Thyroid Nodules in Children

If your child has thyroid nodules, they might not have any symptoms. But sometimes, there may be a lump in their neck that you can feel or see. It’s important to get it checked out. At Cleveland Clinic Children's, your child’s compassionate care team could include:

• Endocrinologists.
• Otolaryngologists.
• Oncologists.
• Radiologists.
• Nurse practitioners.
• Physician assistants.
• Dietitians.
• Child life specialists.

At your child’s first appointment, we’ll talk with you and your child about how they’re feeling and what kind of symptoms — if any — they have. It’s important for us to understand their medical history so we can pinpoint things that could put them at higher risk for thyroid nodules.

Your child’s provider will also do a physical exam, paying special attention to your child’s neck to see how many thyroid nodules they have and how firm they are.

Next, we may recommend several tests to help us diagnose and treat the nodules, including:

• Blood tests to see if their gland is making the correct amounts of thyroid hormone.
• Ultrasound to help us figure out the nodules’ size, quantity and structure (if they’re solid or fluid-filled).
• Needle biopsy, where we use a tiny needle to remove a sample of the thyroid nodule. We use conscious sedation or a local anesthetic, so your child is comfortable during the biopsy.
• Thyroid uptake and scan to check how your child’s thyroid is working. It can provide clues that help us know if a nodule is cancer or not.

Results from these tests can tell us what type of thyroid nodules your child has and if the nodules are cancer. We’ll discuss the test results with you and use them to craft a care plan that’s right for your child.

We base your child’s treatment plan on their test results and medical history. If your child’s thyroid nodule is benign, we may recommend a combination of treatments or even simply watching and waiting.

Monitoring

If a benign nodule isn’t causing symptoms, we may suggest leaving it alone. But we’ll keep a close eye on it — which means your child will get an exam and ultrasound every six to 12 months. We’ll check to see if the nodule has grown and if your child has started having symptoms. If anything has changed, we’ll discuss next-step treatment options.

Surgery

If your child has benign thyroid nodules that are making it hard for them to swallow or causing them to have abnormal hormone levels, we might recommend removing them. We typically recommend a thyroidectomy (total thyroid removal) or lobectomy (partial thyroid removal) if your child has large nodules that are causing them problems.

If we find cancer, we typically recommend a thyroidectomy and sometimes remove the lymph nodes in your child’s neck, too.

Our child life specialists are here to help you and your child prepare for surgery. They can provide emotional support for both of you and help your child understand what to expect. We want to ease your child’s fears (and yours) about having their nodules removed.

Follow-up care

After your child’s treatment for benign thyroid nodules or thyroid cancer, we’ll keep an eye on them with regular exams, ultrasounds and blood tests. If there are any changes, we can catch them quickly.

If we’ve removed your child’s thyroid, they’ll also need lifelong hormone replacement therapy. Our endocrinologists tailor this medication specifically for your child. We’ll make sure their hormone levels are where they need to be so they can stay healthy and keep growing and developing.

Taking the Next Step

When your child needs treatment for thyroid nodules, chances are they’re a little scared about what’s going to happen. And you probably are, too. But you aren’t alone. We’re here to guide you through this experience — every step of the way. Your child will get expert care from highly skilled and caring Cleveland Clinic Children's providers. And you’ll get the answers and support you need to help them recover and get back to being a kid.