Nodular thyroid disease in pediatric age has a lower prevalence than in adulthood but has up to five times higher risk of malignancy. In general, most thyroid nodules in childhood are benign. However, as in adults, the majority of pediatric patients ultimately diagnosed with differentiated thyroid cancer (DTC) present with an asymptomatic thyroid nodule, found on physical examination or during radiological imaging, unrelated to the thyroid, of the head and neck. There has been an increasing incidence in the diagnosis of DTC in pediatric patients over the last 4–5 decades, with much of this trend secondary to an increase in the diagnosis of papillary thyroid cancer (PTC). Finally, the incidence is increased by the surveillance approach of patients with genetic predisposition syndromes.
Recent studies indicate different scoring systems based on thyroid ultrasound. These include central and lateral neck for cervical lymphadenopathy to improve patient selection for fine needle aspiration (FNAB) and better definition of pediatric-specific risk of malignancy. Furthermore, the broadening of knowledge of the oncogenic landscape supports incorporation of oncogene testing to rule-in malignancy of nodules with indeterminate cytology. Finally, it is still debated whether therapy should be surgical, depending on the cytological class after FNAB, on the extent and size of the tumor, and in relation to the long-term side effects of radioiodine, which are not yet completely known in pediatric subjects.
After the publication of scoring systems for the cytological classification and the updating of the clinical guidelines from various national and international scientific associations, the aims of this Research Topic are to further knowledge on the evaluation and management of thyroid nodules and tumors in childhood.
Articles reviewing and/or updating the following will be considered:
- scoring systems for cytological classification in pediatric patients;
- diagnosis of thyroid nodules or tumors in pediatric patients;
- treatment of thyroid nodules or tumors in pediatric patients;
- pediatric-specific risk of malignancy;
Nodular thyroid disease in pediatric age has a lower prevalence than in adulthood but has up to five times higher risk of malignancy. In general, most thyroid nodules in childhood are benign. However, as in adults, the majority of pediatric patients ultimately diagnosed with differentiated thyroid cancer (DTC) present with an asymptomatic thyroid nodule, found on physical examination or during radiological imaging, unrelated to the thyroid, of the head and neck. There has been an increasing incidence in the diagnosis of DTC in pediatric patients over the last 4–5 decades, with much of this trend secondary to an increase in the diagnosis of papillary thyroid cancer (PTC). Finally, the incidence is increased by the surveillance approach of patients with genetic predisposition syndromes.
Recent studies indicate different scoring systems based on thyroid ultrasound. These include central and lateral neck for cervical lymphadenopathy to improve patient selection for fine needle aspiration (FNAB) and better definition of pediatric-specific risk of malignancy. Furthermore, the broadening of knowledge of the oncogenic landscape supports incorporation of oncogene testing to rule-in malignancy of nodules with indeterminate cytology. Finally, it is still debated whether therapy should be surgical, depending on the cytological class after FNAB, on the extent and size of the tumor, and in relation to the long-term side effects of radioiodine, which are not yet completely known in pediatric subjects.
After the publication of scoring systems for the cytological classification and the updating of the clinical guidelines from various national and international scientific associations, the aims of this Research Topic are to further knowledge on the evaluation and management of thyroid nodules and tumors in childhood.
Articles reviewing and/or updating the following will be considered:
- scoring systems for cytological classification in pediatric patients;
- diagnosis of thyroid nodules or tumors in pediatric patients;
- treatment of thyroid nodules or tumors in pediatric patients;
- pediatric-specific risk of malignancy;