Pediatric Thyroid Program
The Pediatric Thyroid Program at Nationwide Children’s Hospital offers comprehensive care for all thyroid diseases in children and adolescents. Our multidisciplinary team collaborates in the evaluation, diagnosis and treatment of thyroid nodules and thyroid cancer. We understand that when your child is sick, your entire family is impacted, and we are committed to making sure everyone in the family understands your child’s diagnosis and treatment plan.
Multidisciplinary Care Team
Endocrinologists: The endocrinologist will often be the first physician to see a patient and will assess thyroid function and determine if further evaluation is necessary. If tissue biopsy or surgical intervention is needed, the endocrinologist will make a referral to another specialist in the Pediatric Thyroid Program . An endocrinologist will also manage thyroid hormone replacement if the thyroid gland is removed as a part of therapy.
Pediatric Surgeons and ENTs: When a thyroid nodule, mass, or cancer is detected, the first line of treatment may be surgical resection. This may involve removal of part or all of the thyroid gland. In addition, lymph nodes are assessed and removed if they are enlarged or suspected to be involved with cancer spread.
Radiologists: Radiologists may be asked by other physicians on the team to do tests on the thyroid or to help in treatment.
- An ultrasound of the thyroid and neck may be performed to check thyroid appearance and size, evaluate for nodules and for abnormal lymph nodes. A radiologist may also be asked to biopsy a nodule using ultrasound guidance.
- Nuclear Medicine thyroid exams can be performed to evaluate thyroid function, look for abnormally functioning nodules, or to look for thyroid cancer spread. Radioactive thyroid therapy can be used to treat overactive thyroid glands and to treat thyroid cancers.
Oncologists: A pediatric oncologist will be consulted if there is thyroid cancer metastases that are not treatable by surgery or radio-iodine therapy and may require other local or systemic treatment.
Pathologists: When a thyroid nodule or mass is detected and a biopsy is necessary, the pathologist will assess the tissue to determine if cancer is present. If removal of part or all of thyroid is needed, the diagnosis of the nodule is made by the pathologist.
Frequently Asked Questions
What is a thyroid nodule?
A thyroid nodule is a bump in the thyroid gland that is found either by examination or by ultrasound imaging.
Is there more than one type of thyroid nodule?
Thyroid nodules are usually harmless, but in a minority of patients they can be caused by cancer. There are also some thyroid nodules that cause overproduction of thyroid hormone, and these cause symptoms of over-active thyroid and are usually benign.
How are thyroid nodules diagnosed?
Thyroid nodules are found either by examination of the neck or by ultrasound imaging. Diagnosis of cancer is made after obtaining tissue by needle biopsy or surgery.
What are the risk factors for pediatric thyroid cancer?
Exposure to head and neck radiation is known to increase the risk for thyroid cancer. Thyroid cancer is also associated with a number of rare genetic syndromes. It is believed that changes in different genes that regulate or control cell growth are responsible for the cancerous changes.
What are the symptoms of thyroid nodules?
Symptoms of thyroid nodules can vary. It is possible to experience an enlarging nodule or bump in the neck, difficulty swallowing, pain with swallowing, voice changes, and in some cases no symptoms at all. If the nodule is producing thyroid hormone, it may cause sleeping difficulty, weight loss, fast heartbeat, nervousness and diarrhea.
How are thyroid nodules treated?
If the thyroid nodule is felt to be benign it will be followed by observation and repeat ultrasound imaging. If the nodule is enlarged and causing symptoms it can also be removed surgically. Your doctor will determine if the nodule needs to be removed.
How is thyroid cancer treated?
If the nodule is determined to be cancer or is very concerning for cancer the entire thyroid gland will be removed. If thyroid cancer has spread to nodes or beyond, then radioactive iodine therapy is indicated.
What is the outlook for patients with thyroid cancer?
Overall the prognosis for thyroid cancer is excellent. Even in the presence of metastatic disease, 30 year survival rates are 90-99% for children with differentiated thyroid cancer. Recurrence of disease can occur years later and therefore the condition requires long-term surveillance with lab tests, ultrasounds and physical examination.