THYROID NODULES IN CHILDREN

OUTCOME AND THERAPY

Abstract

INTRODUCTION
Thyroid nodules occur less frequently in children compared to adults. The estimated prevalence of solid thyroid nodules is approximately 1% to 1.7% of the paediatric population, with the incidence increasing with age. This study aimed to describe the prevalence and outcomes of paediatric patients with thyroid nodule.

METHODOLOGY
Children and adolescents diagnosed with thyroid nodules from 2012 to 2024 at the University Malaya Medical Centre were included in this retrospective review.

RESULT
Twelve patients were referred and diagnosed with thyroid nodule (s). Most were female (91.7%), with a mean age at diagnosis of 12.97 ± 1.97 years. Multinodular goitre was seen in 58.3%. The prevalence of thyroid nodules among paediatric patients with thyroid disease including congenital and acquired cases in our centre was 2%. Seven (58.3%) were Chinese, 4 (33.3%) Malay, and 1 (8.3%) Indian. Seven (58.3%) patients presented with goitre, while 4 (33.3%) were referred post-total thyroidectomy and 1 (8.3%) with symptoms of hyperthyroidism (tremors and palpitations). Eight (66.7%) patients were euthyroid and 3 (25%) were hypothyroid post-total thyroidectomy. Fine needle aspiration cytology was done in 10 (83.3%) patients. Four (33.3%) were confirmed malignant. Of the 4 patients with papillary thyroid cancer, 3 (75%) patients were initially diagnosed with a solitary thyroid nodule. Their mean age at presentation was 12.83 ± 1.66 years, and all underwent total thyroidectomy. One (8.3%) patient developed hypercalcaemic seizure after thyroidectomy. None developed vocal cord paralysis.

CONCLUSION
The prevalence of thyroid nodules in our centre is similar to other studies, with multinodular goitre being most diagnosed. The majority of adolescents with papillary thyroid cancer presented with solitary thyroid nodules. Total thyroidectomy in papillary thyroid cancer is safe with minimal complications.