Balice Piero, Theintz Gérald
Servizio di endocrinologia pediatrica, Ospedale regionale di Bellinzona e Valli, 6500 Bellinzona.
Rev Med Suisse. 2007 Apr 18;3(107):981-5.
Systematic examination of the thyroid gland allows discovering diffuse or multinodular goitres as well as solitary nodules. Goitre may be the only clinical manifestation of an underlying thyroid disease. Its evaluation should consider the familial history as well as nutritional and environmental factors. Thyroid ultrasonography is of critical importance to assess the diagnosis. Hashimoto's thyroiditis, colloid and endemic goitre are the most frequent causes of the diffuse form, particularly during puberty. Multinodular goitre and solitary thyroid nodule are rare in the paediatric age group: both conditions can reveal a malignant lesion. In this case, a total thyroidectomy should be performed. Long term outcome is excellent with an exception for medullary carcinoma which can be part of a multiple endocrine neoplasia (MEN type 2 A).
对甲状腺进行系统检查有助于发现弥漫性或多结节性甲状腺肿以及孤立性结节。甲状腺肿可能是潜在甲状腺疾病的唯一临床表现。对其评估应考虑家族史以及营养和环境因素。甲状腺超声检查对评估诊断至关重要。桥本甲状腺炎、胶质性甲状腺肿和地方性甲状腺肿是弥漫性甲状腺肿最常见的病因,尤其是在青春期。多结节性甲状腺肿和孤立性甲状腺结节在儿童年龄组中较为罕见:这两种情况都可能显示恶性病变。在这种情况下,应进行全甲状腺切除术。除髓样癌外,长期预后良好,髓样癌可能是多发性内分泌肿瘤(2 A型多发性内分泌腺瘤病)的一部分。