Just like in adults, thyroid nodules in children are not uncommon.
The majority of the pediatric patients are asymptomatic and the thyroid nodule is usually discovered as part of a routine physical exam.
However, that does not exclude the possibility of malignancy, which is greater in children than adults.
"Thyroid nodules are five-fold more likely to be malignant in children than in adults, " says Naim Mitre, MD, a Mayo clinic trained pediatric endocrinologist at Children's Mercy and Assistant Professor of Pediatrics at the UMKC School of Medicine who is heading the clinic. "Because of this and a recent increase in the number of related referrals to the Division of Endocrinology by primary care physicians, we saw a need to develop a comprehensive and coordinated clinic at Children's Mercy.”
Opened in March 2011, the Thyroid Nodule and Carcinoma Clinic at Children’s Mercy is the only pediatric-based clinic of its kind in the region that serves as the intake for all thyroid nodules and goiters that are not clearly autoimmune thyroid disease.
The hospital s also one of only a handful in the country to offer a thyroid nodule clinic that relies on a comprehensive multi-disciplinary approach that brings together experts in endocrinology, radiology, pathology and surgery for the diagnosis, treatment and long-term management of thyroid nodules and differentiated carcinoma in pediatric patients.
"The initial evaluation is performed by a pediatric endocrinologist with expertise in thyroid nodules and a thyroid ultrasound is performed by a designated pediatric radiologist," adds Dr. Mitre. "The initial evaluation determines the need for a fine needle aspiration (FNA), that determines the subsequent treatment including surgical evaluation and staging, radioactive iodine ablation and long-term follow up."
The specialists in the clinic conduct a comprehensive evaluation that follows recent published guidelines - the “Revised American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer” and the “American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules."
"Adhering to the guidelines will result in longer follow up, more reliance on ultrasound, increased fine needle aspirations for diagnosis, better pre-surgical diagnosis, less but more directed surgery, and less reliance on radioactive iodine," added Dr. Mitre. "The treatment of these patients will be a coordinated and integrated effort from each of the involved divisions and, working together, we'll ensure that each patient will receive the best care possible."
To learn more about the Thyroid Nodule Clinic at Children's Mercy or refer a patient, call (816) 234-3871. All patients who are referred will have a thyroid ultrasound performed at Children's Mercy.