Consensus statement by the American Association of Clinical Endocrinologists and the American Head and Neck Society Endocrine Surgery Section on Pediatric Benign and Malignant Thyroid Surgery

Objectives A clinical disease state review of recent relevant literature and to generate expert consensus statements regarding the breadth of pediatric thyroid cancer diagnosis, care, with an emphasis on thyroid surgery. To generate expert statements to educate pediatric practitioners on the state of the art and the value of surgical experience in the management of this unusual and challenging disease in children. Methods A literature search and construction of statements which were subjected to a modified Delphi process to measure consensus of the expert author panel. The wording of statements, voting tabulation, and statistical analysis were overseen by a Delphi expert (J. J. S.). Results Twenty-five consensus statements were created and subjected to modified Delphi analysis to measure strength of consensus of the expert author panel. All statements reached a level of consensus and the majority of statements reached the highest level of consensus. Conclusion Pediatric thyroid cancer has many unique nuances such as bulky cervical adenopathy on presentation, an increase incidence of diffuse sclerosing variant, and a longer potential lifespan to endure potential complications from treatment. Complications can be a burden to parents and patients alike. We suggest that optimal outcomes and decreased morbidity will come from the use of advanced imaging, diagnostic testing, and neural monitoring of patients treated in high-volume centers by high-volume surgeons.

Automated summary

A clinical review and expert consensus statements were generated on the diagnosis and care of pediatric thyroid cancer, focusing on the value of surgical experience. Pediatric thyroid cancer presents unique challenges such as bulky cervical adenopathy, diffuse sclerosing variant, and potential complications. Optimal outcomes and decreased morbidity are suggested to come from advanced imaging, diagnostic testing, and neural monitoring in high-volume centers by high-volume surgeons.