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| Main Authors: | , , , , , , , , |
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| Format: | Artículo Open Access |
| Published: |
Wiley
2025
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| Subjects: | |
| Online Access: | https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1002/ohn.1232 |
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Table of Contents:
- Who Is Diagnosing Pediatric Thyroid Nodules? A Tertiary Children's Hospital Review Joy M. Justice Janavi Sethurathnam Nanda Nayak Heidi Chen Kalpnaben Patel Sara Bartz Christopher Baron Barron Patterson Ryan H. Belcher Otolaryngology–Head and Neck Surgery AbstractObjectiveThe incidence of pediatric thyroid cancer has increased. Little is documented about which providers are diagnosing pediatric thyroid nodules and how this impacts care. Our objective was to analyze how nodules are identified and how diagnosing provider type impacts nodule size and management.Study DesignRetrospective chart review.SettingTertiary care children's hospital.MethodsPediatric patients (aged 0‐17) with at least one thyroid nodule diagnosed between 2006 and 2023 were reviewed. Diagnosing provider type, diagnostic method, nodule size, clinical management, and final diagnosis were analyzed.ResultsThe study included 351 patients. Primary care providers diagnosed the largest proportion of nodules (43.0%), followed by incidental nodules by radiologists (24.2%). The proportion diagnosed by radiologists increased from 12% to 31% after 2017 (P < .001). Primary care providers were more likely to use physical exam than pediatric endocrinologists (65% vs 42%, P = .004), who more often used ultrasound (56% vs 37%, P = .02). Primary care providers diagnosed nodules with a median diameter of 1.50 cm, larger than that of pediatric endocrinologists and radiologists, both 0.8 cm (P = .01, P < .001). Compared to patients diagnosed by radiologists, patients diagnosed by primary care providers more often underwent biopsy (P = .02) or surgery (P < .001) and received a malignant diagnosis (P = .001).ConclusionPrimary care providers play a key role in detecting pediatric thyroid nodules, and a physical exam is vital in identifying significant pathology. Radiologic incidental nodules increased in frequency over our study timespan. Future research should consider the impact of socioeconomic status or geographic location on nodule size and management. 10.1002/ohn.1232 http://creativecommons.org/licenses/by-nc-nd/4.0/