Differences in the management of thyroid nodules in children and adolescents as compared to adults

被引:7
作者
Goldfarb, Melanie [1 ]
Dinauer, Catherine [2 ]
机构
[1] Providence St Johns Hlth Ctr, St Johns Canc Inst, Ctr Endocrine Tumors, Santa Monica, CA USA
[2] Yale Sch Med, Dept Pediat, Sect Pediat Endocrinol, New Haven, CT USA
关键词
molecular testing; pediatric thyroid nodules; thyroid nodules; thyroid ultrasound; ASSOCIATION GUIDELINES; CLINICAL UTILITY; BETHESDA SYSTEM; CANCER RISK; CHILDHOOD; SURVIVORS; CARCINOMA; RECOMMENDATIONS; SURVEILLANCE; PREVALENCE;
D O I
10.1097/MED.0000000000000754
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose of review To describe recent advances in the diagnosis and management of thyroid nodules in both children and adults, highlighting differences between the two groups. Recent findings Thyroid nodules are less common in children than adults but the risk of malignancy is higher. Screening recommendations for patients with certain genetic syndromes or specific risk factors for thyroid nodules and cancer continue to evolve ultrasound is the most appropriate imaging modality for evaluating thyroid nodules in all patients, but radiographic risk stratification systems validated in adults have not been extensively studied in children. Criteria for proceeding to fine needle aspiration (FNA) biopsy differ some between children and adults, with nodule size being less of a consideration in young patients. Molecular testing continues to improve the diagnostic capabilities of FNA for all age groups, but options for pediatric thyroid nodules are currently limited. In children, only oncogene panels are validated and their exact utility, along with miRNA classifiers, is an evolving area of study. For adults, data support selection of a specific molecular test based on ultrasound characteristics and pretest probability of malignancy. Multiple series have shown that fusion mutations are more common in pediatric thyroid nodules, while point mutations are seen more often in adult thyroid nodules. Molecular data help guide management recommendations regarding the need for surgery when FNA is indeterminate, but clinical use is still being refined. Radiofrequency ablation is a nonoperative approach that has gained significant traction for the treatment of symptomatic benign nodules in adults, but data are currently extremely limited in children. There are difference in the diagnosis and treatment of thyroid nodules in adults and children, the nuances of which are important for clinical management.
引用
收藏
页码:466 / 473
页数:8
相关论文
共 50 条
  • [41] Thyroid cancer in children and adolescents
    Vander Poorten, Vincent
    Hens, Greet
    Delaere, Pierre
    CURRENT OPINION IN OTOLARYNGOLOGY & HEAD AND NECK SURGERY, 2013, 21 (02) : 135 - 142
  • [42] Thyroid diseases in children and adolescents
    Calkovsky, V
    Hajtman, A.
    BRATISLAVA MEDICAL JOURNAL-BRATISLAVSKE LEKARSKE LISTY, 2009, 110 (01): : 31 - 34
  • [43] The Management of Thyroid Nodules in Patients With Primary Hyperparathyroidism
    Wang, Tracy S.
    Roman, Sanziana A.
    Cox, Heather
    Air, Mamie
    Sosa, Julie Ann
    JOURNAL OF SURGICAL RESEARCH, 2009, 154 (02) : 317 - 323
  • [44] SURGICAL MANAGEMENT OF THYROID NODULES
    Lekaj, Lulezim
    Dajti, Ardian
    Ymeri, Ardian
    Galiqi, Gezim
    Ymeri, Shpetim
    Shega, Bledar
    Celiku, Edmond
    INTERNATIONAL JOURNAL OF ECOSYSTEMS AND ECOLOGY SCIENCE-IJEES, 2015, 5 (01): : 77 - 82
  • [45] Thyroid nodules: diagnosis and management
    Wong, Rosemary
    Farrell, Stephen G.
    Grossmann, Mathis
    MEDICAL JOURNAL OF AUSTRALIA, 2018, 209 (02) : 92 - +
  • [46] Thyroid nodules: diagnosis and management
    Grani, Giorgio
    Sponziello, Marialuisa
    Filetti, Sebastiano
    Durante, Cosimo
    NATURE REVIEWS ENDOCRINOLOGY, 2024, 20 (12) : 715 - 728
  • [47] Management of Incidental Thyroid Nodules
    Abraham, Peter J.
    Lindeman, Brenessa M.
    SURGICAL CLINICS OF NORTH AMERICA, 2024, 104 (04) : 711 - 723
  • [48] Contemporary Management of Thyroid Nodules
    Kobaly, Kristen
    Kim, Caroline S.
    Mandel, Susan J.
    ANNUAL REVIEW OF MEDICINE, 2022, 73 : 517 - 528
  • [49] Updates in the management of thyroid nodules
    Kuo, Jennifer H.
    McManus, Catherine
    Graves, Claire E.
    Madani, Amin
    Khokhar, Mamoona T.
    Huang, Bernice
    Lee, James A.
    CURRENT PROBLEMS IN SURGERY, 2019, 56 (03) : 103 - 127
  • [50] Thyroid disorders and inflammatory bowel disease: an association present in adults but also in children and adolescents
    Calcaterra, Valeria
    Penagini, Francesca
    Rossi, Virginia
    Abbattista, Luisa
    Bianchi, Alice
    Turzi, Massimiliano
    Cococcioni, Lucia
    Zuccotti, Gianvincenzo
    FRONTIERS IN ENDOCRINOLOGY, 2025, 16