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

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.)

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 <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.

Chemotherapy or external radiation

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