Skip to main content

Advertising Disclaimer »

Main menu

  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors
    • Submit Manuscript
    • Author Guidelines
  • Content
    • Current Issue
    • Complete Issue PDF
    • Archive
    • Topic/Program Collections
    • Blog
  • Multimedia
    • Teaching Slides
    • Pediatrics On Call Podcast
  • CME/MOC
    • CME Quizzes
    • MOC Claiming
  • Subscribe
  • Alerts
  • Careers
  • Other Publications
    • American Academy of Pediatrics

User menu

  • Log in
  • My Cart

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • My Cart
  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors
    • Submit Manuscript
    • Author Guidelines
  • Content
    • Current Issue
    • Complete Issue PDF
    • Archive
    • Topic/Program Collections
    • Blog
  • Multimedia
    • Teaching Slides
    • Pediatrics On Call Podcast
  • CME/MOC
    • CME Quizzes
    • MOC Claiming
  • Subscribe
  • Alerts
  • Careers
American Academy of Pediatrics
Article

Consultation with the Specialist

Thyroid Nodules

Jennifer N. Osipoff and Thomas A. Wilson
Pediatrics in Review February 2012, 33 (2) 75-82; DOI: https://doi.org/10.1542/pir.33-2-75
Quiz
Jennifer N. Osipoff
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Thomas A. Wilson
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • Comments
  • Quiz
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Download PDF
  1. Jennifer N. Osipoff, MD*
  2. Thomas A. Wilson, MD*
  1. *Division of Pediatric Endocrinology, Department of Pediatrics, Stony Brook Children's Hospital, State University of New York, Stony Brook, NY.
  • Author Disclosure

    Drs Osipoff and Wilson have disclosed no financial relationships relevant to this article. This commentary does contain a discussion of an unapproved/investigative use of a commercial product/device.

  • Abbreviations:
    FNAB:
    fine-needle aspiration biopsy
    I-131:
    a radioactive isotope of iodine
    MTC:
    medullary thyroid carcinoma
    PTC:
    papillary thyroid carcinoma
    rh-thyrotropin:
    recombinant human thyrotropin
    WDTC:
    well-differentiated thyroid carcinoma
    WBS:
    whole-body scan
  • Educational Gap

    Although most pediatric thyroid masses are benign, some are malignant; thus, pediatricians must be able to assess for risk of malignancy and order appropriate diagnostic tests in conjunction with consultation with an endocrinologist.

    Objectives

    1. Develop a differential diagnosis and initial evaluation plan for a child or adolescent presenting with a thyroid mass.

    2. List the risk factors associated with malignant thyroid nodules.

    3. Understand the limitations of ultrasonography and fine-needle aspiration biopsy in the assessment of a thyroid nodule.

    4. Recognize the risk factors inherent in surgical thyroidectomy.

    5. Appreciate the current controversies in the management of pediatric thyroid nodules.

    Introduction

    Whether as part of a well-child examination, or in response to a patient or parent concern, it is important for the pediatrician to feel comfortable examining the thyroid gland. Although most pediatric thyroid masses are benign (Table 1 and Fig 1), in the event that a lesion is discovered, the pediatrician should be able to assess risk factors for malignancy and order appropriate diagnostic tests while awaiting consultation from the pediatric endocrinologist.

    View this table:
    • In this window
    • In a new window
    Table 1.

    Benign Thyroid Masses

    Figure 1.

    A. A patient with an ectopic thyroid gland (upper protuberance) before treatment. B. The same patient a few months after starting levothyroxine. Note how the gland has shrunk in response to treatment.

    Epidemiology

    Palpable thyroid nodules in the pediatric and adolescent population are relatively rare, having an estimated prevalence of 0.2% to 1.4%, which is 5 to 10 times less than in adults. (1) Despite their lower occurrence, studies estimate 9% to 50% (mean, 26.4%) of thyroid nodules in children and teenagers are cancerous, significantly higher than the estimated 10% to 14% of lesions in adults. (2) In fact, thyroid cancers are …

    Individual Login

    Log in
    You will be redirected to aap.org to login or to create your account.

    Institutional Login

    via Institution

    You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.

    Log in through your institution

    If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

    Purchase access

    You may purchase access to this article. This will require you to create an account if you don't already have one.

    Offer Reprints

    PreviousNext
    Back to top

    Advertising Disclaimer »

    In this issue

    Pediatrics in Review: 33 (2)
    Pediatrics in Review
    Vol. 33, Issue 2
    1 Feb 2012
    • Table of Contents
    • Table of Contents (PDF)
    • About the Cover
    • Index by author
    View this article with LENS
    PreviousNext
    Email Article

    Thank you for your interest in spreading the word on American Academy of Pediatrics.

    NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

    Enter multiple addresses on separate lines or separate them with commas.
    Consultation with the Specialist
    (Your Name) has sent you a message from American Academy of Pediatrics
    (Your Name) thought you would like to see the American Academy of Pediatrics web site.
    CAPTCHA
    This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
    Request Permissions
    Article Alerts
    Log in
    You will be redirected to aap.org to login or to create your account.
    Or Sign In to Email Alerts with your Email Address
    Citation Tools
    Consultation with the Specialist
    Jennifer N. Osipoff, Thomas A. Wilson
    Pediatrics in Review Feb 2012, 33 (2) 75-82; DOI: 10.1542/pir.33-2-75

    Citation Manager Formats

    • BibTeX
    • Bookends
    • EasyBib
    • EndNote (tagged)
    • EndNote 8 (xml)
    • Medlars
    • Mendeley
    • Papers
    • RefWorks Tagged
    • Ref Manager
    • RIS
    • Zotero
    Quiz
    Share
    Consultation with the Specialist
    Jennifer N. Osipoff, Thomas A. Wilson
    Pediatrics in Review Feb 2012, 33 (2) 75-82; DOI: 10.1542/pir.33-2-75
    del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
    Print
    Download PDF
    Insight Alerts
    • Table of Contents

    Jump to section

    • Article
      • Educational Gap
      • Objectives
      • Introduction
      • Epidemiology
      • Clinical Aspects
      • Evaluation
      • Surgical Management
      • Postoperative Management
      • Prognosis
      • References
    • Figures & Data
    • Info & Metrics
    • Comments
    • Quiz

    Related Articles

    • PubMed
    • Google Scholar

    Cited By...

    • Pediatric Neck Masses
    • Google Scholar

    More in this TOC Section

    • Preparing Children for International Travel
    • Type 2 Diabetes Mellitus in Childhood and Adolescence
    • Ear Abnormalities
    Show more Article

    Similar Articles

    Subjects

    • Endocrinology
      • Endocrinology
    • Hematology/Oncology
      • Hematology/Oncology
      • Cancer/Neoplastic
    • Journal Info
    • Editorial Board
    • ABP Content Specifications Map
    • Overview
    • Licensing Information
    • Authors
    • Author Guidelines
    • Submit My Manuscript
    • Librarians
    • Institutional Subscriptions
    • Usage Stats
    • Support
    • Contact Us
    • Subscribe
    • Resources
    • Media Kit
    • About
    • International Access
    • Terms of Use
    • Privacy Statement
    • FAQ
    • AAP.org
    • shopAAP
    • Follow American Academy of Pediatrics on Instagram
    • Visit American Academy of Pediatrics on Facebook
    • Follow American Academy of Pediatrics on Twitter
    • Follow American Academy of Pediatrics on Youtube
    American Academy of Pediatrics

    © 2021 American Academy of Pediatrics