Well-differentiated thyroid carcinoma in children and adolescents is an uncommon entity and the approach to management remains controversial. In pediatric patients, these carcinomas are most likely to present as a neck mass. At presentation, well-differentiated thyroid carcinoma is more likely to have metastasized to lymph nodes and distant extrathyroidal sites, in contrast to the normal presentation in adults. An approach to die evaluation of a neck mass in pediatric patients is discussed. The limitations of laboratory evaluation of thyroid nodules are presented. Diagnosis requires open biopsy or fine-needle aspiration biopsy if experienced aspirationists and cytopathologists are available. Thyroidectomy, radioiodine, and thyroid hormone suppression are die therapies available, and the controversies of these treatments are presented. Periodic follow-up evaluation is indicated for die remainder of die patient's life, as recurrences can occur many years after the initial therapy.
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Wellington Hung (1994) studied this question.