Thyroid nodule in Egyptian children, a 10 years experience

ABSTRACT

The study was done at Al-Azhar University hospitals, health insurance, and some private hospitals in the period from 1990 to 2000. A total number of 141 children, presenting with thyroid nodule were the materials of this study. 112 females and 29 were males. Their age ranged from 5 to 18 years. The thyroid hormonal profile was toxic in 16[11.3%] cases, and authyroid in 125 cases. After thyroid ultrasonography, sintigraphy. fine needle aspiration and cytological examination, surgical excision of the nodule was done, either by enucleation, lobectomy, or total thyroidectomy. The results showed that 100 [70.9%] child has solitary thyroid cold nodule, while in 25 [17.3] cases a dominant nodule was part of multinodular goiter. Histo-pathological examination revealed that malignancy was detected in 34[27.2%] of cold nodules, while adenoma was the commonest lesion 68 [54.4%]. Simple nodule, cyst, and thyroiditis, were detected in 23 [18.4%]. The malignant nodules, were 25/34 [73.5%] papillary carcinoma, and 9/34 [26.5%] follicular carcinoma. Modified radical neck dissection [lymphadenectomy] was done in three children only, where metastatic lymph nodes were excised. The highest incidence of thyroid nodules was detected between I992 and 1995. Fine needle aspiration was done in 86 cases and the results were correlated with the final postoperative histopathology. Non neoplastic Lesions were detected in 56/86 [65.1%] cases. Papillary carcinoma was detected in 11/86 [12.8%], however follicular neoplasm was found in 12/86 [14%]. Atypical cytology was gained in 7/ 86[8.1%]. Histopathological study of the fine needle aspirate in 86 cases revealed adenoma in 32/86 [37.2%], simple nodule in 17/86 [19.8%], papillary carcinoma in 18/86 [20.9%], follicular lesion in 12/86 [13.9%]. Comparing these results with the final post-operative histopathology revealed a diagnostic sensitivity and specificity near 100%. The over all diagnostic accuracy was 94.5% in papillary Iesions, 94. 12% in simple nodular goiter, but in follicular lesions we can not differentiate between benign and malignant lesions