We report on nine children, 9 to 17 years of age, with papillary carci
noma of the thyroid, whereby eight of them had lymph node metastases,
and four had diffuse pulmonary metastases. After total thyroidectomy a
nd up to four cycles of radioiodine treatment, as well as surgical res
ection of metastases negative to radioactive iodine uptake, there was
no evidence of relapsing disease in any of the children. Hence, taking
into consideration and optimal tumor patient follow-up and the improv
ement of the long-term prognosis, we recommended total thyroidectomy,
also for encapsulated, well-differentiated thyroid carcinomas.