Diagnosis of Papillary Carcinoma in Pediatric Patients with 99MTC Scan HyperfunctioningThyroid Nodules in a Iodine Sufficient Area

TANGARI SAREDO, ANA; BENZRIHEN, GABRIELA; BRASLAVSKY, DÉBORA; FARÍAS, JAVIER; FORCLAZ, VERÓNICA; PAPAZIAN, REGINA; SOLARZ, ALEJANDRO; BERGADÁ, IGNACIO

Montevideo

Congreso; XXIII Annual Meeting of the Paediatrics Endocrinology Latinoamerican Society; 2012

XXIII Annual Meeting of the Paediatrics Endocrinology Latinoamerican Society

Thyroid cancer usually has reduced iodine uptake and normal thyroid function. Rarely cancer is reported within or near hyperfunctioning nodules. Higher incidence is reported in iodine deficient areas soon after introduction of iodinization. Fine needle aspiration biopsy (FNAB) of hot nodules is not routinely performed. Objective: We report three adolescents from a iodine sufficient area detected in 3 pediatric endocrinology centers with hyperfunctioning thyroid nodules which upon surgery, histopathology revealed a papillary carcinoma. Results: Case 1 (14yrs) referred due to a firm nodule in her neck, ultrasound(US) showed an heterogeneous irregular cystic-solid mass of 19x14x13 mm, it was hyperfunctioning with normal extranodular thyroid uptake. Due to suspicious US findings, family history of thyroid cancer and unsatisfactory FNAB, thyroidectomy was performed which revealed carcinoma. Case 2 (13yrs) referred due to a firm nodule in her neck, US showed a cystic-solid nodule of 6x3.5x4 cm which was hyperfunctioning with almost total inhibition of contralateral lobe. FNAB was benign, thyroidectomy was decided because of the nodule size allowing diagnosis of carcinoma. Case 3 (15yrs) had hyperthyroidism. US showed a heterogeneous irregular solid nodule of 23x13x21 mm with micro-calcifications. It was hyperfunctioning with normal uptake in the rest of the gland. Nodulectomy led to diagnosis of papillary carcinoma within the nodule. was performed which revealed carcinoma. Case 2 (13yrs) referred due to a firm nodule in her neck, US showed a cystic-solid nodule of 6x3.5x4 cm which was hyperfunctioning with almost total inhibition of contralateral lobe. FNAB was benign, thyroidectomy was decided because of the nodule size allowing diagnosis of carcinoma. Case 3 (15yrs) had hyperthyroidism. US showed a heterogeneous irregular solid nodule of 23x13x21 mm with micro-calcifications. It was hyperfunctioning with normal uptake in the rest of the gland. Nodulectomy led to diagnosis of papillary carcinoma within the nodule. Conclusions: Thyroid glands with hot nodules need to be carefully evaluated because malignance can be present. Further studies will determinate which is the best strategy for accurate diagnosis and treatment of hot nodules in pediatrics.Thyroid glands with hot nodules need to be carefully evaluated because malignance can be present. Further studies will determinate which is the best strategy for accurate diagnosis and treatment of hot nodules in pediatrics.We report three adolescents from a iodine sufficient area detected in 3 pediatric endocrinology centers with hyperfunctioning thyroid nodules which upon surgery, histopathology revealed a papillary carcinoma. Results: Case 1 (14yrs) referred due to a firm nodule in her neck, ultrasound(US) showed an heterogeneous irregular cystic-solid mass of 19x14x13 mm, it was hyperfunctioning with normal extranodular thyroid uptake. Due to suspicious US findings, family history of thyroid cancer and unsatisfactory FNAB, thyroidectomy was performed which revealed carcinoma. Case 2 (13yrs) referred due to a firm nodule in her neck, US showed a cystic-solid nodule of 6x3.5x4 cm which was hyperfunctioning with almost total inhibition of contralateral lobe. FNAB was benign, thyroidectomy was decided because of the nodule size allowing diagnosis of carcinoma. Case 3 (15yrs) had hyperthyroidism. US showed a heterogeneous irregular solid nodule of 23x13x21 mm with micro-calcifications. It was hyperfunctioning with normal uptake in the rest of the gland. Nodulectomy led to diagnosis of papillary carcinoma within the nodule. was performed which revealed carcinoma. Case 2 (13yrs) referred due to a firm nodule in her neck, US showed a cystic-solid nodule of 6x3.5x4 cm which was hyperfunctioning with almost total inhibition of contralateral lobe. FNAB was benign, thyroidectomy was decided because of the nodule size allowing diagnosis of carcinoma. Case 3 (15yrs) had hyperthyroidism. US showed a heterogeneous irregular solid nodule of 23x13x21 mm with micro-calcifications. It was hyperfunctioning with normal uptake in the rest of the gland. Nodulectomy led to diagnosis of papillary carcinoma within the nodule. Conclusions: Thyroid glands with hot nodules need to be carefully evaluated because malignance can be present. Further studies will determinate which is the best strategy for accurate diagnosis and treatment of hot nodules in pediatrics.Thyroid glands with hot nodules need to be carefully evaluated because malignance can be present. Further studies will determinate which is the best strategy for accurate diagnosis and treatment of hot nodules in pediatrics.Results: Case 1 (14yrs) referred due to a firm nodule in her neck, ultrasound(US) showed an heterogeneous irregular cystic-solid mass of 19x14x13 mm, it was hyperfunctioning with normal extranodular thyroid uptake. Due to suspicious US findings, family history of thyroid cancer and unsatisfactory FNAB, thyroidectomy was performed which revealed carcinoma. Case 2 (13yrs) referred due to a firm nodule in her neck, US showed a cystic-solid nodule of 6x3.5x4 cm which was hyperfunctioning with almost total inhibition of contralateral lobe. FNAB was benign, thyroidectomy was decided because of the nodule size allowing diagnosis of carcinoma. Case 3 (15yrs) had hyperthyroidism. US showed a heterogeneous irregular solid nodule of 23x13x21 mm with micro-calcifications. It was hyperfunctioning with normal uptake in the rest of the gland. Nodulectomy led to diagnosis of papillary carcinoma within the nodule. was performed which revealed carcinoma. Case 2 (13yrs) referred due to a firm nodule in her neck, US showed a cystic-solid nodule of 6x3.5x4 cm which was hyperfunctioning with almost total inhibition of contralateral lobe. FNAB was benign, thyroidectomy was decided because of the nodule size allowing diagnosis of carcinoma. Case 3 (15yrs) had hyperthyroidism. US showed a heterogeneous irregular solid nodule of 23x13x21 mm with micro-calcifications. It was hyperfunctioning with normal uptake in the rest of the gland. Nodulectomy led to diagnosis of papillary carcinoma within the nodule. Conclusions: Thyroid glands with hot nodules need to be carefully evaluated because malignance can be present. Further studies will determinate which is the best strategy for accurate diagnosis and treatment of hot nodules in pediatrics.Thyroid glands with hot nodules need to be carefully evaluated because malignance can be present. Further studies will determinate which is the best strategy for accurate diagnosis and treatment of hot nodules in pediatrics.