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Consultation with the specialist: Thyroid nodules

Pediatrics in Review, ISSN: 0191-9601, Vol: 33, Issue: 2, Page: 75-82
2012
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Review Description

• Based on strong research evidence, thyroid nodules in children and teenagers are more likely to be malignant than in adults. • Based on strong research evidence, a history of ionizing radiation to the head or neck is an independent risk factor for the development of thyroid malignancies. • There is strong research evidence, including a recent meta-analysis, (9) supporting the use of fine-needle aspiration biopsy in the evaluation of all pediatric and adolescent patients presenting with a thyroid nodule. • The surgical management and postoperative care of pediatric and adolescent patients who have well-differentiated thyroid carcinomas remains controversial, because the rarity of the disease limits the ability to conduct randomized, prospective research studies. • Numerous studies have demonstrated that, despite presenting with more advanced disease, pediatric and adolescent patients with thyroid carcinoma have a higher survival rate than adults. • The American Thyroid Association has issued strong evidence-based recommendations for the management of medullary thyroid carcinoma, including RET mutation testing and early prophylactic total thyroidectomy in children with high-risk mutations. (10).

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