DOI QR코드

DOI QR Code

Characteristics of thyroid nodules in infant with congenital hypothyroidism

  • Youn, Seo Young (Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine) ;
  • Lee, Jeong Ho (Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine) ;
  • Chang, Yun-Woo (Department of Radiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine) ;
  • Lee, Dong Hwan (Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine)
  • Received : 2013.05.08
  • Accepted : 2013.10.17
  • Published : 2014.02.15

Abstract

Purpose: This study aimed to assess the characteristics of thyroid nodules among infants diagnosed with congenital hypothyroidism. Methods: A retrospective study of 660 infants (374 males, 286 females) diagnosed with congenital hypothyroidism was carried out at the Pediatric Endocrine Clinic in Soonchunhyang University Hospital, Korea, between May 2003 and February 2013. The average age at diagnosis was $1.16{\pm}1.68$ months. Results: Of the 28 patients (4.2%) with thyroid nodules, 17 (2.6%) had cystic thyroid nodules and 11 (1.6%) had solid thyroid nodules. There were no significant differences in gender or age between congenital hypothyroidism patients who hadthyroid nodules and those who did not. All nodules were asymptomatic. The average age at diagnosis of congenital hypothyroidism with nodules was $1.42{\pm}1.39$ months. All detected nodules measured less than 1 cm in diameter. Twenty-two of the 28 infants (78.6%) had only one nodule, while multiple nodules were found in 6 infants (21.4%). Of the 28 infants diagnosed with nodules, 16 underwent thyroid ultrasonography during follow-up and 8 of them (50%) showed no signs of nodules at thyroid ultrasonography. Conclusion: The prevalence of thyroid nodules in infants with congenital hypothyroidism was 4.2%. Most thyroid nodules were small in size and benign, disappearing during follow-up observation. We therefore conclude that thyroid nodules in infants with congenital hypothyroidism can simply be observed and do not require direct treatment.

Keywords

References

  1. Corrias A, Mussa A. Thyroid nodules in pediatrics: which ones can be left alone, which ones must be investigated, when and how. J Clin Res Pediatr Endocrinol 2013;5 Suppl 1:57-69.
  2. Wiersinga WM. Management of thyroid nodules in children and adolescents. Hormones (Athens) 2007;6:194-9.
  3. Niedziela M. Pathogenesis, diagnosis and management of thyroid nodules in children. Endocr Relat Cancer 2006;13:427-53. https://doi.org/10.1677/erc.1.00882
  4. Ridgway EC. Clinical review 30: Clinician's evaluation of a solitary thyroid nodule. J Clin Endocrinol Metab 1992;74:231-5.
  5. Canadian Pediatric Thyroid Nodule (CaPTN) Study Group. The Canadian Pediatric Thyroid Nodule Study: an evaluation of current management practices. J Pediatr Surg 2008;43:826-30. https://doi.org/10.1016/j.jpedsurg.2007.12.019
  6. Raab SS, Silverman JF, Elsheikh TM, Thomas PA, Wakely PE. Pediatric thyroid nodules: disease demographics and clinical management as determined by fine needle aspiration biopsy. Pediatrics 1995;95:46-9.
  7. Chang YW, Lee DH, Hong YH, Hong HS, Choi DL, Seo DY. Congenital hypothyroidism: analysis of discordant US and scintigraphic findings. Radiology 2011;258:872-9. https://doi.org/10.1148/radiol.10100290
  8. Corrias A, Cassio A, Weber G, Mussa A, Wasniewska M, Rapa A, et al. Thyroid nodules and cancer in children and adolescents affected by autoimmune thyroiditis. Arch Pediatr Adolesc Med 2008;162:526-31. https://doi.org/10.1001/archpedi.162.6.526
  9. McHenry CR, Slusarczyk SJ, Khiyami A. Recommendations for management of cystic thyroid disease. Surgery 1999;126:1167-71. https://doi.org/10.1067/msy.2099.101423
  10. Oh SK, Lee JY, Lee DH, Moon IH, Kwon KN, Park KN, et al. The utility of sono-guided sclerotherapy for benign thyroid cyst: prospective study. Korean J Otorhinolaryngol-Head Neck Surg 2012;55:777-81. https://doi.org/10.3342/kjorl-hns.2012.55.12.777
  11. Kim EK, Park CS, Chung WY, Oh KK, Lee JT, Yoo HS. Incidentally found thyroid nodules in women with no previous thyroid disease: its significance. J Korean Radiol Soc 2002;46:449-53.
  12. Lee SK, Kwon SY, Woo SK. Cystic change of thyroid mass: a useful sign in differentiating benign from malignant thyroid lesions? J Korean Soc Ultrasound Med 2007;26:33-40.
  13. American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009;19:1167-214. https://doi.org/10.1089/thy.2009.0110
  14. Marqusee E, Benson CB, Frates MC, Doubilet PM, Larsen PR, Cibas ES, et al. Usefulness of ultrasonography in the management of nodular thyroid disease. Ann Intern Med 2000;133:696-700. https://doi.org/10.7326/0003-4819-133-9-200011070-00011
  15. Millman B, Pellitteri PK. Nodular thyroid disease in children and adolescents. Otolaryngol Head Neck Surg 1997;116(6 Pt 1):604-9. https://doi.org/10.1016/S0194-5998(97)70235-3
  16. Frates MC, Benson CB, Doubilet PM, Kunreuther E, Contreras M, Cibas ES, et al. Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J Clin Endocrinol Metab 2006;91:3411-7. https://doi.org/10.1210/jc.2006-0690
  17. Ezzat S, Sarti DA, Cain DR, Braunstein GD. Thyroid incidentalomas. Prevalence by palpation and ultrasonography. Arch Intern Med 1994;154:1838-40. https://doi.org/10.1001/archinte.1994.00420160075010
  18. Castro MR, Gharib H. Continuing controversies in the management of thyroid nodules. Ann Intern Med 2005;142:926-31. https://doi.org/10.7326/0003-4819-142-11-200506070-00011
  19. Carroll BA. Asymptomatic thyroid nodules: incidental sonographic detection. AJR Am J Roentgenol 1982;138:499-501. https://doi.org/10.2214/ajr.138.3.499
  20. Brander A, Viikinkoski P, Nickels J, Kivisaari L. Thyroid gland: US screening in a random adult population. Radiology 1991;181:683-7. https://doi.org/10.1148/radiology.181.3.1947082
  21. Miki H, Inoue H, Komaki K, Uyama T, Morimoto T, Monden Y. Value of mass screening for thyroid cancer. World J Surg 1998;22:99-102. https://doi.org/10.1007/s002689900356
  22. Tan GH, Gharib H. Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Ann Intern Med 1997;126:226-31. https://doi.org/10.7326/0003-4819-126-3-199702010-00009
  23. Goldfarb M, Gondek SS, Sanchez Y, Lew JI. Clinic-based ultrasound can predict malignancy in pediatric thyroid nodules. Thyroid 2012; 22:827-31. https://doi.org/10.1089/thy.2011.0494
  24. Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Pract Res Clin Endocrinol Metab 2008;22:901-11. https://doi.org/10.1016/j.beem.2008.09.019
  25. Gupta A, Ly S, Castroneves LA, Frates MC, Benson CB, Feldman HA, et al. A standardized assessment of thyroid nodules in children confirms higher cancer prevalence than in adults. J Clin Endocrinol Metab 2013;98:3238-45. https://doi.org/10.1210/jc.2013-1796