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儿童甲状腺结节的管理:单中心经验

Management of Thyroid Nodules in Children: A single-center experience.

作者信息

El Omri Malika, Gabsi Oumaima, Bellakhdher Mouna, Ghammem Monia, Kermani Wassim, Abdelkefi Mohamed

机构信息

Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, University of Sousse, Sousse, 4000, Tunisia.

出版信息

Iran J Otorhinolaryngol. 2025;37(2):65-71. doi: 10.22038/ijorl.2024.78964.3659.

Abstract

INTRODUCTION

Thyroid nodules are a common diagnosis in adults. However, in children, they are rare, occurring in only 1-5% of cases. Early diagnosis and prompt management are crucial due to the higher likelihood of malignancy. The aim of this study was to describe the characteristics of thyroid nodules in children and plan their therapeutic management.

MATERIALS AND METHODS

A retrospective study was conducted on 29 children who underwent surgery for thyroid nodules at our ENT department between 2000 and 2022.

RESULTS

The average age of the patients was 14.4 years, with a clear predominance of females (sex ratio of 0.16). The primary complaint was the appearance of an anterior cervical swelling in 82.7% of cases. The surgical procedures performed on the thyroid gland included isthmectomy in one patient, lobectomy in 16 patients, and total thyroidectomy in 12 patients. Total thyroidectomy was performed in one step in 10 cases and in two steps in 2 cases where papillary carcinoma was found in the final histological examination of the lobectomy parts. Papillary carcinoma was confirmed in four cases (13.8%) after definitive histological examination. All patients had favourable outcomes. The mean follow-up was 31 months for benign cases and 15 months after the last course of radioactive iodine therapy for malignant cases.

CONCLUSION

Thyroid nodules are uncommon in children. To evaluate the risk of malignancy in children with thyroid nodules, ultrasound and cytology should be performed. This will help determine the appropriate surgical management.

摘要

引言

甲状腺结节在成人中是常见诊断。然而,在儿童中却很罕见,仅发生于1% - 5%的病例中。由于恶性可能性更高,早期诊断和及时处理至关重要。本研究的目的是描述儿童甲状腺结节的特征并规划其治疗管理。

材料与方法

对2000年至2022年间在我们耳鼻喉科接受甲状腺结节手术的29名儿童进行了回顾性研究。

结果

患者的平均年龄为14.4岁,女性明显占主导(性别比为0.16)。82.7%的病例主要症状是颈部前方肿胀。对甲状腺进行的手术操作包括1例患者行峡部切除术,16例患者行叶切除术,12例患者行全甲状腺切除术。10例全甲状腺切除术为一次性完成,2例在叶切除术部分的最终组织学检查中发现乳头状癌的患者分两步进行。最终组织学检查确诊4例(13.8%)为乳头状癌。所有患者预后良好。良性病例的平均随访时间为31个月,恶性病例在最后一次放射性碘治疗疗程后的随访时间为15个月。

结论

甲状腺结节在儿童中并不常见。为评估儿童甲状腺结节的恶性风险,应进行超声检查和细胞学检查。这将有助于确定合适的手术管理方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1191/11949436/f613bb381dc3/ijo-37-71-g001.jpg

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