[Source: Guangzhou Daily client]
Many people found themselves with thyroid nodules during physical examination, and some people chose to ignore them because they thought it was "no big deal". In fact, in doing so, it is likely to miss the opportunity of early detection of cancer. Recently, the General Surgery Department of the First Affiliated Hospital of Jinan University received a 9-year-old boy. He chose to ignore it and delayed his treatment for three years. Finally, he found eosinophilic thyroid cancer in the right lobe of the thyroid.
Took three years to see the doctor, and the size of nodules doubled
(Related data drawing)
Lele (pseudonym), 9 years old, is a healthy and lively pupil. Three years ago, his father found that there was a small nodule in the front of the right side of Lele's neck, which was the size of the nucleus of longans, so his family didn't take it seriously. In the past three years, the small nodules have grown twice. Last month, the family took Lele to the local hospital for CT examination. The results showed that Lele's right thyroid lobe was diffusely enlarged, about 2.6 × 2.5 × 2.5 cm in size, which was larger than the nodules of ordinary adults. In order to seek further treatment, they found Professor Wang Cunchuan, General Surgery Department of the First Affiliated Hospital of Jinan University.
Wang Cunchuan introduced that the incidence of thyroid nodules in young and middle-aged people is high, and most of them are adult women, while children are rare. The child is only 9 years old and male, which violates the normal incidence rate. According to the Guidelines for Diagnosis and Treatment of Thyroid Diseases in China, the younger the age, the greater the probability of malignancy. The malignant rate of thyroid nodules in adults is less than 5%, but that of children is 26%, which is five times that of adults. In addition, the size of Lele's nodules is far larger than that of ordinary adults, so the degree of malignancy is very high.
Surgical treatment is the first choice without scar through areola approach
"Thyroid treatment is mainly surgery." Considering that Lele is in a critical period of growth and development, in order to minimize the psychological impact after surgery, Wang Cunchuan decided to adopt the endoscopic surgery via the areola approach, with small and hidden scars and high aesthetics.
How is thyroid surgery in children different from that in adults? Wang Cunchuan introduced that the first test was the level of anesthesia. The children used the smallest endotracheal tube, which was only one pen thick, while the adult tube was three to four pens thick. It was very difficult to achieve precise anesthesia. Secondly, test the level of creating surgical space. The children's skin is very thin, and they enter through the areola. When passing through the skin, they can neither pierce the skin nor hurt the muscles deeply. The strength control requirements are very high, and the depth is appropriate. Without rich surgical experience, they can't do it. Finally, the cutting level is tested. Children have shorter necks than adults, and most of the surgical instruments are for adults to use. When removing a lump, it is like holding a meatball with chopsticks if you are an adult. But surgery on children is like holding mung beans with chopsticks, and a little carelessness will lead to bleeding.
The operation was very smooth. In the afternoon, Professor Wang Cunchuan took charge of the operation. The operation ended in less than an hour, and the tumor was completely removed. The biopsy results showed that the nodule was a follicular mass, and Lele was clinically diagnosed with eosinophilic thyroid carcinoma in the right lobe of thyroid.
Children's thyroid nodules should not ignore these symptoms and be alert
On the day after the operation, Lele was able to get out of bed and walk freely, drinking water and talking without problems. The postoperative pathological results showed that the tumor was malignant, but fortunately, the radical effect could be achieved after the tumor was removed. The big stone in Lele's father's heart finally fell to the ground, and he said regretfully: "I blame myself for not taking thyroid nodules too seriously and delaying it for three years."
Wang Jianxue, the doctor in charge of Lele, said that Lele does not need radiotherapy and chemotherapy in the future, and needs to regularly check the thyroid level and adjust the dosage according to the actual situation. On the fourth day after operation, Lele was discharged successfully.
At present, the cause of thyroid disease in children is not very clear, and it is generally considered to be related to heredity. Wang Cunchuan reminded that parents should be alert to thyroid diseases and go to the hospital in time if they find children with neck thickening, tenderness, neck color deepening, high metabolic sweating, body temperature higher than others all the year round, heart rate acceleration and other symptoms.
Article and picture/Guangzhou Daily · New Flower City reporter: Zhang Qingmei Correspondent: Zhou Xiaoxing, Zhang Cancheng
Guangzhou Daily · Xinhuacheng Editor: He Xuehua
key word: Thyroid nodule
Guangzhou Daily
Thyroid carcinoma
