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Needle core biopsy in the diagnosis of pediatric thyroid neoplasms: a single institution retrospective review

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Abstract

Purpose

Our institution routinely utilizes needle core biopsy (NCB), instead of fine needle aspiration, in the evaluation of pediatric thyroid nodules. This practice initially arose from limited cytopathology services in our hospital. Given the lack of information regarding the utility of NCB in diagnosing pediatric thyroid neoplasms, we set out to review our institution’s experience with this technique.

Methods

We performed a single institution retrospective chart review of all children who underwent thyroidectomy for primary thyroid pathology.

Results

Seventy-four patients, with a mean age of 12.9 ± 4.5 (SD) years, underwent partial or total thyroidectomy between 2002 and 2010. Seven of these patients had medically refractive hyperthyroidism. The remaining 67 patients had one or more thyroid nodules as identified by ultrasound. 24 (36 %) of these cases were malignant on final pathology. 14 (58 %) of the malignant cases were papillary thyroid carcinoma. 46 of the thyroid nodule cases underwent pre-operative NCB. Biopsy results for these patients were non-diagnostic in 6 (13 %), benign in 11 (24 %), atypical in 17 (37 %), and malignant in 12 (26 %). There were no complications arising from NCB. Sensitivity of NCB for diagnosing papillary carcinoma (PC) and follicular neoplasm was calculated at 0.88 (0.47–1.0, 95 % CI) and 0.84 (0.60–0.97, 95 % CI), respectively. Of the 28 patients not undergoing preoperative NCB, 12 underwent hemithyroidectomy, with one patient (8 %) requiring completion thyroidectomy for PC. Overall, the sensitivity of NCB in diagnosing PC and follicular thyroid neoplasms was 0.85 (0.55–0.99, 95 % CI), while the specificity was 0.63 (0.42–0.82, 95 % CI).

Conclusions

Needle core biopsy appears to have a low rate of associated complications, and its sensitivity for diagnosing PC and follicular neoplasm is comparable to what has been reported for fine needle aspiration biopsy in a similar patient population.

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References

  1. Cooper DS, Doherty GM, Haugen BR et al (2009) Revised american thyroid association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19(11):1167–1214

    Article  PubMed  Google Scholar 

  2. Gharib H, Papini E, Valcavi R et al (2006) American association of clinical endocrinologists and associazione medici endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract 12(1):63–102

    Article  PubMed  Google Scholar 

  3. Belfiore A, La Rosa GL (2001) Fine-needle aspiration biopsy of the thyroid. Endocrinol Metab Clin North Am 30(2):361–400

    Article  PubMed  CAS  Google Scholar 

  4. Gharib H, Papini E (2007) Thyroid nodules: clinical importance, assessment, and treatment. Endocrinol Metab Clin North Am 36(3):707–735 vi

    Article  PubMed  CAS  Google Scholar 

  5. Tan GH, Gharib H (1997) Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Ann Intern Med 126(3):226–231

    Article  PubMed  CAS  Google Scholar 

  6. Castro MR, Gharib H (2003) Thyroid fine-needle aspiration biopsy: progress, practice, and pitfalls. Endocr Pract 9(2):128–136

    Article  PubMed  Google Scholar 

  7. Cooper DS, Doherty GM, Haugen BR et al (2006) Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 16(2):109–142

    Article  PubMed  Google Scholar 

  8. Mortensen JD, Woolner LB, Bennett WA (1955) Gross and microscopic findings in clinically normal thyroid glands. J Clin Endocrinol Metab 15(10):1270–1280

    Article  PubMed  CAS  Google Scholar 

  9. Halac I, Zimmerman D (2005) Thyroid nodules and cancers in children. Endocrinol Metab Clin North Am 34(3):725–744 x

    Article  PubMed  CAS  Google Scholar 

  10. Raab SS, Silverman JF, Elsheikh TM, Thomas PA, Wakely PE (1995) Pediatric thyroid nodules: disease demographics and clinical management as determined by fine needle aspiration biopsy. Pediatrics 95(1):46–49

    PubMed  CAS  Google Scholar 

  11. Dinauer CA, Breuer C, Rivkees SA (2008) Differentiated thyroid cancer in children: diagnosis and management. Curr Opin Oncol 20(1):59–65

    Article  PubMed  Google Scholar 

  12. The Canadian Pediatric Thyroid Nodule (CaPTN) Study Group (2008) The Canadian Pediatric Thyroid Nodule Study: an evaluation of current management practices. J Pediatr Surg 43(5):826–830

    Google Scholar 

  13. Okada T, Sasaki F, Takahashi H et al (2006) Management of childhood and adolescent thyroid carcinoma: long-term follow-up and clinical characteristics. Eur J Pediatr Surg 16(1):8–13

    Article  PubMed  CAS  Google Scholar 

  14. Chaukar DA, Rangarajan V, Nair N et al (2005) Pediatric thyroid cancer. J Surg Oncol 92(2):130–133

    Article  PubMed  Google Scholar 

  15. Reiners C, Demidchik YE (2003) Differentiated thyroid cancer in childhood: pathology, diagnosis, therapy. Pediatr Endocrinol Rev. 1(Suppl 2):230–235 (discussion 235–236)

    PubMed  Google Scholar 

  16. Yamashita S, Saenko V (2007) Mechanisms of disease: molecular genetics of childhood thyroid cancers. Nat Clin Pract Endocrinol Metab 3(5):422–429

    Article  PubMed  CAS  Google Scholar 

  17. Dinauer C, Francis GL (2007) Thyroid cancer in children. Endocrinol Metab Clin North Am 36(3):779–806 vii

    Article  PubMed  CAS  Google Scholar 

  18. Josefson J, Zimmerman D (2008) Thyroid nodules and cancers in children. Pediatr Endocrinol Rev 6(1):14–23

    PubMed  Google Scholar 

  19. Bargren AE, Meyer-Rochow GY, Sywak MS, Delbridge LW, Chen H, Sidhu SB (2010) Diagnostic utility of fine-needle aspiration cytology in pediatric differentiated thyroid cancer. World J Surg 34(6):1254–1260

    Article  PubMed  Google Scholar 

  20. Amrikachi M, Ponder TB, Wheeler TM, Smith D, Ramzy I (2005) Thyroid fine-needle aspiration biopsy in children and adolescents: experience with 218 aspirates. Diagn Cytopathol 32(4):189–192

    Article  PubMed  Google Scholar 

  21. Kapila K, Pathan SK, George SS, Haji BE, Das DK, Qadan LR (2010) Fine needle aspiration cytology of the thyroid in children and adolescents: experience with 792 aspirates. Acta Cytol 54(4):569–574

    PubMed  Google Scholar 

  22. Corrias A, Einaudi S, Chiorboli E et al (2001) Accuracy of fine needle aspiration biopsy of thyroid nodules in detecting malignancy in childhood: comparison with conventional clinical, laboratory, and imaging approaches. J Clin Endocrinol Metab 86(10):4644–4648

    Article  PubMed  CAS  Google Scholar 

  23. Arda IS, Yildirim S, Demirhan B, Firat S (2001) Fine needle aspiration biopsy of thyroid nodules. Arch Dis Child 85(4):313–317

    Article  PubMed  CAS  Google Scholar 

  24. Hung W (1999) Solitary thyroid nodules in 93 children and adolescents. a 35-years experience. Horm Res 52(1):15–18

    Article  PubMed  CAS  Google Scholar 

  25. Stevens C, Lee JK, Sadatsafavi M, Blair GK (2009) Pediatric thyroid fine-needle aspiration cytology: a meta-analysis. J Pediatr Surg 44(11):2184–2191

    Article  PubMed  Google Scholar 

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Conflict of interest

The authors are unaware of any conflicts of interest pertaining to this study.

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Authors and Affiliations

  1. Bobby R. Alford Department of Otolaryngology, Baylor College of Medicine, Houston, TX, USA

    W. K. Yunker & C. M. Giannoni

  2. Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA

    S. F. Hassan, L. B. Ferrell, D. E. Wesson, M. L. Brandt & M. E. Lopez

  3. Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA

    M. J. Hicks

  4. Department of Radiology, Baylor College of Medicine, Houston, TX, USA

    C. I. Cassady & J. A. Hernandez

  5. 6701 Fannin St 12th Floor, CCC 1210, Houston, TX, 77030, USA

    M. E. Lopez

Authors
  1. W. K. Yunker
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  2. S. F. Hassan
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  3. L. B. Ferrell
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  4. M. J. Hicks
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  5. C. M. Giannoni
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  6. D. E. Wesson
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  7. C. I. Cassady
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  8. J. A. Hernandez
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  9. M. L. Brandt
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  10. M. E. Lopez
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Corresponding author

Correspondence to M. E. Lopez.

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Yunker, W.K., Hassan, S.F., Ferrell, L.B. et al. Needle core biopsy in the diagnosis of pediatric thyroid neoplasms: a single institution retrospective review. Pediatr Surg Int 29, 437–443 (2013). https://doi.org/10.1007/s00383-013-3278-8

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  • DOI: https://doi.org/10.1007/s00383-013-3278-8

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