Aim: Study the characteristics of thyroid nodules in children, to assess the rate of malignancy and follow their evolution.
Method: We carried out a retrospective study involving children under 16 years old, operated on for thyroid nodules in the ENT department of the Rabta hospital between years 2000 and 2020.
Results: We operated 36 patients. Eleven of them had malignant tumors. Malignancy rate was about 30.5%. Median age was 15, of which 80.5% were adolescents. Female represented 80% of our population. Malignancy was significantly higher in male (71.4% of males had malignant tumor versus 20.7% of female; p= 0.018).
On Ultra Sonography (US), hypoechoic and unwell limited characters were significantly more observed in malignancy (respectively p=0.037 and p=0.041).
At the histological study, all malignant tumors were papillary carcinomas. Metastatic lymph nodes were present at diagnosis in 63.6% of cases.
Post operative complication rate was relatively low with 15.4% of transient hypoparathyroidism and no laryngeal nerve damage.
From the children operated on for benign tumors, 38% needed substitutive therapy. Two of the eighteen followed needed thyroid surgery at 4 and 6 years postoperatively.
For malignant tumors, the median follow-up was about 19 months. Three of the eight patients followed (37.5%), had lymph node recurrence. These three children had lateral lymph node metastatic involvement at diagnosis.
Conclusion: Cancers among operated thyroid nodules in children under 16 years old are highly frequent. Male gender, irregular limits and hypoechoic caracter of the nodule on US are correlated to malignancy. Fine needle aspiration should be a routine exam in children.
Key words: Thyroid nodule, Children, Surgery, Radio iodine, Outcome