Paeds Cases · endocrinology-diabetes-and-growth
Thyroid nodules, goitre and thyroid cancer — OSCE
OSCE station: communicating the risk-stratification and multidisciplinary pathway for an adolescent thyroid nodule.
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Study tools
Target exams
MRCPCH ClinicalRACP DCE
Prompt
A 14-year-old and parent attend after the teen found a painless right-neck lump. The GP ultrasound suggested a nodule. The family is anxious about cancer and surgery.
Objectives
- Explain that most paediatric thyroid nodules are benign but that childhood risk is higher than adult risk, justifying a structured pathway. [1] [5]
- Outline the ultrasound (TI-RADS) and FNA (Bethesda) steps in plain language. [1] [2]
- Reassure without over-promising, and avoid promising surgery or radioiodine before the diagnosis is complete. [1]
- Agree a follow-up plan and safety-net for red flags (rapid growth, voice change, nodes). [1]
References5ShowHide
- [1]Francis GL Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid, 2015.PMID 25900731
- [2]Tessler FN ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. Journal of the American College of Radiology, 2017.PMID 28372962
- [5]Goldfarb M Differences in the management of thyroid nodules in children and adolescents as compared with adults. Current Opinion in Endocrinology, Diabetes and Obesity, 2022.PMID 35777975
- [9]Kothari R Composition and Priorities of Multidisciplinary Pediatric Thyroid Programs: A Consensus Statement. Thyroid, 2025.PMID 39950999
- [13]Wells SA Jr Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid, 2015.PMID 25810047