the following: nodular goiter in 19 patients, cystic nodular goiter in 5, follicular adenoma in 20, fetal adenoma in 3, nodular goiter and follicu lar adenoma in 6, papillary carcinoma in 6, and follicular carcinoma in 1 p atient. We concluded that an increased incidence of thyroid cancer has been noted in children with nodular goiter in Lower Silesia during the last 12 years. Thyroid cancer was observed mostly in patients with single nodules a nd was associated with a high risk of malignancy.