Thyroid nodules and cancer in children and adolescents affected by autoimmune thyroiditis

Andrea Corrias, Alessandra Cassio, Giovanna Weber, Alessandro Mussa, Malgorzata Wasniewska, Anna Rapa, Roberto Gastaldi, Silvia Einaudi, Federico Baronio, Maria Cristina Vigone, Maria Francesca Messina, Milva Bal, Gianni Bona, Carlo De Sanctis

Research output: Contribution to journalArticle

Abstract

Objective: To investigate the association between juvenile autoimmune thyroiditis (JAT) and thyroid cancer in pediatric patients. Design:Weconducted a retrospective study among children and adolescents affected by JAT. Settings: Data from 6 Italian pediatric endocrinology centers were collected. Participants: Three hundred sixty-five children and adolescents affected by JAT diagnosed at 3.6 to 17.0 years of age. Interventions: All patients underwent clinical examination and thyroid function test every 6 to 12 months and thyroid echography every 12 to 24 months. Fine-needle aspiration biopsy was performed in 39 patients with nodule diameter of 1 cm or larger, as well as in 4 patients with nodule diameter of less than 1 cm and echographic findings suspicious for neoplasm. Twenty-three patients underwent surgery. Main Outcome Measures: Thyroid function, echographic pattern, nodule diameter, the presence of lymphadenopathy, and cytologic and histologic diagnoses were considered. Results: Thyroid nodules were found in 115 patients; findings in 11 of these were consistent with papillary carcinoma, with 5 exhibiting lymph node metastasis. The prevalence of male sex among patients with cancer was greater than that among patients with JAT (odds ratio [OR], 2.95; 95% confidence interval [CI], 1.44-6.20). The growth of nodules during levothyroxine sodium therapy (OR, 15.60; 95% CI, 1.87-181.90) and the finding of lymphadenopathy (OR, 5.44; 95% CI, 1.05-30.50) were statistically significantly associated with the presence of cancer, while uninodularity and hypoechogenicity were not. Conclusions: The observed prevalences of thyroid nodules and thyroid cancer in our JAT case series were 31.5% and 3.0%, respectively. Papillary carcinoma was the only histotype detected. The finding of lymphadenopathy, a lack of response to levothyroxine therapy, and nodule hypoechogenicity suggested malignancy. Fine-needle aspiration biopsy was reliable in selecting patients for referral to surgery.

Original languageEnglish
Pages (from-to)526-531
Number of pages6
JournalArchives of Pediatrics and Adolescent Medicine
Volume162
Issue number6
DOIs
Publication statusPublished - Jun 2008

Fingerprint

Autoimmune Thyroiditis
Thyroid Nodule
Thyroid Neoplasms
Papillary Carcinoma
Odds Ratio
Confidence Intervals
Fine Needle Biopsy
Thyroxine
Neoplasms
Thyroid Gland
Pediatrics
Thyroid Function Tests
Endocrinology
Ultrasonography
Referral and Consultation
Retrospective Studies
Lymph Nodes
Outcome Assessment (Health Care)
Neoplasm Metastasis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Thyroid nodules and cancer in children and adolescents affected by autoimmune thyroiditis. / Corrias, Andrea; Cassio, Alessandra; Weber, Giovanna; Mussa, Alessandro; Wasniewska, Malgorzata; Rapa, Anna; Gastaldi, Roberto; Einaudi, Silvia; Baronio, Federico; Vigone, Maria Cristina; Messina, Maria Francesca; Bal, Milva; Bona, Gianni; De Sanctis, Carlo.

In: Archives of Pediatrics and Adolescent Medicine, Vol. 162, No. 6, 06.2008, p. 526-531.

Research output: Contribution to journalArticle

Corrias, A, Cassio, A, Weber, G, Mussa, A, Wasniewska, M, Rapa, A, Gastaldi, R, Einaudi, S, Baronio, F, Vigone, MC, Messina, MF, Bal, M, Bona, G & De Sanctis, C 2008, 'Thyroid nodules and cancer in children and adolescents affected by autoimmune thyroiditis', Archives of Pediatrics and Adolescent Medicine, vol. 162, no. 6, pp. 526-531. https://doi.org/10.1001/archpedi.162.6.526
Corrias, Andrea ; Cassio, Alessandra ; Weber, Giovanna ; Mussa, Alessandro ; Wasniewska, Malgorzata ; Rapa, Anna ; Gastaldi, Roberto ; Einaudi, Silvia ; Baronio, Federico ; Vigone, Maria Cristina ; Messina, Maria Francesca ; Bal, Milva ; Bona, Gianni ; De Sanctis, Carlo. / Thyroid nodules and cancer in children and adolescents affected by autoimmune thyroiditis. In: Archives of Pediatrics and Adolescent Medicine. 2008 ; Vol. 162, No. 6. pp. 526-531.
@article{dc6c778ab2b4478c901e63693336b7c0,
title = "Thyroid nodules and cancer in children and adolescents affected by autoimmune thyroiditis",
abstract = "Objective: To investigate the association between juvenile autoimmune thyroiditis (JAT) and thyroid cancer in pediatric patients. Design:Weconducted a retrospective study among children and adolescents affected by JAT. Settings: Data from 6 Italian pediatric endocrinology centers were collected. Participants: Three hundred sixty-five children and adolescents affected by JAT diagnosed at 3.6 to 17.0 years of age. Interventions: All patients underwent clinical examination and thyroid function test every 6 to 12 months and thyroid echography every 12 to 24 months. Fine-needle aspiration biopsy was performed in 39 patients with nodule diameter of 1 cm or larger, as well as in 4 patients with nodule diameter of less than 1 cm and echographic findings suspicious for neoplasm. Twenty-three patients underwent surgery. Main Outcome Measures: Thyroid function, echographic pattern, nodule diameter, the presence of lymphadenopathy, and cytologic and histologic diagnoses were considered. Results: Thyroid nodules were found in 115 patients; findings in 11 of these were consistent with papillary carcinoma, with 5 exhibiting lymph node metastasis. The prevalence of male sex among patients with cancer was greater than that among patients with JAT (odds ratio [OR], 2.95; 95{\%} confidence interval [CI], 1.44-6.20). The growth of nodules during levothyroxine sodium therapy (OR, 15.60; 95{\%} CI, 1.87-181.90) and the finding of lymphadenopathy (OR, 5.44; 95{\%} CI, 1.05-30.50) were statistically significantly associated with the presence of cancer, while uninodularity and hypoechogenicity were not. Conclusions: The observed prevalences of thyroid nodules and thyroid cancer in our JAT case series were 31.5{\%} and 3.0{\%}, respectively. Papillary carcinoma was the only histotype detected. The finding of lymphadenopathy, a lack of response to levothyroxine therapy, and nodule hypoechogenicity suggested malignancy. Fine-needle aspiration biopsy was reliable in selecting patients for referral to surgery.",
author = "Andrea Corrias and Alessandra Cassio and Giovanna Weber and Alessandro Mussa and Malgorzata Wasniewska and Anna Rapa and Roberto Gastaldi and Silvia Einaudi and Federico Baronio and Vigone, {Maria Cristina} and Messina, {Maria Francesca} and Milva Bal and Gianni Bona and {De Sanctis}, Carlo",
year = "2008",
month = "6",
doi = "10.1001/archpedi.162.6.526",
language = "English",
volume = "162",
pages = "526--531",
journal = "Archives of Pediatrics and Adolescent Medicine",
issn = "1072-4710",
publisher = "American Medical Association",
number = "6",

}

TY - JOUR

T1 - Thyroid nodules and cancer in children and adolescents affected by autoimmune thyroiditis

AU - Corrias, Andrea

AU - Cassio, Alessandra

AU - Weber, Giovanna

AU - Mussa, Alessandro

AU - Wasniewska, Malgorzata

AU - Rapa, Anna

AU - Gastaldi, Roberto

AU - Einaudi, Silvia

AU - Baronio, Federico

AU - Vigone, Maria Cristina

AU - Messina, Maria Francesca

AU - Bal, Milva

AU - Bona, Gianni

AU - De Sanctis, Carlo

PY - 2008/6

Y1 - 2008/6

N2 - Objective: To investigate the association between juvenile autoimmune thyroiditis (JAT) and thyroid cancer in pediatric patients. Design:Weconducted a retrospective study among children and adolescents affected by JAT. Settings: Data from 6 Italian pediatric endocrinology centers were collected. Participants: Three hundred sixty-five children and adolescents affected by JAT diagnosed at 3.6 to 17.0 years of age. Interventions: All patients underwent clinical examination and thyroid function test every 6 to 12 months and thyroid echography every 12 to 24 months. Fine-needle aspiration biopsy was performed in 39 patients with nodule diameter of 1 cm or larger, as well as in 4 patients with nodule diameter of less than 1 cm and echographic findings suspicious for neoplasm. Twenty-three patients underwent surgery. Main Outcome Measures: Thyroid function, echographic pattern, nodule diameter, the presence of lymphadenopathy, and cytologic and histologic diagnoses were considered. Results: Thyroid nodules were found in 115 patients; findings in 11 of these were consistent with papillary carcinoma, with 5 exhibiting lymph node metastasis. The prevalence of male sex among patients with cancer was greater than that among patients with JAT (odds ratio [OR], 2.95; 95% confidence interval [CI], 1.44-6.20). The growth of nodules during levothyroxine sodium therapy (OR, 15.60; 95% CI, 1.87-181.90) and the finding of lymphadenopathy (OR, 5.44; 95% CI, 1.05-30.50) were statistically significantly associated with the presence of cancer, while uninodularity and hypoechogenicity were not. Conclusions: The observed prevalences of thyroid nodules and thyroid cancer in our JAT case series were 31.5% and 3.0%, respectively. Papillary carcinoma was the only histotype detected. The finding of lymphadenopathy, a lack of response to levothyroxine therapy, and nodule hypoechogenicity suggested malignancy. Fine-needle aspiration biopsy was reliable in selecting patients for referral to surgery.

AB - Objective: To investigate the association between juvenile autoimmune thyroiditis (JAT) and thyroid cancer in pediatric patients. Design:Weconducted a retrospective study among children and adolescents affected by JAT. Settings: Data from 6 Italian pediatric endocrinology centers were collected. Participants: Three hundred sixty-five children and adolescents affected by JAT diagnosed at 3.6 to 17.0 years of age. Interventions: All patients underwent clinical examination and thyroid function test every 6 to 12 months and thyroid echography every 12 to 24 months. Fine-needle aspiration biopsy was performed in 39 patients with nodule diameter of 1 cm or larger, as well as in 4 patients with nodule diameter of less than 1 cm and echographic findings suspicious for neoplasm. Twenty-three patients underwent surgery. Main Outcome Measures: Thyroid function, echographic pattern, nodule diameter, the presence of lymphadenopathy, and cytologic and histologic diagnoses were considered. Results: Thyroid nodules were found in 115 patients; findings in 11 of these were consistent with papillary carcinoma, with 5 exhibiting lymph node metastasis. The prevalence of male sex among patients with cancer was greater than that among patients with JAT (odds ratio [OR], 2.95; 95% confidence interval [CI], 1.44-6.20). The growth of nodules during levothyroxine sodium therapy (OR, 15.60; 95% CI, 1.87-181.90) and the finding of lymphadenopathy (OR, 5.44; 95% CI, 1.05-30.50) were statistically significantly associated with the presence of cancer, while uninodularity and hypoechogenicity were not. Conclusions: The observed prevalences of thyroid nodules and thyroid cancer in our JAT case series were 31.5% and 3.0%, respectively. Papillary carcinoma was the only histotype detected. The finding of lymphadenopathy, a lack of response to levothyroxine therapy, and nodule hypoechogenicity suggested malignancy. Fine-needle aspiration biopsy was reliable in selecting patients for referral to surgery.

UR - http://www.scopus.com/inward/record.url?scp=44649201647&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=44649201647&partnerID=8YFLogxK

U2 - 10.1001/archpedi.162.6.526

DO - 10.1001/archpedi.162.6.526

M3 - Article

C2 - 18524742

AN - SCOPUS:44649201647

VL - 162

SP - 526

EP - 531

JO - Archives of Pediatrics and Adolescent Medicine

JF - Archives of Pediatrics and Adolescent Medicine

SN - 1072-4710

IS - 6

ER -