Clinical, pathological, radiological characteristics and prognosis of patients with thyroid nodules diagnosed and monitored in Çukurova University Medical Faculty pediatric endocrine polyclinic

Objective: In this study, it was planned to retrospectively examine the clinical, pathological, radiological features and prognosis of patients diagnosed with thyroid nodules in the Pediatric Endocrine Outpatient Clinic of Çukurova University Faculty of Medicine. Material and Method: 104 patients with thyroid nodules who were followed up by the pediatric endocrinology outpatient clinic between 2000 and 2021 were included in this study. Physical examination findings at presentation, symptoms at presentation, size of the nodule, cystic or solid state, ultrasonography findings, thyroid function tests, presence of Hashimoto's disease and Graves' disease, presence of cold or hot nodules, radiotherapy history, family history, follow-up frequency, fine needle aspiration biopsy results, trucut biopsy results, pathology results were analyzed. Results: While 69.2% (72) of the patients were women, the female / male ratio was 2.3 / 1. There was a family history of nodules in 21 (20.2%) of the patients. In 50% (52) of all patients, the presenting symptom was neck swelling. Of the patients, 24.0% (25) had anti-microsomal antibody and 21.2% (22) had anti-thyroglobulin antibody positivity. Solid nodules were detected in 58.7% (61) of the patients, cystic in 22.1% (23), and mixed nodules in 19.2% (20). Nodule diameter was 1cm in 44.2% (46) of the patients. In the ultrasonographic evaluation of the patients, 27.9% (29) had cervical lymph node and 18.3% calcification. Thyroid gland in 32.7% (34) of the patients was in a homogeneous appearance and in 67.3% (70) in a heterogeneous appearance. While thyroid malignancy was detected in 16 of 19 operated patients, papillary carcinoma was the most common type of carcinoma in 52.6% (10). 15.9% (3) of the patients had invasion at the surgical margin, 5.2% (1) in the lymph node and 5.2% (1) in the trachea. When the relationship of demographic, laboratory and ultrasonographic characteristics of the patients with malignancy was evaluated, the presence of lymph node, size (1cm), calcification and heterogeneous echogenicity were found to be associated with malignancy in univariate analysis (p <0.05). Age, gender, free T4 and TSH levels, presence of anti-thyroglobulin and anti-microsomal antibodies, and multinodular structure were not associated with malignancy (p> 0.005). Logistic regression analysis showed that the presence of lymph node increased the risk of malignancy by 4.4 times, heterogeneous echogenicity 7.5 times and nodule diameter ≥1 cm increased 13.3 times. Conclusion: It was shown that age, gender, family history, serum T4 Tsh values, antimicrosomal and antithyroglobulin positivity, cystic or solid nodule were not associated with malignancy. The presence of a cervical lymph node, the diameter of the nodule ≥1cm, and the heterogeneity of the nodule were shown to be significant in terms of malignancy development. Keywords: Thyroid nodule, malignancy, calcification, echogenicity