# Case Report: endoscopic thyroidectomy via total areola approach in a six-year-old patient with thyroid follicular adenoma

## TL;DR

A 6-year-old girl successfully underwent endoscopic thyroidectomy via a total areola approach for a thyroid follicular adenoma, showing safety and good cosmetic results.

## Contribution

This is the first reported case of endoscopic thyroidectomy via total areola approach in a very young child, demonstrating its feasibility and benefits.

## Key findings

- The procedure achieved complete resection with minimal blood loss and no complications.
- Excellent cosmetic outcomes were observed at 3-month follow-up.
- Special pediatric instruments and monitoring techniques improved the safety of the surgery.

## Abstract

Endoscopic thyroidectomy (ET) has become increasingly popular globally, but its application in young children remains largely unexplored. This study reports a 6-year-old girl with a neck mass who underwent ET via total areola approach.

After ultrasonographic (ACR TI-RADS 4) and cytological (TBSRTC 4) confirmation, the patient underwent endoscopic right and isthmic thyroidectomy with inferior parathyroid auto-transplantation under general anesthesia. The procedure utilized 3 mm pediatric instruments, intraoperative neuromonitoring and near-infrared auto fluorescent parathyroid monitoring.

The procedure achieved complete resection with 215 min operative time and minimal blood loss. The pathological diagnosis was thyroid follicular adenoma. At 3-month follow-up, no complications and excellent cosmetic outcomes were observed.

ET via total areola approach proves highly suitable for young children because of its safety and cosmetic advantages. Experienced surgeons, small-size special surgical instruments and auxiliary monitoring techniques are helpful to improve the safety of pediatric ET.