Address for correspondence: Dr Sushmita Bhatnagar, 56/B, Venus Apartments, Worli Sea Face, Worli, Mumbai 400018.
E-mail - bhatnagar_s1206@yahoo.co.in

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Comparative Analysis

TABLE 2: Differentiating features between benign and malignant lesions on diagnostic tests.

Features	Benign	Malignant
Thyroid function tests	May be abnormal	Normal
Antithyroid antibodies	May be raised in thyroiditis	Normal
Calcitonin levels (pentagastrin stimulation)	High in Thyroid cell hyperplasia	Raised in Medullary carcinoma of thyroid
Serum Carcinogenic Embryonic Antigen (CEA)	Normal	High in MCT
Ultrasonography	multiple, solid isoechogenic or nonechogenic lesions and a uniform peripheral halo.	thick irregular halo
Colour doppler	No vascular flow in a cystic lesion	Increased vascularity in a cystic lesion or intranodular flow in solid lesion
Thyroid scintigraphy	Not proven worthwhile to distinguish benign from malignant disease Classic hot nodules have about 6% of malignancy Classic cold nodules have about 30% of malignancy
Total body Radioactive Iodine Ablation (RIA) scans	Normal	Hot spots at metastatic sites, most commonly lungs

Conclusions

Thyroid cancers in children usually occur in the age group of more than 10 years of age. If a child presents with a nodule in the thyroid, since the chances of it being malignant are high, it should be rapidly and thoroughly evaluated. In children, not many diagnostic tests will be able to confirm malignancy, except for histopathological examination of the biopsy from the nodule. In younger children, biopsy from needle aspiration is most often inadequate in which situation an open biopsy becomes mandatory. The prognosis of the children with thyroid malignancies does not correspond to the degree of invasion and the metastases, hence treatment should never be denied to these children, in spite of the higher risk of recurrence. The overall 20 year survival rate is in the range of 92-100%.

References

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