Pediatric thyroid nodules

What are pediatric thyroid nodules?

Thyroid nodules are growths or lumps in your thyroid gland. Most thyroid nodules are not cancerous; however, in some children, they are an indication of thyroid cancer. These benign masses are usually soft and compressible and are found during a routine examination.

What are the signs and symptoms of pediatric thyroid nodules?

Many children with thyroid nodules do not have any symptoms, so the nodules are initially discovered during a routine physical exam.

For those who do have symptoms, they may include:

• Neck mass/swelling

• Difficulty swallowing

• Difficulty breathing

• Neck or throat pain

• Hoarseness

How are pediatric thyroid nodules diagnosed?

There are several methods for diagnosing thyroid nodules. Your child’s doctor may use a combination of these methods:

• History and physical exam

• Urine test

• Blood tests to check thyroid hormone levels

• Ultrasound (a noninvasive test that uses sound waves to take pictures of the thyroid)

• Fine needle biopsy (removal of a small amount of thyroid tissue using a thin needle; the tissue is later examined under a microscope. Repeated biopsies may be necessary.)

What are the causes of pediatric thyroid nodules?

Possible contributors may include:

• Iron deficiency

• Hashimoto’s disease (thyroiditis)

• Goiter

• Thyroid cyst

• Thyroid cancer

The exact cause of thyroid nodules is unknown.​​​​​​​

How are pediatric thyroid nodules treated?

The treatment of thyroid nodules depending on the growth and development of the mass, the radiology findings, and the biopsy results.

• Observation - Some nodules with benign pathology may be observed and followed over time. 

• Surgery - Other nodules may need to be surgically removed. Surgery includes removing part or all of the thyroid gland. This is recommend if the child (less than) < 13 year of age, nodules that grow over time, nodules causing difficulty breathing or swallowing, or if the pathology is concerning.

• Medication - For patients who have had their thyroid gland removed, they may need to take thyroid replacement medication: an oral medication taken after surgery to replace the hormones that your child’s body will no longer be able to produce.

• Radioactive iodine treatment - If the mass is cancer, patients may need radioactive iodine treatment. Radioactive iodine treatment involves taking a pill that targets and kills any remaining thyroid tissue left after surgery.

• External radiation or chemotherapy - In rare cases external radiation or chemotherapy may be required to treat extensive or residual disease.