BACKGROUND/ PURPOSE: Thyroidectomy is the primary therapy for thyroid cancer and an established treatment of hyperthyroidism. Because of the relative rarity of these conditions in childhood, few single-institution series exist in the pediatric literature. Here we analyze our institution's experience to assess patient demographics, operative risks, and the role of preoperative testing. METHODS: This is a retrospective chart review of 175 consecutive patients not older than 18 years who underwent thyroid surgery at Children's Hospital Boston from 1970 to 2004. RESULTS: The most common indication for thyroidectomy was thyroid nodules (83%), followed by hyperthyroidism (7%) and goiter (7%). For children referred for nodules, we observed a peak incidence in adolescence and a female to male ratio of 3.7:1. Cancer was found in 36%, with papillary thyroid cancer the most common subtype (85%). Operative complications were rare, with permanent hypocalcemia in 2 (4.7%) of 43 patients who underwent bilateral resection for thyroid nodules (no cases of permanent hypocalcemia in other procedures). Permanent unilateral vocal cord paralysis was documented in 2 children after the resection of malignant nodules. CONCLUSIONS: Pediatric thyroidectomy can be performed with low operative risk. Because permanent hypocalcemia remains an obligate risk of bilateral thyroidectomy, we recommend the routine use of preoperative fine-needle aspiration to guide the extent of initial surgical resection, reserving near-total thyroidectomy for those cases where cytology is positive for malignancy.
BACKGROUND/ PURPOSE: Thyroidectomy is the primary therapy for thyroid cancer and an established treatment of hyperthyroidism. Because of the relative rarity of these conditions in childhood, few single-institution series exist in the pediatric literature. Here we analyze our institution's experience to assess patient demographics, operative risks, and the role of preoperative testing. METHODS: This is a retrospective chart review of 175 consecutive patients not older than 18 years who underwent thyroid surgery at Children's Hospital Boston from 1970 to 2004. RESULTS: The most common indication for thyroidectomy was thyroid nodules (83%), followed by hyperthyroidism (7%) and goiter (7%). For children referred for nodules, we observed a peak incidence in adolescence and a female to male ratio of 3.7:1. Cancer was found in 36%, with papillary thyroid cancer the most common subtype (85%). Operative complications were rare, with permanent hypocalcemia in 2 (4.7%) of 43 patients who underwent bilateral resection for thyroid nodules (no cases of permanent hypocalcemia in other procedures). Permanent unilateral vocal cord paralysis was documented in 2 children after the resection of malignant nodules. CONCLUSIONS: Pediatric thyroidectomy can be performed with low operative risk. Because permanent hypocalcemia remains an obligate risk of bilateral thyroidectomy, we recommend the routine use of preoperative fine-needle aspiration to guide the extent of initial surgical resection, reserving near-total thyroidectomy for those cases where cytology is positive for malignancy.
Authors: Gary L Francis; Steven G Waguespack; Andrew J Bauer; Peter Angelos; Salvatore Benvenga; Janete M Cerutti; Catherine A Dinauer; Jill Hamilton; Ian D Hay; Markus Luster; Marguerite T Parisi; Marianna Rachmiel; Geoffrey B Thompson; Shunichi Yamashita Journal: Thyroid Date: 2015-07 Impact factor: 6.568
Authors: Samantha Ly; Mary C Frates; Carol B Benson; Hope E Peters; Frederick D Grant; Laura A Drubach; Stephan D Voss; Henry A Feldman; Jessica R Smith; Justine Barletta; Monica Hollowell; Edmund S Cibas; Francis D Moore; Biren Modi; Robert C Shamberger; Stephen A Huang Journal: J Clin Endocrinol Metab Date: 2016-08-08 Impact factor: 5.958
Authors: Anjuli Gupta; Samantha Ly; Luciana A Castroneves; Mary C Frates; Carol B Benson; Henry A Feldman; Ari J Wassner; Jessica R Smith; Ellen Marqusee; Erik K Alexander; Justine Barletta; Peter M Doubilet; Hope E Peters; Susan Webb; Biren P Modi; Harriet J Paltiel; Harry Kozakewich; Edmund S Cibas; Francis D Moore; Robert C Shamberger; P Reed Larsen; Stephen A Huang Journal: J Clin Endocrinol Metab Date: 2013-06-04 Impact factor: 5.958