In the United States an explosive rise in the frequency of differentiated papillary thyroid cancer (PTC) had been seen, resulting in a nearly 800% increase over the prior 35 years, according to the Surveillance, Epidemiology and End Results (SEER) registry data. Similar increases have been verified in Europe and Japan. Differentiated thyroid carcinoma, PTC and follicular thyroid carcinoma, are rare in children, representing 0 .5-3.0% of all childhood cancers. The incidence increases with age, and peak incidence is observed between 15 and 19 years of age. PTC is the most common hystotype comprising about 85% of all thyroid cancer. Lymph node metastasis (LNM) occur early and often in PTC, initially located in compartment VI. They are often small, escaping the detection by the surgeon in up to 50%. The outcome of juvenile PTC was fair, but there were many recurrences. In accordance with the American Thyroid Association (ATA) guidelines for pediatric PTC, a prophylactic lymph node dissection (LND) in patients clinically negative for LNM, is not recommended.
