Paediatric thyroid lesions

Thomas Davies, Karis McFeely, Judith Foster, Radiology Plymouth University Hospital Trust

Ultrasound evaluation plays an integral part in the diagnosis and subsequent management of thyroid lesions in children. Paediatric thyroid scanning can be a daunting prospect. This poster provides a pictorial review of the ultrasound appearances of common paediatric thyroid lesions and their diagnostic features.

The spectrum of paediatric thyroid lesions is wide. Broadly, they can be split into acquired and congenital causes of disease. An understanding of the embryogenesis, anatomy and function of the thyroid gland is important for accurate diagnosis.

Acquired paediatric thyroid lesions arise following completed thyroid development. They differ from those encountered in the adult population in several ways. They are relatively rare, affecting 1%–2% of this population, and the risk of thyroid cancer is significantly higher than in adults. Cases to be presented include papillary cancers, intermediate lesions and thyroiditis. Certain ultrasound features and patterns can lead to confident categorisation into a benign or malignant process. An intermediate group with both benign and malignant characteristics also exists and it is important to identify these as they will require further investigation and assessment.

Congenital paediatric thyroid lesions arise from anomalous thyroid development. Cases to be presented include thyroglossal cysts. They are the most common congenital cystic neck mass, and arise from failure of thyroglossal duct involution during foetal development. They can be associated with ectopic thyroid tissue and have characteristic ultrasound appearances.

Accurate and timely assessment of the paediatric thyroid lesion is essential for safe and effective management. This poster aims to build the confidence of those performing paediatric thyroid ultrasound using case based examples.

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