Abstract
Amaç: Çocukluk döneminde karşılaşılan
tiroid nodüllerinde tanısal yaklaşımı ve cerrahi yönetimi değerlendirmek. Yöntem: Tiroid nodülü nedeni ile Ocak
2012 ve Ocak 2015 yılları arasında ameliyat edilen 14 çocuk hastanın dosyaları
geriye dönük olarak incelendi. Hastaların yaşı, cinsiyeti, klinik bulguları,
tiroid fonksiyon testleri, ultrasonografi raporları, sintigrafi raporları, ince
iğne aspirasyon biyopsi (İİAB) raporları, yapılan ameliyatlar, patoloji
sonuçları ve postoperatif komplikasyonlar değerlendirildi. Bulgular:
Olguların 12’i kız ve ikisi erkekti.
Ortanca yaş 14 (8-17) yıl idi. 14
hastada boyunda ele gelen şişlik, birer hastada gece terlemesi ve yutma güçlüğü
saptandı. Bir hastada boyuna radyoterapi uygulama öyküsü mevcuttu. Tiroid
nodülleri USG bulgularına göre değerlendirildiğinde dokuz hastada hipoekoik,
dört hastada hipo-hiperekoik, bir hastada solid nodül saptandı. Tiroid
sintigrafilerinde, 10’unda hipoaktif nodül, ikisinde hiper-hipo aktif nodül
saptandı, iki hastada özellik saptanmadı. İİAB’nde birer hastada benign sitoloji
ve önemi belirlenemeyen foliküler neoplazi, üç hastada malignite şüphesi, yedi
hastada foliküler neoplazi saptandı, iki hastada materyal yetersiz bulundu.
Patoloji preparatlarında 9/14’sinde (%64.2) malignite saptandı. Dokuz hastaya
total tiroidektomi (altısına patoloji sonucu tamamlayıcı tiroidektomi)
tiroidektomi, beş hastaya lobektomi yapıldı. Yedi hastaya boyun disseksiyonu
uygulandı. Sonuç: Çocuklardaki
tiroid nodülleri yüksek malignite riski nedeni ile hızla değerlendirilmeli ve
güncel kılavuzlar eşliğinde multidisipliner olarak yaklaşılmalıdır.
Keywords
References
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- 4. Filippo De Luca, Tommaso Aversa, Luca Alessi, Valeria Cama, Daria Costanzo, Cristina Genovese, Veronica Scuderi, Roberta Vadalà and Giuseppe Zoccali, Thyroid nodules in childhood: indications for biopsy and surgery, De Luca et al. Italian Journal of Pediatrics 2014;40-48
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- 7. Aşan Önder, Zehra Aycan, Approach to thyroid nodules in children and adolescents, The Turkish Journal of Pediatrics 2014; 56: 219-225
- 8. Wu XC, Chen VW, Steele B, Roffers S, Klotz JB, Correa CN, Carozza SE. Cancer incidence in adolescents and young adults in the United States, 1992–1997. J Adolesc Health 2003; 32:405–415.
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- 10. Lyshchik A, Drozd V, Demidchik Y, Reiners C. Diagnosis of thyroid cancer in children: value of grayscale and power doppler US. 2005; Radiology 235:604–613.
- 11. Drozd VM, Lushchik ML, Polyanskaya ON, Fridman MV, Demidchik YE, Lyshchik AP, Biko J, Reiners C, Shibata Y, Saenko VA, Yamashita S. The usual ultrasonographic features of thyroid cancer are less frequent in small tumors that develop after a long latent period after the Chernobyl radiation release accident. Thyroid 2009;19:725–734.
- 12. Leboulleux S, Girard E, Rose M, Travagli JP, Sabbah N, Caillou B, Hartl DM, Lassau N, Baudin E, Schlumberger M. Ultrasound criteria of malignancy for cervical lymph nodes in patients followed up for differentiated thyroid cancer. J Clin Endocrinol Metab 2007; 92:3590–3594.
- 13. Baloch ZW, LiVolsi VA, Asa SL, Rosai J, Merino MJ, Randolph G, Vielh P, DeMay RM, Sidawy MK, Frable WJ. Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn Cytopathol 2008;36:425–437.
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- 15. Savio R, Gosnell J, Palazzo FF, Sywak M, Agarwal G, Cowell C, Shun A, Robinson B, Delbridge LW. The role of a more extensive surgical approach in the initial multimodality management of papillary thyroid cancer in children. J Pediatr Surg 2005;40:1696–1700.
- 16. Tucker MA, Jones PH, Boice JD Jr, Robison LL, Stone BJ, Stovall M, Jenkin RD, Lubin JH, Baum ES, Siegel SE, et al. Therapeutic radiation at a young age is linked to secondary thyroid cancer. The Late Effects Study Group. Cancer Res 1991;51:2885–2888.
- 17. Jeremy T. Guılle, Adwoa Opoku-Boateng, Susan l. Thıbeault, Herbert Chen. Evaluation and Management of the Pediatric Thyroid Nodule, The Oncologist 2015;20:19–27
- 18. Tuncer R. Pediatrik Tiroid Kanserleri. Turkiye Klinikleri Journal of Surgical Medical Sciences 2007;3(49), 41-44.
- 19. Şenyücel MF. Çocukluk Çağı Tiroid Tümörleri. Turkiye Klinikleri Journal of Pediatric Surgery Special Topics 2011;4(1), 138-147. 20. Tuggle CT, Roman SA, Wang TS, Boudourakis L, Thomas DC, Udelsman R, Ann Sosa J. Pediatric endocrine surgery: who is operating on our children? Surgery 2008;144:869–877; discussion 877.
Abstract
References
- 1. Howlader N, Noone AM, Krapcho M, Garshell J, Neyman N, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds) EER Cancer Statistics Review, 1975–2010. Available at http://seer.cancer.gov/csr/1975_2010/(updated June 14, 2013; accessed November 18, 2013).
- 2. Vergamini LB, Frazier AL, Abrantes FL, Ribeiro KB, Rodriguez-Galindo C. Increase in the incidence of differentiated thyroid carcinoma in children, adolescents, and young adults: a population-based study. J Pediatr 2014;164:1481–1485.
- 3. Hogan AR, Zhuge Y, Perez EA, Koniaris LG, Lew JI, Sola JE. Pediatric thyroid carcinoma: incidence and outcomes in 1753 patients. J Surg Res 2009;156:167–172
- 4. Filippo De Luca, Tommaso Aversa, Luca Alessi, Valeria Cama, Daria Costanzo, Cristina Genovese, Veronica Scuderi, Roberta Vadalà and Giuseppe Zoccali, Thyroid nodules in childhood: indications for biopsy and surgery, De Luca et al. Italian Journal of Pediatrics 2014;40-48
- 5. Francis GL, Waguespack SG, Bauer AJ, Angelos P, Benvenga S, Cerutti JM, et al. Management guidelines for children with thyroid nodules and differentiated thyroid cancer. Thyroid. 2015;25(7):716–759. doi: 10.1089/thy.2014.0460.
- 6. Hay ID, Gonzalez-Losada T, Reinalda MS, Honetschlager JA, Richards ML, Thompson GB. Long-term outcome in 215 children and adolescents with papillary thyroid cancer treated during 1940 through 2008. World J Surg 2010;34:1192–1202.
- 7. Aşan Önder, Zehra Aycan, Approach to thyroid nodules in children and adolescents, The Turkish Journal of Pediatrics 2014; 56: 219-225
- 8. Wu XC, Chen VW, Steele B, Roffers S, Klotz JB, Correa CN, Carozza SE. Cancer incidence in adolescents and young adults in the United States, 1992–1997. J Adolesc Health 2003; 32:405–415.
- 9. Gupta A, Ly S, Castroneves LA, Frates MC, Benson CB, Feldman HA, Wassner AJ, Smith JR, Marqusee E, Alexander EK, Barletta J, Doubilet PM, Peters HE, Webb S, Modi BP, Paltiel HJ, Kozakewich H, Cibas ES, Moore FD Jr, Shamberger RC, Larsen PR, Huang SA. A standardized assessment of thyroid nodules in children confirms higher cancer prevalence than in adults. J Clin Endocrinol Metab 2013; 98:3238–3245.
- 10. Lyshchik A, Drozd V, Demidchik Y, Reiners C. Diagnosis of thyroid cancer in children: value of grayscale and power doppler US. 2005; Radiology 235:604–613.
- 11. Drozd VM, Lushchik ML, Polyanskaya ON, Fridman MV, Demidchik YE, Lyshchik AP, Biko J, Reiners C, Shibata Y, Saenko VA, Yamashita S. The usual ultrasonographic features of thyroid cancer are less frequent in small tumors that develop after a long latent period after the Chernobyl radiation release accident. Thyroid 2009;19:725–734.
- 12. Leboulleux S, Girard E, Rose M, Travagli JP, Sabbah N, Caillou B, Hartl DM, Lassau N, Baudin E, Schlumberger M. Ultrasound criteria of malignancy for cervical lymph nodes in patients followed up for differentiated thyroid cancer. J Clin Endocrinol Metab 2007; 92:3590–3594.
- 13. Baloch ZW, LiVolsi VA, Asa SL, Rosai J, Merino MJ, Randolph G, Vielh P, DeMay RM, Sidawy MK, Frable WJ. Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn Cytopathol 2008;36:425–437.
- 14. Welch Dinauer CA, Tuttle RM, Robie DK, McClellan DR, Svec RL, Adair C, Francis GL. Clinical features associated with metastasis and recurrence of differentiated thyroid cancer in children, adolescents and young adults. Clin Endocrinol 1998;49:619–628.
- 15. Savio R, Gosnell J, Palazzo FF, Sywak M, Agarwal G, Cowell C, Shun A, Robinson B, Delbridge LW. The role of a more extensive surgical approach in the initial multimodality management of papillary thyroid cancer in children. J Pediatr Surg 2005;40:1696–1700.
- 16. Tucker MA, Jones PH, Boice JD Jr, Robison LL, Stone BJ, Stovall M, Jenkin RD, Lubin JH, Baum ES, Siegel SE, et al. Therapeutic radiation at a young age is linked to secondary thyroid cancer. The Late Effects Study Group. Cancer Res 1991;51:2885–2888.
- 17. Jeremy T. Guılle, Adwoa Opoku-Boateng, Susan l. Thıbeault, Herbert Chen. Evaluation and Management of the Pediatric Thyroid Nodule, The Oncologist 2015;20:19–27
- 18. Tuncer R. Pediatrik Tiroid Kanserleri. Turkiye Klinikleri Journal of Surgical Medical Sciences 2007;3(49), 41-44.
- 19. Şenyücel MF. Çocukluk Çağı Tiroid Tümörleri. Turkiye Klinikleri Journal of Pediatric Surgery Special Topics 2011;4(1), 138-147. 20. Tuggle CT, Roman SA, Wang TS, Boudourakis L, Thomas DC, Udelsman R, Ann Sosa J. Pediatric endocrine surgery: who is operating on our children? Surgery 2008;144:869–877; discussion 877.
Details
| Subjects | Health Care Administration |
|---|---|
| Journal Section | Articles |
| Authors | |
| Publication Date | August 20, 2017 |
| Submission Date | May 10, 2017 |
| Acceptance Date | June 7, 2017 |
| Published in Issue | Year 2017 Volume: 10 Issue: 2 |
Cite
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