Abstract
Although papillary thyroid carcinoma (PTC) is relatively rare in children, particularly in the prepubertal age group, its biological behavior resembles that of other pediatric solid tumors, where delayed diagnosis can significantly affect outcomes. In the broader oncology context, rare pediatric malignancies, such as prepubertal PTC, highlight the importance of tailoring diagnostic and therapeutic strategies to those applied in adults. PTC in prepubertal children is a rare occurrence that presents with a high likelihood of distant metastasis. The present study describes 2 cases of PTC in 9-year-old girls with irrelevant medical, surgical, or family history. The first case was that of a 9-year-old girl with a painless neck swelling for 4 weeks. An ultrasonography revealed diffuse thyroid lesions and cervical lymphadenopathy. She underwent a total thyroidectomy with bilateral neck dissection. Pathological analysis confirmed diffuse sclerosing PTC with numerous positive lymph nodes. She recovered well and received radioactive iodine therapy. The second case was that of a 9-year-old girl with right-sided neck swelling for 1 year. Imaging revealed a Thyroid Imaging Reporting and Data System 5 nodule and suspicious lymph nodes. She underwent a total thyroidectomy with bilateral central and right lateral neck dissection. Pathological analysis confirmed unifocal conventional PTC with 17 positive lymph nodes. She recovered well, received radioactive iodine therapy, and remained recurrence-free for 3 years. In addition, in the present study, a literature search was performed on the PubMed and Google Scholar database, covering the period from January, 2017 to February, 2025. The search used combinations of the following key words: 'papillary thyroid carcinoma', 'papillary thyroid cancer', 'thyroid neoplasm', 'pediatric' and 'prepubertal'. Only articles published in the English language and reporting individual prepubertal PTC cases were considered. From this search, 9 relevant cases were identified and were included in a brief review of the literature, of which 5 cases were females. The ages of the patients ranged from 5 to 17 years. The right thyroid lobe was involved in 4 patients, and bilateral involvement was reported in 1 case. Tumors were multifocal in 7 patients, and lymph nodes were involved in 8 patients. A total of 7 cases were of conventional variation, and distant metastases were reported in 4 cases, all of which were in the lungs. Total thyroidectomy was performed for all the cases. As demonstrated herein, papillary thyroid carcinoma in prepubertal children is uncommon. Total thyroidectomy may provide good long-term outcomes.