Thyroid Masses: Approach to Diagnosis and Management in Childhood and Adolescence
Nancy J. Hopwood 1
Robert P. Kelch MD2
1 Professor of Pediatrics and Chief of Pediatric Endocrinology
2 Professor and Chair, Department of Pediatrics, Department of Pediatrics and Communicable Diseases, The University of Michigan Medical Center, CS Mott Children's Hospital, Ann Arbor, MI.
The approach to the evaluation of a neck mass requires careful history and physical examination to determine if the mass is thyroidal or nonthyroidal. Thyromegaly can be classified as diffuse or nodular, painless or painful, or associated with a solitary or multiple nodules. While the most common cause of diffuse enlargement is chronic lymphocytic thyroiditis, the presence of nodularity should prompt consideration of cancer. Results of a radionuclide scan, ultrasonogram, and/or a fine-needle aspiration of a cystic nodule should help guide the physician to those patients in need of an open thyroid biopsy.
