Endocrine Abstracts

Introduction: Thyroidectomy in the pediatric population is a seldom-performed surgical procedure, primarily associated with thyroid neoplasms. However, certain benign thyroid gland conditions, such as Graves’ disease, toxic adenomas, congenital hyperthyroidism, and goiter, also necessitate surgical intervention in children. Performing such surgeries in pediatric patients poses significant challenges for surgeons. This study aims to investigate the epidemiological and clinical characteristics, as well as therapeutic outcomes, of children undergoing thyroid surgery in our institution.

Materials and Methods: A retrospective study was conducted on 25 children who underwent thyroid surgery in our department between 2010 and 2023, including systematic histopathological analysis.

Results: The average age of the patients was 14.6 years, with a notable female predominance (90.5%). Relevant medical histories included Graves’ disease in 5 cases (22.7%) and one case of congenital hypothyroidism. The most common presentation was basi-cervical swelling. The surgical indication was established based on compressive thyroid nodules in 17 patients (68%) and in 7 cases (28%) within the context of known Graves’ disease. Additionally, one case involved suspicious thyroid nodules with cervical polyadenopathies and chronic cough. Total thyroidectomy was performed in 14 patients (56%), lobo-isthmectomy in 10 patients (40%), and isthmectomy in 1 patient (4%). Bilateral mediastino-recurrent functional lymph node dissection was carried out in one case. The average postoperative hospitalization duration was 3 days (range: 2 to 6 days). Histopathological examination revealed 9 cases of multinodular goiter, 5 cases of Graves’ disease, 4 cases of lymphocytic thyroiditis, 5 cases of vesicular adenoma, 1 case of oncocytic adenoma, and 1 case of papillary thyroid carcinoma with lymph node and pulmonary metastases, necessitating IRA therapy. Postoperative complications were reported in 32% of cases, with hypocalcemia being the most common (60%). No recurrent laryngeal nerve paralysis was identified. Favorable outcomes were observed in all patients.

Conclusion: Pediatric thyroid disorders requiring surgical intervention are considerably rarer than in adults. Benign thyroid nodules and Graves’ disease are the most common surgical indications. Surgical management in children can be intricate, necessitating careful consideration and expertise.