Objective: We aimed to evaluate the clinical, radiological and pathological findings of children and adolescents with thyroid nodules.
Method: Data of 121 children and adolescent with thyroid nodule and had fine needle aspiration (FNA) were examined retrospectively. Concomitant thyroid disease, ultrasound (US) features of the nodule, FNA and histopathological results were recorded. FNA results were assessed according to The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC).
Results: Median age of the cases was 14 years (range 3-18 years) and 81% were female. FNA results of patients were insufficient in 1 (0.8%), benign in 68 (56.2 %), indeterminate in 44 (36.4%) and malignant in 8 (6.6%) patients. Among 39 patients who were directed to surgery, 10 patients had differentiated thyroid cancer (DTC). The total malignancy rate was 10.0% (10/100). Control FNA results showed progress according to TBSRTC in 18.7% of benign results and 4 of 75 patients had DTC in surgical excision. 2 of 22 patients with atypia of undetermined significance (AUS) who continued follow-up was diagnosed with DTC. Male gender, presence of Hashimoto thyroiditis and US findings of uninodularity; hypoechogenicity; increased blood flow; irregular margins; solid structure; microcalcification and presence of abnormal cervical lymph nodes were associated with malignancy.
Conclusion: Our results revealed that, thyroid nodules are 10% malignant in children and adolescents. Patients with AUS has 9% potential for malignancy and patients with initially benign FNA result may have changes in TBSTRC findings in repeat FNA with a 5.3% false negative rate.
Keywords: Adolescents; Children; Fine-needle aspiration; Thyroid nodule.