Pediatric Thyroid Disorders

An interactive discussion about malignant and benign pediatric thyroid disorders between Todd Ponsky, MD and Diana Diesen, MD. Dr. Diesen is assistant professor of surgery and pediatric surgery fellowship program director at the University of Texas Southwestern Medical Center and is a member of the Children's Health Pediatric Thyroid Center at the Children's Medical Center of Dallas. Contents 00:00 Introduction 02:31 Asymptomatic thyroid nodule 03:00 History 04:08 Risks factors for thyroid nodules and cancers 04:25 Family history 04:56 Physical exam 05:24 Physical exam pearls 06:03 Concerning physical exam findings 06:56 Laboratory evaluation 07:42 Thyroid scintigraphy 08:08 Hot thyroid nodules 09:13 Nodule with normal TSH 09:26 Thyroid ultrasound 10:15 Thyroid cysts 10:52 Lesion size and FNA biopsy 11:53 Anesthesia for FNA 12:30 Lymph node evaluation 13:12 Suspicious lymph node features 13:40 Papillary thyroid cancer 14:34 Lobectomy vs thyroidectomy 16:05 Thyroidecomy technique 17:07 Use of nerve monitor 17:40 Lymph node dissection 18:59 Post-operative management 20:37 Follow up 21:43 Radioactive iodine ablation 22:38 Thyroid hormone replacement therapy 22:54 Follicular cells on FNA 24:59 Frozen section for follicular lesions 25:55 Follicular carcinoma 26:36 Follicular adenoma 27:14 Pharmacologic TSH suppression 28:12 Benign FNA 29:45 Inadequate FNA specimen 30:32 Medullary carcinoma 33:22 Multiple endocrine neoplasia 37:26 Management of pheochromocytoma and hyperparathyroidism in MEN 2B 38:27 Central lymph node dissection in medullary thyroid cancer 39:42 Post-op medullary thyroid care 41:08 Recurrent/persistent medullary thyroid cancer 41:38 Systemic chemotherapy for MTC 42:03 Grave’s disease 42:57 Painful thyroid Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: http://creativecommons.org/licenses/by/3.0/