Gerus Sylwester, Rasiewicz Marcin, Baglaj Maciej
Department of Pediatric Surgery and Urology, Wroclaw Medical University, Wroclaw, Poland.
Arch Med Sci. 2021 Apr 10;21(3):802-807. doi: 10.5114/aoms/130994. eCollection 2025.
Surgical diseases of the thyroid gland in children are rare in comparison with those in the adult population. The aim of the study was to assess clinical aspects of thyroid follicular adenoma in children and attempt to develop a management algorithm that is useful in clinical practice.
The clinical database of all children operated on due to thyroid disease in the years 1993-2018 at the university pediatric surgical center was reviewed. The children in whom the postoperative histology report showed follicular adenoma were selected and their medical files were analyzed in detail. Clinical course of the disease, medical and family history, results of imaging studies, details of surgical management and final outcome were assessed in each case.
Among 183 children operated on for thyroid pathology in the study period there were 56 patients with follicular adenoma (30.6%). Their age ranged from 7 to 18 years. Seven patients were found to be hypothyroid and a further seven showed hyperthyroid status initially. Ultrasound scan showed a solitary nodule in 37 (66.1%) children. Multiple nodules in one lobe were detected in 5 patients, while a further 14 children showed bilateral thyroid pathology. The result of preoperative cytologic examination was suspicious in 12 (21.4%) children. All children were subjected to operative management. Forty-two (75%) children underwent at least unilateral total lobectomy. No patient showed a recurrent thyroid disease.
Follicular adenoma in children presents a wide clinical and morphological spectrum. High incidence of associated diseases of other systems and congenital anomalies of the thyroid gland may indicate a complex etiology of follicular adenoma with participation of still unknown endogenic factors in children.
与成人相比，儿童甲状腺外科疾病较为罕见。本研究的目的是评估儿童甲状腺滤泡性腺瘤的临床特征，并尝试制定一种在临床实践中有用的管理算法。
回顾了1993年至2018年在大学儿科手术中心因甲状腺疾病接受手术的所有儿童的临床数据库。选择术后组织学报告显示为滤泡性腺瘤的儿童，并详细分析他们的病历。评估每个病例的疾病临床过程、病史和家族史、影像学检查结果、手术管理细节及最终结果。
在研究期间接受甲状腺疾病手术的183名儿童中，有56例患有滤泡性腺瘤（30.6%）。他们的年龄在7至18岁之间。7名患者被发现甲状腺功能减退，另有7名患者最初表现为甲状腺功能亢进。超声扫描显示37名（66.1%）儿童有单个结节。5名儿童在一个叶中发现多个结节，另有14名儿童表现为双侧甲状腺病变。12名（21.4%）儿童术前细胞学检查结果可疑。所有儿童均接受手术治疗。42名（75%）儿童至少接受了单侧全叶切除术。没有患者出现甲状腺疾病复发。
儿童滤泡性腺瘤呈现出广泛的临床和形态学谱。其他系统相关疾病和甲状腺先天性异常的高发病率可能表明儿童滤泡性腺瘤病因复杂，有仍未知的内源性因素参与。
