Abstract
To provide a comprehensive, up-to-date guide for the surgical management of the most common malignant and benign thyroid diseases within the pediatric population. 26.4% of nodules are malignant in the pediatric population. Concerning ultrasound features of hypoechogenicity, irregular margins, increased intranodular blood flow, or microcalcifications should prompt FNA, while size criteria is less important. The Bethesda System is effective in stratifying risk in pediatric nodules. The role of molecular genetic testing to guide patient management is emerging. Total thyroidectomy has become more frequent in the treatment of differentiated thyroid cancer due to its aggressive nature in the pediatric population and concern for recurrence. The role of adjunctive radiofrequency iodine ablation and the impact of extensive resection on survival are controversial. Management of pediatric thyroid disease can be complex and should be managed by a multidisciplinary team with an experienced, high-volume surgeon.
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