Endocrine Abstracts

JOINT3629

Introduction: Thyroid gland diseases among children and adolescents are rare. The purpose of the current study was to describe the pediatric patients treated with surgery of the thyroid gland, including the diagnostic evaluation, type of surgical treatment, complications and pathological findings.

Methods: Patients with an age of less than 18 years at the time surgery with a procedure coded for a surgery on the thyroid gland (KBAAxx) were extracted from the electronic medical journal system.

Results: 32 patients with a median age of 16 years (range 3 - 17) were operated during a twelve-year period from January 2012 to December 2023. The frequency of preoperative imaging was ultrasound scan (US) (97%), thyroid scintigraphy (41%), magnetic resonance imaging (MRI) (25%) and computerized tomography (CT) scan (9%). Almost all patients had TSH measured (97%) and more than half were evaluated with a fine needle aspiration (FNA) (59%). Six patients had genetic dispositions to thyroid disease (19%). Forty surgical procedures were performed in 32 patients. The procedures were hemi-thyroidectomy (15 patients), total thyroidectomy in one (9) or two procedures (8). Further, 7 patients had simultaneous lymphadenectomy performed in the central and/or lateral neck compartments. The pathological examination revealed thyroid cancer in 14 patients (45%). The majority was papillary thyroid cancer (11), one classic follicular cancer, one oncocytic cancer, and one medullary cancer. Of patients with thyroid cancer, 4 (29%) had lymph node metastasis and none had distant metastases. There was one permanent paresis of the recurrent laryngeal nerve out of 49 nerves at risk (2%). One had permanent hypoparathyroidism out of 17 patients at risk (6%).

Conclusion: Most pediatric patients with thyroid disease are only evaluated by US and TSH before surgery. Compared with adult thyroid patients, genetic dispositions and cancer frequency are more common, whereas complications after surgery are rare.