Thyroid neoplasms: incidental findings on extent of disease evaluation CT for other pediatric malignancies

William J. Hammond, Todd E. Heaton, Benjamin A. Farber, Usman A. Mahmood, Jill S. Gluskin, Suzanne L. Wolden, Michael P. La Quaglia, Charles A. Sklar, Anita P. Price

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Purpose We performed a retrospective analysis to evaluate the risk of thyroid cancer in incidental thyroid nodules (ITNs) discovered on CT in patients with a history of pediatric cancer. Methods With IRB approval we reviewed the records of pediatric oncology patients age ≤ 21y with newly detected thyroid nodules on surveillance CT of the neck, chest, chest/abdomen/pelvis, or PET/CT performed between April 2008 and March 2015. Patients with < 6 months of follow-up after incidental findings, a history of primary thyroid malignancy, or incomplete records were excluded. Results The final cohort (N = 68) included 35 females and 33 males (mean age 16.0 ± 4.3[SD] years) with a mean follow-up time of 3.7 ± 1.9[SD] years after CT detection of ITN(s). Twenty patients (29.4%) received a follow-up thyroid ultrasound, eleven (16.2%) of whom underwent fine needle aspiration (FNA) for cytopathologic diagnosis. Among these, six (8.8%) underwent thyroid resection, with final pathology demonstrating papillary carcinoma in five (7.4%) and benign pathology in one. Conclusions Despite the low incidence of thyroid nodules and low risk of thyroid malignancy in the general pediatric population, we found a significant rate of malignancy in CT-detected ITNs in our pediatric oncology patients, and recommend ultrasound and FNA of these nodules in this high-risk population. Level of evidence Level IV, retrospective study with no comparison group.

Original languageEnglish (US)
Pages (from-to)938-943
Number of pages6
JournalJournal of Pediatric Surgery
Volume52
Issue number6
DOIs
StatePublished - Jun 2017
Externally publishedYes

Keywords

  • Adolescents
  • Children
  • CT
  • Incidentaloma
  • Papillary carcinoma
  • Thyroid nodule
  • Ultrasound

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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