Thyroid nodules are less common in children than in adults and their management is still controversial. We reviewed the medical records of twenty-two children younger than 18 years of age, with thyroid nodules removed surgically between January,
1986
and December, 1989. Twenty-one of them were females. Thyroid scintiscanning showed cold nodules in all 22 patients(100%), of which 11 were malignant(50%). Histologic type was papillary in 7 and follicular in 4. Initial treatment was total
thyroidectomy
with neck dissection in 7 patients with papillary carcinoma, and lobectomy in 4 with follicular carcinoma. At surgery, node metastasis were present in all 7 papillary cancers, of which 3 had much bigger metastatic nodes than primary nodules of
thyroid
glands. There was no distant metastasis. Surgical complications were negligible but transient hypocalcemia in 2 patients. All patients with malignant nodules were treated with thyroid suppressive therapy after operation. We conclude that more
aggressive
surgical treatment is necessary for children with cold nodules of thyroid gland because of great possibility of malignancy and advancd stage at initial examination.
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