TY - JOUR
T1 - Thyroid nodules and cancer in children and adolescents affected by autoimmune thyroiditis
AU - Corrias, Andrea
AU - Cassio, Alessandra
AU - Weber, Giovanna
AU - Mussa, Alessandro
AU - Wasniewska, Malgorzata
AU - Rapa, Anna
AU - Gastaldi, Roberto
AU - Einaudi, Silvia
AU - Baronio, Federico
AU - Vigone, Maria Cristina
AU - Messina, Maria Francesca
AU - Bal, Milva
AU - Bona, Gianni
AU - De Sanctis, Carlo
PY - 2008/6
Y1 - 2008/6
N2 - Objective: To investigate the association between juvenile autoimmune thyroiditis (JAT) and thyroid cancer in pediatric patients. Design:Weconducted a retrospective study among children and adolescents affected by JAT. Settings: Data from 6 Italian pediatric endocrinology centers were collected. Participants: Three hundred sixty-five children and adolescents affected by JAT diagnosed at 3.6 to 17.0 years of age. Interventions: All patients underwent clinical examination and thyroid function test every 6 to 12 months and thyroid echography every 12 to 24 months. Fine-needle aspiration biopsy was performed in 39 patients with nodule diameter of 1 cm or larger, as well as in 4 patients with nodule diameter of less than 1 cm and echographic findings suspicious for neoplasm. Twenty-three patients underwent surgery. Main Outcome Measures: Thyroid function, echographic pattern, nodule diameter, the presence of lymphadenopathy, and cytologic and histologic diagnoses were considered. Results: Thyroid nodules were found in 115 patients; findings in 11 of these were consistent with papillary carcinoma, with 5 exhibiting lymph node metastasis. The prevalence of male sex among patients with cancer was greater than that among patients with JAT (odds ratio [OR], 2.95; 95% confidence interval [CI], 1.44-6.20). The growth of nodules during levothyroxine sodium therapy (OR, 15.60; 95% CI, 1.87-181.90) and the finding of lymphadenopathy (OR, 5.44; 95% CI, 1.05-30.50) were statistically significantly associated with the presence of cancer, while uninodularity and hypoechogenicity were not. Conclusions: The observed prevalences of thyroid nodules and thyroid cancer in our JAT case series were 31.5% and 3.0%, respectively. Papillary carcinoma was the only histotype detected. The finding of lymphadenopathy, a lack of response to levothyroxine therapy, and nodule hypoechogenicity suggested malignancy. Fine-needle aspiration biopsy was reliable in selecting patients for referral to surgery.
AB - Objective: To investigate the association between juvenile autoimmune thyroiditis (JAT) and thyroid cancer in pediatric patients. Design:Weconducted a retrospective study among children and adolescents affected by JAT. Settings: Data from 6 Italian pediatric endocrinology centers were collected. Participants: Three hundred sixty-five children and adolescents affected by JAT diagnosed at 3.6 to 17.0 years of age. Interventions: All patients underwent clinical examination and thyroid function test every 6 to 12 months and thyroid echography every 12 to 24 months. Fine-needle aspiration biopsy was performed in 39 patients with nodule diameter of 1 cm or larger, as well as in 4 patients with nodule diameter of less than 1 cm and echographic findings suspicious for neoplasm. Twenty-three patients underwent surgery. Main Outcome Measures: Thyroid function, echographic pattern, nodule diameter, the presence of lymphadenopathy, and cytologic and histologic diagnoses were considered. Results: Thyroid nodules were found in 115 patients; findings in 11 of these were consistent with papillary carcinoma, with 5 exhibiting lymph node metastasis. The prevalence of male sex among patients with cancer was greater than that among patients with JAT (odds ratio [OR], 2.95; 95% confidence interval [CI], 1.44-6.20). The growth of nodules during levothyroxine sodium therapy (OR, 15.60; 95% CI, 1.87-181.90) and the finding of lymphadenopathy (OR, 5.44; 95% CI, 1.05-30.50) were statistically significantly associated with the presence of cancer, while uninodularity and hypoechogenicity were not. Conclusions: The observed prevalences of thyroid nodules and thyroid cancer in our JAT case series were 31.5% and 3.0%, respectively. Papillary carcinoma was the only histotype detected. The finding of lymphadenopathy, a lack of response to levothyroxine therapy, and nodule hypoechogenicity suggested malignancy. Fine-needle aspiration biopsy was reliable in selecting patients for referral to surgery.
UR - http://www.scopus.com/inward/record.url?scp=44649201647&partnerID=8YFLogxK
U2 - 10.1001/archpedi.162.6.526
DO - 10.1001/archpedi.162.6.526
M3 - Article
SN - 1072-4710
VL - 162
SP - 526
EP - 531
JO - Archives of Pediatrics and Adolescent Medicine
JF - Archives of Pediatrics and Adolescent Medicine
IS - 6
ER -