Çocukluk çağı tiroid nodüllerine yaklaşım
Çocuklarda
tiroid nodül gelişiminde genetik ve çevresel bir çok faktör rol oynamaktadır.
Çocukluk çağında palpe edilebilen tiroid nodül sıklığı %2 olarak
bildirilmektedir. Günümüzde ultrasonografinin daha yaygın olarak kullanılması
nedeniyle bu oranın %5’ e kadar çıktığını gösteren çalışmalar mevcuttur.
Çocukluk çağında tespit edilen tiroid nodüllerinin büyük bir kısmının benign
karakterde olmasına karşın erişkin yaş grubu ile kıyaslandığında çocuklarda
tiroid nodül malignansi insidansının daha yüksek olduğu bildirilmektedir.
Çocukluk çağı tiroid nodüllü olgularda tanı anında uzak metastaz yapma riski ve
tedavi sonrası rekürrens riskinin erişkin yaş grubuna göre daha yüksek olması
nedeniyle de bu olguların erken tanı ve tedavisi hayati önem arz etmektedir.
Günümüzde radyolojik görüntüleme tekniklerinin kullanımının artması,
immünohistokimyasal ve moleküler tanı yöntemlerinin gelişmesi tiroid nodüllü
olguların erken tanı almasına ve uygun tedavi yönetiminin belirlenmesine
yardımcı olmaktadır. Bu yazıda çocukluk çağında tiroid nodül gelişimine yol
açan nedenlerle ve malignansiyi telkin eden bulgular irdelenerek güncel tanı ve
takip yaklaşımları literatür eşliğinde sunulmuştur.
Anahtar Kelimeler:
Çocukluk çağı, tiroid nodül, güncel yaklaşım
Approach to thyroid nodules in childhood
Many
genetic and environmental factors play role in the etiology of thyroid nodules
in the childhood. The incidence of palpable thyroid nodules in childhood is
known as 2%. There are studies indicating that this incidence is increased to
5% since thyroid ultrasonography is used more commonly. Although most of the
thyroid nodules are benign in the children, incidence of malignancy of thyroid
nodules in childhood is quite higher than adults. The early diagnosis and
treatment of thyroid nodules in childhood is of vital importance since risk of
distant metastasis at the time of diagnosis and recurrence rate after treatment
is much higher than adult age group. Nowadays, the higher utilization rates of
radiological imaging, immunohistochemical and molecular diagnostic techniques
help the early diagnosis of the cases and selection of proper therapeutic interventions. In this paper, predisposal factors and risk
factors for malignancy of thyroid nodules in childhood is discussed, treatment
and follow-up approach is reviewed with the literature.
Keywords:
Childhood, current approach, thyroid nodules,
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- ISSN: 2149-8296
- Yayın Aralığı: Yılda 4 Sayı
- Başlangıç: 2010
- Yayıncı: DNT Ortadoğu Yayıncılık AŞ