Thyroid nodules in children, although relatively rare, have become more frequently diagnosed due to progress in imaging techniques, such as ultrasound. These nodules can either be benign or malignant, with a significant difference in prognosis. This article reviews the clinical, diagnostic, and therapeutic aspects of thyroid nodules in children, emphasizing the importance of a careful and individualized approach. The clinical evaluation includes consideration of risk factors such as radiation exposure and family history, along with physical signs like nodule palpability and lymphadenopathy. Ultrasound is the primary diagnostic tool, with high-frequency probes (≥12MHz) providing detailed information on nodule size, structure, and suspicious features. The TIRADS classification system is used to stratify malignancy risk, guiding decisions regarding biopsy or monitoring. Fine needle aspiration (FNA) is recommended for nodules with suspicious ultrasound features and has a sensitivity of 86-100% and specificity of 65-98.5%. If FNA results are inconclusive, further imaging and FNA procedures are indicated. Regular follow-up is essential, with a new ultrasound recommended every 6 to 12 months. Malignant cases require surgery and ongoing clinical monitoring. The article also highlights the management guidelines by the American Thyroid Association for pediatric thyroid nodules and differentiated thyroid cancer.
Keywords
Thyroid nodules, pediatrics, TIRADS classification, fine needle aspiration