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Int J Pediatr Otorhinolaryngol. 2014 Oct;78(10):1742-6. doi: 10.1016/j.ijporl.2014.07.037. Epub 2014 Aug 8.

Nodular recurrence and hypothyroidism following partial thyroidectomy for benign nodular thyroid disease in children and adolescents.

Author information

1
Service d'ORL et Chirurgie Cervico Faciale, CHU de Montpellier, Université Montpellier 1, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France. Electronic address: mohamed.akkari.orl@gmail.com.
2
Service d'ORL et Chirurgie Cervico Faciale, CHU de Montpellier, Université Montpellier 1, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France.
3
Service d'Endocrinologie Pédiatrique, CHU de Montpellier, Université Montpellier 1, Hôpital Arnaud de Villeneuve, 371 avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France.
4
Service des maladies endocriniennes, CHU de Montpellier, Université Montpellier 1, Hôpital Lapeyronie, 371 avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France.

Abstract

OBJECTIVES:

Diagnostic and therapeutic processing of a thyroid nodule in children and adolescents may require lobectomy-isthmusectomy (LI) or nodule-resection (NR). Very few data in the literature report the long-term evolution of the remaining thyroid lobe in a defined pediatric population. In this study, we aimed to answer the following questions: Does a nodule recurrence occur in the remainder lobe? Is a post-operative thyroxine treatment necessary?

MATERIAL AND METHODS:

This retrospective study describes 28 patients under 18 who underwent LI (22 cases) or NR (6 cases) from January 2004 to March 2012. Ten of them were lost to follow up, 18 could be assessed (4 NR (22%) and 14 LI (78%) - mean follow-up 45±31 months). All patients benefited of post-operative thyroid ultrasonography, and regular endocrinologic follow-up. The following data were analysed: emergence of new thyroid nodules, evolution of pre-existing nodules, occurrence of post-operative hypothyroidism and requirement for completion thyroidectomy.

RESULTS:

The mean age at the time of surgery was 14.3±1.9 years. Two patients (11%) had pre-existing nodules in the remaining thyroid gland, none of which showed an increase in size after surgery. De novo nodules developed in five patients (27.8%). Three patients who underwent LI (21.4%) needed thyroxine treatment for post-operative hypothyroidism. One patient (5.5%) needed completion thyroidectomy.

CONCLUSIONS:

In this children and adolescents population, after performing LI or NR, remaining thyroid tissue stays free of nodules in 72.2% of the cases. A post-operative thyroxin treatment is necessary in 21.4% of cases after LI.

KEYWORDS:

Children; Hypothyroidism; Lobectomy–isthmusectomy; Nodule resection; Post-operative thyroxin treatment; Thyroid nodule

PMID:
25156198
DOI:
10.1016/j.ijporl.2014.07.037
[Indexed for MEDLINE]
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