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Papillary thyroid carcinoma may be multifocal in up to 50% of affected children. Surgeons must weigh the higher risks of recurrence when surgical resection is less than subtotal thyroidectomy against the higher risks of complications with subtotal/total thyroidectomy. An 11-year-old girl presented to our surgical department with a thyroid mass. Computed tomography (CT) revealed a lesion, missed by ultrasonography, which reversed the decision to perform conservative thyroid surgery. The lesion proved to be non-neoplastic. CT may be a useful adjunct when ultrasound demonstrates a solitary lesion and conservative surgery is considered, and may prove to be able to distinguish neoplastic from non-neoplastic lesions based on contrast enhancement characteristics, but caution is advised in assuming that all nodules are neoplastic.

CT scanning may adversely influence choice of surgery in paediatric papillary thyroid carcinoma - a note of caution