NODULAR THYROID-DISEASE IN CHILDREN AND ADOLESCENTS

Thyroid nodules in children are extremely uncommon. Most thyroid nodul es, both benign and malignant, present as asymptomatic neck masses. A thyroid nodule in a child is significant because of the risk of malign ancy. A review of medical records at our institution demonstrated 71 p atients 20 years of age and younger with surgically managed thyroid no dules, of which 45 were benign and 26 were malignant, Our diagnostic w orkup, including serum thyroid studies, radiologic evaluation, and fin e-needle aspiration, is discussed, Because of the possibility of malig nancy, we recommend that all solitary thyroid nodules be excised in ch ildren unless fine-needle aspiration definitively determines a benign histology. The extent and type of surgical management is controversial and is still subject to much debate. Partial thyroidectomy appears ad equate for benign disease, but even though there is no statistical dif ference in survival, we recommend total thyroidectomy for the manageme nt of malignant disease.