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Paediatric papillary thyroid cancer: what to expect?

© BMJ Publishing Group Limited 2021. No commercial reuse. See rights and permissions. Published by BMJ. DESCRIPTION Papillary thyroid cancer is a rare tumour presentation in paediatric age, and although its incidence is rising, it accounts for 1.4% of all malignancies in this age. The presentation of this differentiated thyroid tumour in paediatric age is often linked to lymph nodes and pulmonary metastases. The latter generally is diagnosis after radioactive iodine as they are normally not seen in Xray or CT scans. 3 The prognosis is good when the optimal treatment is provided. The treatment derived from the experience in adult population since this is a rare tumour in children. 4 We present a case of 12yearold female patient with a papillary thyroid cancer that was submitted to total thyroidectomy with central compartment lymphadenectomy (figure 1). The first and only complain that lead to the diagnosis was enlargement of the thyroid gland. During utrasound, it showed a highly diffuse Doppler signal throw out the thyroid (figure 2). This was confirmed in the histological result where there was a lymphoid papillary tumour dissemination all over the gland. Of the 20 lymph nodes resected, 16 present metastases (figure 1). She started radioactive iodine with good final overall result. No signs of metastases were found in the 6month postsurgical intervention. The patient had no family history of hereditary tumours, including thyroid cancer. The patient is awaiting results of genetic testing. This case makes awareness for the diagnosis of thyroid tumour in paediatric age. The principal differences of presentation compared with adults are: ► Advanced disease at presentation as shown in figure 2. ► Need for total thyroidectomy and central compartment lymphadenectomy because of frequent lymph node metastases as shown in figure 1.