Neck nodule and thyroid cancer in young without radiation exposure history

Purpose: The aim of this study was to analyze the results of histopathological studies in neck masses observed in young patients. The neck masses were detected using ultrasonography and fine-needle aspiration cytology (FNAC). Methods: In this retrospective study, we analyzed 234 young patients who were surgically treated for neck masses at Chang Gung Medical Center in Linkou. The mean age of the 234 young patients was 16.3 ± 4.0 years (range 1-20 years). Neck ultrasonography studies were conducted using a real-time ultrasonographic machine and a 10 MHz transducer. FNAC was performed for the suspected neck nodules. Results: Of the 234 cases, 187 (79.9%) were surgically confirmed to be benign lesions, including four cases that were diagnosed as atypical adenoma. Malignant thyroid masses were identified in 47 patients. Surgery confirmed 22 cases to be lesions that were non-thyroid in origin, including those developing from a cyst, soft tissue, and with a lymphatic origin. Diagnostic accuracies of the FNAC and frozen section examination were found to be 91.1 and 97.7%, respectively. Conclusions: In the study population, 20.1% of the neck masses were malignant. Except in cases of follicular thyroid neoplasm, neck ultrasonography with FNAC could effectively identify the thyroid or non-thyroid origin of these masses with high-diagnostic accuracy.