PEDIATRICS Vol. 58 No. 4 October 1976, pp. 521-525
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Solitary Thyroid Nodules in Childhood: Is the Incidence of Thyroid Carcinoma Declining?

Mary D. Scott M.D.1 and John D. Crawford M.D.1

1 Children's Service, Massachusetts General Hospital, the Department of Pediatrics, Harvard Medical School, and the Shriners Burns Institute, Boston, Massachusetts

Solitary thyroid nodules in childhood had a 40% to 70% incidence of malignancy in the era of low-dose therapeutic irradiation. In the last 15 years, 36 children have been evaluated for such nodules, with a final diagnosis of carcinoma in 17%, adenoma in 58%, and miscellaneous diagnoses in 26%. All patients with carcinoma were euthyroid and had no history of irradiation in infancy. Treatment included thyroidectomy and full-replacement thyroid therapy. Benign neoplasms were often "cold" by scan; all patients were euthyroid except one adolescent boy with T3 toxicosis. A majority proved to be follicular adenomas at surgery. Miscellaneous benign conditions outnumbered carcinoma and included variations in migration or embryologic development of the thyroid anlagen, thyroiditis, and a thyroid abcess. A 99mTc scan proved more valuable in diagnosis than thyroid function tests: a "hot" nodule usually suggested a developmental abnormality of the thyroid rather than a tumor. Our series of children, born since the dangers of irradiation have become common knowledge, suggests there may be a changing trend in the pathology encountered in solitary thyroid nodules.

Submitted on December 8, 1975
Accepted on March 18, 1976




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