Thyroid Cancer in Children 101: Endocrine Neck Ultrasound Best for recurrent disease in the neck lymph nodes.
1. Children with PTC who have residual/recurrent disease are most likely to have cervical lymph node disease.
2. US, in conjunction with Thyroglobulin TG levels, has proven highly effective in identifying and localizing regional nodal metastases in both adults and children with PTC.
3. US is more sensitive than a TSH-stimulated TG to identify disease.
4. US has also proven useful for directing FNA of suspicious lesions/lymph nodes in the thyroid bed or lateral neck that can then be evaluated by routine cytology and TG immunoassay of the needle washout, especially if cytopathology is equivocal or uninformative.
5. Therefore, US is the most important clinical tool for identifying cervical disease and is recommended at routine intervals.
6. Endocrine neck ultrasound is recommended in the follow-up of children with PTC.
7. Neck US should be performed at least 6 months after initial surgery and then at 6- to 12-month intervals. 8.Follow-up beyond 5 years should be individualized based on recurrence risk.