​Children also get thyroid nodules?

It is only for medical professionals to read.
Be careful with these symptoms.
The 12-year-old Hao Hao has eaten a lot recently, but his weight has dropped.
The parents are afraid of something wrong.
They took Hao Hao to the hospital for an examination and found that the child has hyperthyroidism and thyroid.
Nodules
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"I checked it on the Internet, and the Internet said that the nodules may become cancerous, which is scary
.

You said, my family does not have a history of tumors, and my grandparents are very healthy.
Why do children have nodules when they are so young?" The parent said
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Why are other people’s children not allowed? What factors are related to thyroid nodules? Thyroid nodules are scattered lesions in the thyroid that can be clearly separated from the surrounding thyroid tissue
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Women and the elderly are high-risk groups
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Thyroid hypoplasia and congenital hypothyroidism caused by thyroglossal duct cyst, Hashimoto's thyroiditis, radiation and some genetic syndromes related to thyroid involvement are all related to thyroid nodules in children
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What are the symptoms of thyroid nodules and how can they be found? Most patients with benign thyroid nodules have no clinical symptoms, and some children may be accompanied by hypothyroidism and hyperthyroidism
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If the local skin of the nodule has redness, heat, and pain, acute purulent thyroiditis is more likely
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High-resolution ultrasonography is the preferred method to evaluate thyroid nodules.
Ultrasound can confirm the presence of thyroid nodules, determine the location, number, size, shape, wall structure, acoustic halo, and internal echo (solid or cystic) of thyroid nodules.
It has high resolution for benign or malignant thyroid nodules, calcification and cervical lymph node conditions
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However, in order to determine the benign and malignant nodules, cytopathological examination is still needed.
Fine-needle aspiration biopsy (FNAB) is the best method to assess whether a thyroid nodule is benign or malignant
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In addition, the following examinations are also essential: thyroid function: observe whether it is associated with hyperthyroidism; thyroid autoantibodies: positive indicates that there may be Hashimoto’s thyroiditis; calcitonin examination: elevated is a specific marker of medullary thyroid carcinoma (MTC) Because of the low prevalence of MTC in children, serum Ct should be used as a routine examination index only for children with a family history of MTC or MEN, or suspected of MTC in cytology
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Which clues of ultrasound suggest malignant nodules? ①Single solid nodule; ②Echoic nodule; ③The nodule is located under the capsule; ④The shape and edge of the nodule are irregular, and the halo is absent; ⑤The nodule grows aggressively (no pressure on adjacent tissues);⑥ Heterogeneous echo characteristics; ⑦Multiple lesions in a single clinical nodule; ⑧Microcalcification, needle-like diffuse distribution or clustered distribution of calcification; ⑨Inside the nodule shows abundant blood flow (for those with normal TSH level); ⑩At the same time There are abnormalities in the cervical lymph nodes, such as round lymph nodes, irregular or fuzzy borders, uneven internal echo, internal calcification, and unclear demarcation of the cortex and medulla
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Under what circumstances do fine needle aspiration biopsy (FNAB)? Thyroid nodules with a diameter of more than 1cm can be considered for FNAB; for thyroid nodules with a diameter of less than 1cm, ultrasound-guided FNAB should also be considered for thyroid nodules with a diameter of less than 1cm: ①Ultrasound examination suggests that the nodule has malignant signs; ②Neck Ultrasound imaging of lymph nodes is abnormal; ③Have a history of cervical radiation exposure or exposure to radiation pollution; ④Have a family history of thyroid cancer; ⑤18F-FDG PET imaging is positive; ⑥With abnormally elevated serum Ct levels
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Are thyroid nodules related to thyroid cancer? Will thyroid nodules become hyperthyroidism? Children's thyroid nodules are less common than adults, but the risk of malignancy is higher than that of adults.
It is estimated that 10%~25% of children's thyroid nodules are malignant, while adults only account for 5%~15%
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Thyroid nodules may be found at the beginning of thyroid cancer, including papillary carcinoma, follicular carcinoma, medullary carcinoma, of which papillary carcinoma is the most common (about 80%), and may gradually develop into thyroid cancer, such as adenoma 10% can become cancerous, so follow-up is very important
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When thyroid nodules are accompanied by thyroid dysfunction, they are accompanied by hyperthyroidism
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Which children with thyroid nodules are more likely to develop thyroid cancer? History of radiation exposure to the head and neck or exposure to radioactive dust; male; less than 10 years old; history of whole body radiation therapy; history of severe benign thyroid disease (congenital hypothyroidism, Hashimoto's thyroiditis, hyperthyroidism, follicular adenoma); Family history of thyroid cancer, multiple endocrine neoplasia syndrome (MEN)
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How to solve the problem of thyroid nodules? Benign thyroid nodules in children: Fine needle aspiration biopsy suggests benign, and nodules ≤ 4cm, most choose to follow-up observation every 6 to 12 months, and the neck ultrasound and thyroid function should be carefully examined during follow-up
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If the nodule is stable, review the ultrasound every 1~2/year
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During follow-up, it was found that the nodule grew significantly (nodule volume increased> 50%), accompanied by symptoms and signs suggesting malignant change of the nodule (such as hoarseness, difficulty breathing/swallowing, fixed nodules, swollen lymph nodes in the neck, etc.
) And ultrasound signs, FNAB should be performed again in time
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Surgery may be considered in the following situations: ①Local compression symptoms obviously related to the nodule; ②Combined with hyperthyroidism, and medical treatment is ineffective; ③The tumor is located behind the sternum or in the mediastinum; ④The nodule grows progressively, and it is clinically considered to be malignant.
Prone to or combined with high-risk factors for thyroid cancer
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Children with malignant and suspicious malignant thyroid nodules: mainly surgical treatment
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For a larger proportion of differentiated thyroid cancer (DTC), total or near-total thyroidectomy should be selected, followed by 131I treatment; if there is a family history of MTC or MEN2, RET gene mutation testing is recommended, because the incidence of MTC in mutation-positive patients Significant increase, preventive total thyroidectomy should be performed, and the age of resection depends on the risk of MTC
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Even if malignant thyroid nodules in children are accompanied by metastases, there is still a good prognosis
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The long-term survival rate of DTC exceeds 90%; the 5-year and 15-year survival rates of MTC both exceed 85%
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