Scott M D, Crawford J D
Pediatrics. 1976 Oct;58(4):521-5.
Solitary thyroid nodules in childhood had a 40% to 70% incidence of malignancy in the era of low-dose therapeutic irradiation. In the last 15 years, 36 children have been evaluated for such nodules, with a final diagnoses of carcinoma in 17%, adenoma in 58%, and miscellaneous diagnoses in 26%. All patients with carcinoma were euthyroid and had no history of irradiation in infancy. Treatment included thyroidectomy and full-replacement thyroid therapy. Benign neoplasms were often "cold" by scan; all patients were euthyroid except one adolescent body with T3 toxicosis. A majority proved to be follicular adenomas at surgery. Miscellaneous benign conditions outnumbered carcinoma and included variations in migration or embryologic development of the thyroid anlagen, thyroiditis, and a thyroid abcess. A 99mTc scan proved more valuable in diagnosis than thyroid function tests: a "hot" nodule usually suggested a developmental abnormality of the thyroid rather than a tumor. Our series of children, born since the dangers of irradiation have become common knowledge, suggests there may be a changing trend in the pathology encountered in solitary thryoid nodules.
在低剂量治疗性放射治疗时代，儿童期孤立性甲状腺结节的恶性发生率为40%至70%。在过去15年中，对36名患有此类结节的儿童进行了评估，最终诊断为癌的占17%，腺瘤的占58%，其他诊断的占26%。所有癌患者甲状腺功能正常，且婴儿期无放射史。治疗包括甲状腺切除术和全量替代甲状腺治疗。良性肿瘤扫描时通常为“冷”结节；除一名患有T3中毒的青少年外，所有患者甲状腺功能均正常。大多数在手术中被证明是滤泡性腺瘤。其他良性疾病的数量超过了癌，包括甲状腺原基迁移或胚胎发育异常、甲状腺炎和甲状腺脓肿。99mTc扫描在诊断中比甲状腺功能测试更有价值：“热”结节通常提示甲状腺发育异常而非肿瘤。我们这组自放射危险已广为人知后出生的儿童表明，孤立性甲状腺结节的病理学可能存在变化趋势。
