Although most pediatric thyroid masses are benign, some are malignant; thus, pediatricians must be able to assess for risk of malignancy and order appropriate diagnostic tests in conjunction with consultation with an endocrinologist.

Whether as part of a well-child examination, or in response to a patient or parent concern, it is important for the pediatrician to feel comfortable examining the thyroid gland. Although most pediatric thyroid masses are benign (Table 1 and Fig 1), in the event that a lesion is discovered, the pediatrician should be able to assess risk factors for malignancy and order appropriate diagnostic tests while awaiting consultation from the pediatric endocrinologist.

Palpable thyroid nodules in the pediatric and adolescent population are relatively rare, having an estimated prevalence of 0.2% to 1.4%, which is 5 to 10 times less than in adults. (1) Despite their lower occurrence, studies estimate 9% to 50% (mean,...

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