Samenvatting
Slechts een klein deel van de zwellingen in de hals bij kinderen wordt veroorzaakt door schildkliernoduli. Het relatief hoge risico op een maligne proces is een reden tot zorgvuldige evaluatie waarbij specialistisch advies gewenst is. Aan de hand van twee ziektegeschiedenissen illustreren wij de diagnostische dilemma’s en doen we op basis van de literatuur een voorstel voor de diagnostische en therapeutische aanpak van kinderen met een solitaire schildkliernodus. De dunnenaaldbiopsie heeft een centrale rol waarbij met behulp van de TSH-waarden en het echografisch onderzoek de juiste patiënten geselecteerd kunnen worden.
Summary
Thyroid nodules represent a minority of the neck masses in children. As the risk of malignancy is relatively high work up should be thorough.We present two children with a thyroid nodule and propose a diagnostic and therapeutic approach based upon our experience and a review of the literature. Fine needle aspiration has a central position in the diagnostic work up in which thyroidal ultrasonography and measurement of serum TSH concentration are helpful initial steps.
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Mw. drs. A.P. Bech, arts-assistent afdeling Kindergeneeskunde, mw. dr. H.L. Claahsen-van der Grinten, kinderarts-endocrinoloog, dhr. dr. C. Noordam, kinderarts-endocrinoloog, UMC St Radboud, Nijmegen.
Correspondentieadres: Dr. Noordam, 833 Metabole en Endocriene ziekten, UMC St Radboud, Postbus 9101, 6500 HB Nijmegen.
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Bech, A.P., der Claahsen-van Grinten, H.L. & Noordam, C. Solitaire schildkliernoduli bij kinderen. KIND 77, 179–183 (2009). https://doi.org/10.1007/BF03086387
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DOI: https://doi.org/10.1007/BF03086387