{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T14:05:09Z","timestamp":1789567509100,"version":"build-2803163510"},"reference-count":71,"publisher":"Bioscientifica","issue":"5","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this work was to summarize current evidence and practical management considerations for thyroid nodules in children and adolescents with cancer predisposition syndromes (CPSs), focusing on follicular cell-derived nodules and non-medullary thyroid carcinoma (NMTC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We synthesized current paediatric guideline recommendations and recent cohort, pathology, and molecular studies addressing CPS-associated nodular thyroid disease, including PTEN hamartoma tumour syndrome (PHTS), DICER1 syndrome, familial adenomatous polyposis, and related endocrine neoplasia syndromes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Evidence quantifying syndrome-stratified malignancy risk among paediatric CPS patients presenting with nodules remains limited and is largely derived from mixed-age or retrospectively ascertained cohorts with surveillance and verification bias. High-resolution ultrasound (US) is central to risk stratification. US-guided fine-needle aspiration (FNA) is a cornerstone of evaluation yet frequently yields indeterminate results, particularly in follicular-patterned and encapsulated lesions (e.g. PHTS and DICER1 syndrome), and sampling error is accentuated in polyclonal multinodular disease. Molecular testing may aid aetiologic clarification and, in selected settings, risk refinement. However, panels optimized for sporadic adult disease may have reduced \u2018rule-out\u2019 utility in CPSs. Biochemical assessment (TSH \u00b1 free thyroxine) complements imaging, while routine thyroglobulin is not recommended, and thyroid autoantibodies should be viewed as adjunctive rather than directive markers in CPSs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Management of thyroid nodules in paediatric CPSs is best approached through integrated, multidisciplinary risk assessment that combines expert ultrasound, context-aware cytology and molecular interpretation, and shared decision-making. This review proposes a CPS-adapted, multidisciplinary risk assessment framework and highlights the need for prospective multicentre registries and harmonized protocols to define syndrome-specific outcomes and evidence-based thresholds for surveillance and intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/etj-26-0100","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T17:52:36Z","timestamp":1787939556000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-17","source":"Crossref","is-referenced-by-count":0,"title":["Approaches to thyroid nodules in paediatric cancer predisposition syndromes"],"prefix":"10.1530","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4577-0503","authenticated-orcid":true,"given":"Michaela","family":"Kuhlen","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Paediatric Haematology\/Oncology, Otto-von-Guericke-University 1 , ,","place":["Magdeburg, Germany"]},{"name":"Paediatrics and Adolescent Medicine, Faculty of Medicine, University of Augsburg 2 , ,","place":["Augsburg, Germany"]},{"name":"Bavarian Cancer Research Centre (BZKF) 3 , ,","place":["Augsburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuele","family":"Naviglio","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS \u2018Burlo Garofolo\u2019 4 , ,","place":["Trieste, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Hirtz","sequence":"additional","affiliation":[{"name":"Centre for Child and Adolescent Medicine, Helios University Hospital Wuppertal, Witten\/Herdecke University 5 , ,","place":["Wuppertal, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calogero","family":"Virgone","sequence":"additional","affiliation":[{"name":"Department of Women and Child\u2019s Health, University of Padua 6 , ,","place":["Padua, Italy"]},{"name":"Paediatric Surgery Unit, University Hospital of Padua 7 , ,","place":["Padua, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald R","family":"de Krijger","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Centre for Paediatric Oncology 8 , ,","place":["Utrecht, The Netherlands"]},{"name":"Department of Pathology, University Medical Centre Utrecht 9 , ,","place":["Utrecht, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Theurer","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University Hospital Essen, University of Duisburg-Essen 10 , ,","place":["Essen, Germany"]},{"name":"Endocrine Tumour Centre and ENETS Centre at West German Cancer Centre (WTZ), Centre of Endocrine Medicine (CEM), EndoERN and EURACAN 11 , ,","place":["Essen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Waespe","sequence":"additional","affiliation":[{"name":"Division of Paediatric Haematology\/Oncology, Department of Paediatrics, Inselspital, University Hospital Bern 12 , ,","place":["Bern, Switzerland"]},{"name":"CANSEARCH Research Platform in Paediatric Oncology and Haematology, Department of Paediatrics, Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva 13 , ,","place":["Geneva, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antje","family":"Redlich","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Paediatric Haematology\/Oncology, Otto-von-Guericke-University 1 , ,","place":["Magdeburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"SIOPE Host Genome Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2882-6798","authenticated-orcid":true,"given":"Karin A W","family":"Wadt","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Kyriakidis","sequence":"additional","affiliation":[{"name":"Laboratory of Blood Diseases and Childhood Cancer Biology, School of Medicine, University of Crete, Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3591-0499","authenticated-orcid":true,"given":"Francesca","family":"Alt","sequence":"additional","affiliation":[{"name":"Center for Pediatric and Adolescent Medicine, Department of Pediatric Hematology\/Oncology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorus","family":"Kouwenberg","sequence":"additional","affiliation":[{"name":"Princess Maxima Center for Paediatric Oncology, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4840-5010","authenticated-orcid":true,"given":"Noelle","family":"Cullinan","sequence":"additional","affiliation":[{"name":"Department of Paediatric Oncology, National Children's Cancer Service, Children's Health Ireland, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Piccolo","sequence":"additional","affiliation":[{"name":"Neuro-Oncology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy, and Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Meinhardt","sequence":"additional","affiliation":[{"name":"Clinic for Paediatric Immunology and Rheumatology, Centre for Paediatrics and Adolescent Medicine, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4716-9423","authenticated-orcid":true,"given":"Anna","family":"Poluha","sequence":"additional","affiliation":[{"name":"Department of Molecular Diagnostics and Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsi","family":"Jahnukainen","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland, and NORDFERTIL Research Lab Stockholm, Karolinska Institute and University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"EXPeRT Endocrine Working Group Members","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7960-6069","authenticated-orcid":true,"given":"Jelena","family":"Roganovic","sequence":"additional","affiliation":[{"name":"Children's Hospital Zagreb, Department of Pediatric Oncology and Haematology, Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1333-2912","authenticated-orcid":true,"given":"Fredrik","family":"Baecklund","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Unit, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0017-6332","authenticated-orcid":true,"given":"Tal","family":"Ben-Ami","sequence":"additional","affiliation":[{"name":"Paediatric Haematology\/Oncology Unit, Kaplan Medical Centre, Rehovot, Israel, affiliated with Hadassah-Hebrew University Medical School, Jerusalem, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2149-329X","authenticated-orcid":true,"given":"Luca","family":"Bergamaschi","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2091-2686","authenticated-orcid":true,"given":"Ewa","family":"Bien","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Haematology, and Oncology, Medical University of Gdansk, Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7093-8975","authenticated-orcid":true,"given":"Malgorzata","family":"Krawczyk","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Haematology, and Oncology, Medical University of Gdansk, Gdansk, Poland, and Paediatric Haematology\/Oncology, Department of Paediatrics, University Hospital Tuebingen, Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia Castaneda","family":"Heredia","sequence":"additional","affiliation":[{"name":"Pediatric Cancer Center Barcelona, Hospital Sant Joan de D\u00e9u. Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuno Jorge","family":"dos Reis Farinha","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1082-6810","authenticated-orcid":true,"given":"Maria Debora","family":"De Pasquale","sequence":"additional","affiliation":[{"name":"Oncohematology, Hemopoietic Transplantation, Cellular Therapies and Clinical Trials, Bambino Ges\u00f9 Children's Hospital, IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4747-1032","authenticated-orcid":true,"given":"Evelina","family":"Miele","sequence":"additional","affiliation":[{"name":"Oncohematology, Hemopoietic Transplantation, Cellular Therapies and Clinical Trials, Bambino Ges\u00f9 Children's Hospital, IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5632-2672","authenticated-orcid":true,"given":"Maria Gabriela","family":"Guillen Burrieza","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5521-9892","authenticated-orcid":true,"given":"Ricardo Lopez","family":"Almaraz","sequence":"additional","affiliation":[{"name":"Paediatric Haematology and Oncology Unit, Hospital Universitario de Cruces, Barakaldo-Bizkaia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4031-6619","authenticated-orcid":true,"given":"Apostolos","family":"Pourtsidis","sequence":"additional","affiliation":[{"name":"Pediatric and Adolescent Oncology Clinic, Children's Hospital MITERA, Marousi, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Reguerre","sequence":"additional","affiliation":[{"name":"Paediatric Oncology and Haematology Unit, CHU Saint Denis de La R\u00e9union, Bellepierre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2840-0308","authenticated-orcid":true,"given":"Bilgehan","family":"Yalcin","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4462-5523","authenticated-orcid":true,"given":"Gianni","family":"Bisogno","sequence":"additional","affiliation":[{"name":"Department of Woman and Child's Health, University Padua, Padua, Italy, and Pediatric Hematology Oncology Division, University Hospital of Padua, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Paediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy, and Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2520-139X","authenticated-orcid":true,"given":"Daniel","family":"Orbach","sequence":"additional","affiliation":[{"name":"SIREDO Oncology Center, Institut Curie, 75005, Paris Sciences et Lettres University, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"2026091609165277900_bib1","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1089\/thy.2014.0460","article-title":"Management guidelines for children with thyroid nodules and differentiated thyroid cancer","volume":"25","author":"Francis","year":"2015","journal-title":"Thyroid"},{"key":"2026091609165277900_bib2","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1148\/radiol.2018171170","article-title":"Thyroid nodules in pediatric patients: sonographic characteristics and likelihood of cancer","volume":"288","author":"Richman","year":"2018","journal-title":"Radiology"},{"key":"2026091609165277900_bib3","doi-asserted-by":"crossref","first-page":"2823","DOI":"10.1007\/s00431-021-04032-z","article-title":"Clinical, sonographical, and pathological findings of pediatric thyroid nodules","volume":"180","author":"Cimbek","year":"2021","journal-title":"Eur J Pediatr"},{"key":"2026091609165277900_bib4","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1159\/000526116","article-title":"Indeterminate thyroid fine-needle aspirations in pediatrics: exploring clinicopathologic features and utility of molecular profiling","volume":"95","author":"Baran","year":"2022","journal-title":"Horm Res Paediatr"},{"key":"2026091609165277900_bib5","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1210\/jc.2017-01603","article-title":"Findings of thyroid ultrasound examination within 3 years after the Fukushima nuclear power plant accident: the Fukushima health management survey","volume":"103","author":"Shimura","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"key":"2026091609165277900_bib6","doi-asserted-by":"crossref","DOI":"10.1530\/ETJ-22-0146","article-title":"2022 European Thyroid Association Guidelines for the management of pediatric thyroid nodules and differentiated thyroid carcinoma","volume":"11","author":"Lebbink","year":"2022","journal-title":"Eur Thyroid J"},{"key":"2026091609165277900_bib7","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.jasc.2023.05.005","article-title":"The 2023 Bethesda System for reporting thyroid cytopathology","volume":"12","author":"Ali","year":"2023","journal-title":"J Am Soc Cytopathol"},{"key":"2026091609165277900_bib8","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1001\/jamapediatrics.2016.0486","article-title":"Thyroid disorders in children and adolescents: a review","volume":"170","author":"Hanley","year":"2016","journal-title":"JAMA Pediatr"},{"key":"2026091609165277900_bib9","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/s00428-025-04384-z","article-title":"Unmasking familial follicular cell-derived thyroid neoplasms associated with syndromes: DICER1 and PTEN-Hamartoma tumor syndromes","volume":"488","author":"Riascos","year":"2026","journal-title":"Virchows Arch"},{"key":"2026091609165277900_bib10","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1158\/1078-0432.CCR-24-1947","article-title":"Update on pediatric surveillance recommendations for PTEN hamartoma tumor syndrome, DICER1-related tumor predisposition, and Tuberous sclerosis complex","volume":"31","author":"Schultz","year":"2025","journal-title":"Clin Cancer Res"},{"key":"2026091609165277900_bib11","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1210\/jc.2016-2954","article-title":"Quantification of thyroid cancer and multinodular goiter risk in the DICER1 syndrome: a family-based cohort study","volume":"102","author":"Khan","year":"2017","journal-title":"J Clin Endocrinol Metab"},{"key":"2026091609165277900_bib12","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2023.9705","article-title":"Longitudinal analysis of cancer risk in children and adults with germline PTEN variants","volume":"6","author":"Yehia","year":"2023","journal-title":"JAMA Netw Open"},{"key":"2026091609165277900_bib13","doi-asserted-by":"crossref","DOI":"10.1016\/j.gim.2025.101385","article-title":"DICER1 in pediatric and adult cancer predisposition populations: prevalence, phenotypes, and mosaicism","volume":"27","author":"Salvador","year":"2025","journal-title":"Genet Med"},{"key":"2026091609165277900_bib14","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1053\/j.gastro.2025.10.029","article-title":"Incidence of cancer in patients with familial adenomatous polyposis in the Netherlands: a nationwide cohort study","volume":"170","author":"Bouchiba","year":"2026","journal-title":"Gastroenterology"},{"key":"2026091609165277900_bib15","doi-asserted-by":"crossref","first-page":"e2214","DOI":"10.1210\/clinem\/dgae107","article-title":"Clinically relevant germline variants in children with nonmedullary thyroid cancer","volume":"109","author":"van der Tuin","year":"2024","journal-title":"J Clin Endocrinol Metab"},{"key":"2026091609165277900_bib16","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.3390\/genes11111364","article-title":"Genetic mutations and variants in the susceptibility of familial non-medullary thyroid cancer","volume":"11","author":"Miasaki","year":"2020","journal-title":"Genes"},{"key":"2026091609165277900_bib17","doi-asserted-by":"crossref","first-page":"3787","DOI":"10.1158\/1078-0432.CCR-25-0631","article-title":"Contribution of germline predisposition to pediatric thyroid cancer","volume":"31","author":"Harrison","year":"2025","journal-title":"Clin Cancer Res"},{"key":"2026091609165277900_bib18","doi-asserted-by":"crossref","first-page":"e1121","DOI":"10.1210\/clinem\/dgaa944","article-title":"Natural history of thyroid disease in children with PTEN hamartoma tumor syndrome","volume":"106","author":"Smith","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"key":"2026091609165277900_bib19","doi-asserted-by":"crossref","first-page":"1754","DOI":"10.1158\/1078-0432.CCR-24-3819","article-title":"Cancer and overgrowth manifestations of PTEN hamartoma tumor syndrome: management recommendations from the International PHTS Consensus Guidelines Working Group","volume":"31","author":"Dhawan","year":"2025","journal-title":"Clin Cancer Res"},{"key":"2026091609165277900_bib20","doi-asserted-by":"crossref","first-page":"2009","DOI":"10.1210\/jc.2017-02698","article-title":"DICER1 mutations are frequent in adolescent-onset papillary thyroid carcinoma","volume":"103","author":"Wasserman","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"key":"2026091609165277900_bib21","doi-asserted-by":"crossref","first-page":"4611","DOI":"10.1210\/jc.2016-2043","article-title":"Age- and gender-specific risk of thyroid cancer in patients with familial adenomatous polyposis","volume":"101","author":"Uchino","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"2026091609165277900_bib22","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1093\/jnci\/djac188","article-title":"Cancer risks by sex and variant type in PTEN Hamartoma tumor syndrome","volume":"115","author":"Hendricks","year":"2023","journal-title":"J Natl Cancer Inst"},{"key":"2026091609165277900_bib23","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1111\/his.15278","article-title":"Can thyroid histomorphology identify patients with PTEN hamartoma tumour syndrome?","volume":"85","author":"Dababneh","year":"2024","journal-title":"Histopathology"},{"key":"2026091609165277900_bib24","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s10689-018-0085-3","article-title":"Prevalence of thyroid diseases in familial adenomatous polyposis: a systematic review and meta-analysis","volume":"18","author":"Chenbhanich","year":"2019","journal-title":"Fam Cancer"},{"key":"2026091609165277900_bib25","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1038\/s41379-018-0070-2","article-title":"Cribriform-morular variant of thyroid carcinoma: a neoplasm with distinctive phenotype associated with the activation of the WNT\/beta-catenin pathway","volume":"31","author":"Cameselle-Teijeiro","year":"2018","journal-title":"Mod Pathol"},{"key":"2026091609165277900_bib26","doi-asserted-by":"crossref","first-page":"3628","DOI":"10.1158\/1078-0432.CCR-24-3860","article-title":"Updated recommendations for pediatric surveillance in hereditary endocrine neoplasia syndromes: multiple endocrine neoplasias, hyperparathyroidism-jaw tumor syndrome, and carney complex","volume":"31","author":"Wasserman","year":"2025","journal-title":"Clin Cancer Res"},{"key":"2026091609165277900_bib27","doi-asserted-by":"crossref","first-page":"1831","DOI":"10.1158\/1078-0432.CCR-24-3301","article-title":"Update on cancer screening recommendations for individuals with Li-Fraumeni syndrome","volume":"31","author":"Achatz","year":"2025","journal-title":"Clin Cancer Res"},{"key":"2026091609165277900_bib28","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1007\/s40618-020-01435-x","article-title":"Familial non-medullary thyroid cancer: a critical review","volume":"44","author":"Capezzone","year":"2021","journal-title":"J Endocrinol Investig"},{"key":"2026091609165277900_bib29","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1038\/s41431-020-0651-7","article-title":"Cancer surveillance guideline for individuals with PTEN hamartoma tumour syndrome","volume":"28","author":"Tischkowitz","year":"2020","journal-title":"Eur J Hum Genet"},{"key":"2026091609165277900_bib30","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/s10689-021-00264-y","article-title":"Surveillance recommendations for DICER1 pathogenic variant carriers: a report from the SIOPE Host Genome Working Group and CanGene-CanVar Clinical Guideline Working Group","volume":"20","author":"Bakhuizen","year":"2021","journal-title":"Fam Cancer"},{"key":"2026091609165277900_bib31","doi-asserted-by":"crossref","first-page":"4566","DOI":"10.1158\/1078-0432.CCR-24-0953","article-title":"Pediatric cancer screening in hereditary gastrointestinal cancer risk syndromes: an update from the AACR Childhood Cancer Predisposition Working Group","volume":"30","author":"MacFarland","year":"2024","journal-title":"Clin Cancer Res"},{"key":"2026091609165277900_bib32","doi-asserted-by":"crossref","DOI":"10.1093\/bjs\/znae070","article-title":"Updated European guidelines for clinical management of familial adenomatous polyposis (FAP), MUTYH-associated polyposis (MAP), gastric adenocarcinoma, proximal polyposis of the stomach (GAPPS) and other rare adenomatous polyposis syndromes: a joint EHTG-ESCP revision","volume":"111","author":"Zaffaroni","year":"2024","journal-title":"Br J Surg"},{"key":"2026091609165277900_bib33","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1001\/jamaoto.2019.3051","article-title":"Harms of pediatric thyroid cancer overdiagnosis","volume":"146","author":"Murakami","year":"2020","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"2026091609165277900_bib34","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1159\/000503323","article-title":"Overdiagnosis of Juvenile thyroid cancer","volume":"9","author":"Takano","year":"2020","journal-title":"Eur Thyroid J"},{"key":"2026091609165277900_bib35","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/S2213-8587(25)00289-X","article-title":"Thyroid cancer in adolescents and young adults: a population-based study in 185 countries worldwide","volume":"14","author":"Li","year":"2026","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2026091609165277900_bib36","doi-asserted-by":"crossref","first-page":"e165","DOI":"10.1210\/clinem\/dgab622","article-title":"Age, American Thyroid Association Risk Group, and response to therapy are prognostic factors in children with differentiated thyroid cancer","volume":"107","author":"Redlich","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"key":"2026091609165277900_bib37","doi-asserted-by":"crossref","DOI":"10.1002\/pbc.29076","article-title":"Differentiated thyroid carcinoma in children: a retrospective analysis of 125 pediatric cases from a single institution in India","volume":"68","author":"Thankamony","year":"2021","journal-title":"Pediatr Blood Cancer"},{"key":"2026091609165277900_bib38","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1177\/10507256251363978","article-title":"Clinical and pathological factors associated with disease persistence in pediatric patients with differentiated thyroid carcinoma","volume":"35","author":"De Leo","year":"2025","journal-title":"Thyroid"},{"key":"2026091609165277900_bib39","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1089\/thy.2019.0229","article-title":"Extrathyroidal extension is an important predictor of regional lymph node metastasis in pediatric differentiated thyroid cancer","volume":"30","author":"Jain","year":"2020","journal-title":"Thyroid"},{"key":"2026091609165277900_bib40","doi-asserted-by":"crossref","first-page":"2031","DOI":"10.1210\/jc.2015-3290","article-title":"Pediatric differentiated thyroid carcinoma in the Netherlands: a nationwide follow-up study","volume":"101","author":"Klein Hesselink","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"2026091609165277900_bib41","doi-asserted-by":"crossref","DOI":"10.1148\/radiol.241015","article-title":"Pediatric thyroid nodules: K-TIRADS\/ACR TI-RADS pediatric-specific biopsy cutoff incorporating clinical risk factors","volume":"315","author":"Lee","year":"2025","journal-title":"Radiology"},{"key":"2026091609165277900_bib42","article-title":"The diagnostic efficacy and inappropriate biopsy rate of ACR TI-RADS and ATA guidelines for thyroid nodules in children and adolescents","volume":"14","author":"Li","year":"2023","journal-title":"Front Endocrinol"},{"key":"2026091609165277900_bib43","doi-asserted-by":"crossref","first-page":"408","DOI":"10.2214\/AJR.22.28231","article-title":"Thyroid nodules on ultrasound in children and young adults: comparison of diagnostic performance of radiologists\u2019 impressions, ACR TI-RADS, and a deep learning algorithm","volume":"220","author":"Yang","year":"2023","journal-title":"AJR Am J Roentgenol"},{"key":"2026091609165277900_bib44","doi-asserted-by":"crossref","first-page":"3975","DOI":"10.3390\/cancers15153975","article-title":"Performance of ACR TI-RADS and the Bethesda system in predicting risk of malignancy in thyroid nodules at a large Children\u2019s Hospital and a comprehensive review of the pediatric literature","volume":"15","author":"Hess","year":"2023","journal-title":"Cancers"},{"key":"2026091609165277900_bib45","doi-asserted-by":"crossref","first-page":"188","DOI":"10.2214\/AJR.18.20099","article-title":"Assessment of the American College of Radiology thyroid imaging reporting and data system for thyroid nodule malignancy risk stratification in a pediatric population","volume":"212","author":"Lim-Dunham","year":"2019","journal-title":"AJR Am J Roentgenol"},{"key":"2026091609165277900_bib46","doi-asserted-by":"crossref","DOI":"10.1016\/j.jpedsurg.2024.161924","article-title":"Assessing the diagnostic accuracy of TI-RADS in pediatric thyroid nodules: a multi-institutional review","volume":"60","author":"Srivatsa","year":"2025","journal-title":"J Pediatr Surg"},{"key":"2026091609165277900_bib47","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.jacr.2017.01.046","article-title":"ACR Thyroid imaging, reporting and data system (TI-RADS): white paper of the ACR TI-RADS committee","volume":"14","author":"Tessler","year":"2017","journal-title":"J Am Coll Radiol"},{"key":"2026091609165277900_bib48","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1007\/s00247-020-04804-z","article-title":"Utility of sonography for identifying metastatic cervical adenopathy in children with differentiated thyroid carcinoma at presentation","volume":"51","author":"Navallas","year":"2021","journal-title":"Pediatr Radiol"},{"key":"2026091609165277900_bib49","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1210\/jc.2018-00774","article-title":"Clinical and molecular characteristics may alter treatment strategies of thyroid malignancies in DICER1 syndrome","volume":"104","author":"van der Tuin","year":"2019","journal-title":"J Clin Endocrinol Metab"},{"key":"2026091609165277900_bib50","doi-asserted-by":"crossref","DOI":"10.1530\/ETJ-23-0135","article-title":"Autonomously functioning thyroid nodules present intermediate malignancy risk according to European Thyroid Imaging Reporting and Data System (EU-TIRADS) and yield indeterminate cytology results","volume":"12","author":"Kyrilli","year":"2023","journal-title":"Eur Thyroid J"},{"key":"2026091609165277900_bib51","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1093\/ejendo\/lvaf133","article-title":"Autoimmune thyroiditis in paediatric thyroid cancer: clinical features and outcomes","volume":"193","author":"Kuhlen","year":"2025","journal-title":"Eur J Endocrinol"},{"key":"2026091609165277900_bib52","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1515\/jpem-2020-0383","article-title":"Papillary thyroid carcinoma in children with Hashimoto's thyroiditis - a review of the literature between 2000 and 2020","volume":"33","author":"Sur","year":"2020","journal-title":"J Pediatr Endocrinol Metab"},{"key":"2026091609165277900_bib53","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1530\/ERC-22-0061","article-title":"Clinicopathologic features of thyroid nodules with PTEN mutations on preoperative testing","volume":"29","author":"Quaytman","year":"2022","journal-title":"Endocr Relat Cancer"},{"key":"2026091609165277900_bib54","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1530\/EJE-20-1480","article-title":"Clinical utility of sonographic features in indeterminate pediatric thyroid nodules","volume":"184","author":"Richman","year":"2021","journal-title":"Eur J Endocrinol"},{"key":"2026091609165277900_bib55","doi-asserted-by":"crossref","first-page":"6112","DOI":"10.3390\/jcm14176112","article-title":"Toward standardized management of indeterminate thyroid nodules in pediatric patients: a systematic review and call for a comprehensive risk stratification model","volume":"14","author":"Tuli","year":"2025","journal-title":"J Clin Med"},{"key":"2026091609165277900_bib56","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1093\/ajcp\/aqaf034","article-title":"Pediatric thyroid nodules: a comprehensive study of cytology, histology, molecular findings, and risk of malignancy with emphasis on atypia of undetermined significance category","volume":"164","author":"Ixchel Sanchez","year":"2025","journal-title":"Am J Clin Pathol"},{"key":"2026091609165277900_bib57","doi-asserted-by":"crossref","first-page":"2339","DOI":"10.1210\/clinem\/dgaf090","article-title":"Approach to the pediatric patient with thyroid nodules","volume":"110","author":"Lai","year":"2025","journal-title":"J Clin Endocrinol Metab"},{"key":"2026091609165277900_bib58","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1200\/JCO.21.01861","article-title":"Fusion oncogenes are associated with increased metastatic capacity and persistent disease in pediatric thyroid cancers","volume":"40","author":"Franco","year":"2022","journal-title":"J Clin Oncol"},{"key":"2026091609165277900_bib59","doi-asserted-by":"crossref","first-page":"e1683","DOI":"10.1210\/clinem\/dgaa935","article-title":"Distant metastases from childhood differentiated thyroid carcinoma: clinical course and mutational landscape","volume":"106","author":"Nies","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"key":"2026091609165277900_bib60","doi-asserted-by":"crossref","first-page":"3324","DOI":"10.1210\/clinem\/dgaa389","article-title":"Genetic alterations in pediatric thyroid cancer using a comprehensive childhood cancer gene panel","volume":"105","author":"Alzahrani","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"2026091609165277900_bib61","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1089\/thy.2019.0802","article-title":"RET, NTRK, ALK, BRAF, and MET fusions in a large cohort of pediatric papillary thyroid carcinomas","volume":"30","author":"Pekova","year":"2020","journal-title":"Thyroid"},{"key":"2026091609165277900_bib62","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1001\/jamaoncol.2022.1655","article-title":"Evaluation of the molecular landscape of pediatric thyroid nodules and use of a multigene genomic classifier in children","volume":"8","author":"Gallant","year":"2022","journal-title":"JAMA Oncol"},{"key":"2026091609165277900_bib63","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1136\/jmedgenet-2011-100152","article-title":"Two distinct thyroid tumours in a patient with Cowden syndrome carrying both a 10q23 and a mitochondrial DNA germline deletion","volume":"48","author":"Pradella","year":"2011","journal-title":"J Med Genet"},{"key":"2026091609165277900_bib64","doi-asserted-by":"crossref","DOI":"10.1002\/bies.201700082","article-title":"PTEN in the maintenance of genome integrity: from DNA replication to chromosome segregation","volume":"39","author":"Hou","year":"2017","journal-title":"Bioessays"},{"key":"2026091609165277900_bib65","article-title":"RET fusion genes in pediatric and adult thyroid carcinomas: cohort characteristics and prognosis","volume":"30","author":"Bulanova","year":"2023","journal-title":"Endocr Relat Cancer"},{"key":"2026091609165277900_bib66","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.14309\/ajg.0000000000001747","article-title":"Thyroid nodules in children with familial adenomatous polyposis","volume":"117","author":"Smith","year":"2022","journal-title":"Am J Gastroenterol"},{"key":"2026091609165277900_bib67","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1089\/thy.2024.0496","article-title":"Composition and priorities of multidisciplinary pediatric thyroid programs: a consensus statement","volume":"35","author":"Kothari","year":"2025","journal-title":"Thyroid"},{"key":"2026091609165277900_bib68","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1089\/thy.2015.0020","article-title":"2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines task force on thyroid nodules and differentiated thyroid cancer","volume":"26","author":"Haugen","year":"2016","journal-title":"Thyroid"},{"key":"2026091609165277900_bib69","doi-asserted-by":"crossref","first-page":"R47","DOI":"10.1530\/EC-19-0566","article-title":"Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: a problematic entity","volume":"9","author":"Zajkowska","year":"2020","journal-title":"Endocr Connect"},{"key":"2026091609165277900_bib70","doi-asserted-by":"crossref","DOI":"10.3892\/or.2024.8778","article-title":"Cribriform morular thyroid carcinoma: clinicopathological and molecular basis for both a preventive and therapeutic approach for a rare tumor (Review)","volume":"52","author":"Cameselle-Garcia","year":"2024","journal-title":"Oncol Rep"},{"key":"2026091609165277900_bib71","doi-asserted-by":"crossref","first-page":"R109","DOI":"10.1530\/ERC-17-0014","article-title":"Cribriform-morular variant of papillary thyroid carcinoma: a distinctive type of thyroid cancer","volume":"24","author":"Lam","year":"2017","journal-title":"Endocr Relat Cancer"}],"container-title":["European Thyroid Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.bioscientifica.com\/etj\/article-pdf\/doi\/10.1530\/ETJ-26-0100\/524410\/etj-26-0100.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.bioscientifica.com\/etj\/article-pdf\/doi\/10.1530\/ETJ-26-0100\/524410\/etj-26-0100.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T13:17:05Z","timestamp":1789564625000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.bioscientifica.com\/etj\/article\/15\/5\/ETJ260100\/78105\/Approaches-to-thyroid-nodules-in-paediatric-cancer"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,28]]},"references-count":71,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10,1]]}},"URL":"https:\/\/doi.org\/10.1530\/etj-26-0100","relation":{},"ISSN":["2235-0640","2235-0802"],"issn-type":[{"value":"2235-0640","type":"print"},{"value":"2235-0802","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,28]]},"article-number":"ETJ260100"}}