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Thyroid Nodules in Children and Cancer Risk

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Thyroid Cancer

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Abstract

Thyroid nodules are diagnosed less frequently in children and adolescents when compared to adults. However, similar to adults, the incidence of both thyroid nodules and thyroid cancer in pediatric patients has increased over the last several decades. The reason for the increase is not entirely clear but is likely related to a combination of several factors, to include an increase in incidentally discovered thyroid nodules found during non-thyroid-related head and neck imaging (ultrasound (US), CT, and MRI), increased use of radiological surveillance for children at risk of developing thyroid malignancy (i.e., survivors of primary malignancy exposed to radiation therapy), and variety of additional factors with unknown but confounding impact such as the presence of autoimmune thyroid disease, the degree of iodine sufficiency, and exposure to medical and environmental ionizing radiation. In adult patients, there is controversy whether the increasing incidence of thyroid cancer is related to the identification of subclinical disease. This same concern is relevant to the pediatric age as well, however, because of a fivefold risk of malignancy for a nodule discovered in a child or adolescent when compared to an adult patient (25 % vs 5 %, respectively). Thorough evaluation of the nodule found in a child or adolescent should be based on individual risk factors and ultrasound features rather than on the method of discovery.

These considerations highlight the importance of establishing appropriate clinical expertise and resources in order to perform accurate evaluation and management.

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  1. Division of Endocrinology and Diabetes, Department of Pediatrics, The Children’s Hospital of Philadelphia, The Perelman School of Medicine, The University of Pennsylvania, 34th Street and Civic Center Boulevard Suite 11 NW 30, Philadelphia, PA, 19014, USA

    Andrew J. Bauer MD

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  1. Department of Medicine, MedStar Washington Hospital Center Georgetown University School of Medicine, Washington, DC, USA

    Leonard Wartofsky

  2. Nuclear Medicine Research MedStar Research Institute and Washington Hospital Center, Georgetown University School of Medicine Washington Hospital Center, Washington, DC, USA

    Douglas Van Nostrand

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Bauer, A.J. (2016). Thyroid Nodules in Children and Cancer Risk. In: Wartofsky, L., Van Nostrand, D. (eds) Thyroid Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3314-3_27

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