Thyroid lobectomy in childhood: a case study of papillary carcinoma

Papillary thyroid carcinoma (PTC) is the most common form of thyroid cancer in children, although its presentation in this age group remains rare. PTC, despite having a good prognosis, can present more aggressively in children than in adults. Diagnosis typically begins with physical examination and ultrasound, followed by fine-needle aspiration biopsy (FNAB) for cytological assessment using the Bethesda system. Standard treatment for PTC is surgery — lobectomy or total thyroidectomy depending on disease spread, cytological findings, and patient profile. This paper presents the clinical case of a 9-year-old female patient with a suspicious thyroid nodule, successfully treated through thyroid lobectomy. Ultrasound revealed a solid, hypoechoic nodule with microcalcifications in the right thyroid lobe. FNAB returned a Bethesda V classification, raising suspicion for papillary carcinoma. After a multidisciplinary evaluation by the medical team (endocrinologist, surgeon, cytopathologist, radiologist, pediatric oncologist), a right thyroid lobectomy was decided upon for both diagnostic and therapeutic purposes. During surgery, a well-confined nodule was identified with no apparent invasion into surrounding tissues. Histopathological analysis confirmed papillary thyroid carcinoma, follicular variant, no vascular or extrathyroidal invasion, no metastases in the examined lymph nodes. These findings suggested a localized disease form with an excellent prognosis. Following the intervention, the patient recovered without complications: vital parameters remained stable, with no signs of bleeding or local infection; follow-up ultrasound at 6 weeks showed no residual formations, and normal structure of the left lobe and surrounding tissues. There was no need for total thyroidectomy or radioactive iodine therapy, in accordance with current protocols for localized cases. The importance of early diagnosis, appropriate surgical treatment, and careful clinical follow-up is discussed, as well as the role of a multidisciplinary team in managing pediatric endocrine oncology cases.