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Pediatric Thyroid Surgery
Published in Madan Laxman Kapre, Thyroid Surgery, 2020
Thyroid pathologies for children treat a varied mix of benign and malignant conditions. Functionality of the gland may vary physiologically and pathologically. Surgical problems are often a manifestation of the embryological remnant variations, and therefore thorough anatomical knowledge is a must for due planning, e.g., thyroid cyst or resultant abscess due to infection prone remnants of otherwise uncommon third and fourth branchial arches or thyroglossal duct cyst containing entire thyroid tissue and likewise. Since these are majorly indolent conditions, it is essential to minimize or avoid iatrogenic morbidity. Pediatric thyroid cancers are a distinct entity with a different biological behavior than the adult counterpart. They are much more aggressive with higher chances of nodal and distant metastases. Many of these require adjuvant treatment in view of higher stages. However, prognosis is excellent with more than 95% 10-year survival outcomes in a major series [1].
Answers
Published in Thomas Hester, Iain MacGarrow, Surgical SBAs for Finals with Explanatory Answers, 2018
Treatment consists of radioactive iodine 131. Thyroidectomy is advised in patients with symptoms of tracheal compression. In younger patients it may be advisable to manage operatively, as there is a risk of haemorrhage into a thyroid cyst, leading to acute tracheal compression. The cosmetic appearance of a large neck mass may also prompt surgery.
Head and neck
Published in Jonathan M. Fishman, Vivian A. Elwell, Rajat Chowdhury, OSCEs for the MRCS Part B, 2017
Jonathan M. Fishman, Vivian A. Elwell, Rajat Chowdhury
The differential diagnosis includes the following: Simple thyroid cystAdenoma/simple hyperplastic noduleProminent nodule in a multinodular goitreEnlarged lobe (e.g. Hashimoto's thyroiditis)Haemorrhage into a cyst/noduleCarcinoma – Primary or rarely secondary
Non-functional parathyroid cyst masquerading as a thyroid cyst: Report of two cases and review of the literature
Published in Acta Oto-Laryngologica Case Reports, 2018
Guled M. Jama, Paramita Baruah, Abigail Pugh, Leonard Liew
Ultrasonography is considered to be the first line imaging modality as part of the diagnostic workup [7]. The sensitivity and specificity of this is operator-dependent but is likely to reveal a cystic nodule that can often be difficult to differentiate from a thyroid cyst [8]. The absence of comet tail artefacts, which, if present, would indicate a colloid cyst, as well as the lack of other cystic lesions within the thyroid lobes may raise the suspicion of a parathyroid origin [9]. However, differentiation of parathyroid cysts from thyroid cysts based on radiological findings is challenging [1].