2025 Volume 71 Issue 3 Pages 132-138
Follicular carcinoma, a rare differentiated thyroid carcinoma in children, poses challenges when determining treatment strategies including surgery and radioactive iodine therapy (RAI). We report a case of pulmonary metastasis after hemithyroidectomy treated with completion thyroidectomy and RAI. A 10-year-old girl presented to a local physician with anterior neck swelling and was referred to our department. Ultrasonography revealed a well-defined, 22-mm tumor with a hypoechoic rim in the right thyroid lobe. Fine-needle aspiration cytology suggested follicular neoplasm. Conservative observation was performed after obtaining informed consent. Eight months later, ultrasonography showed tumor invasion into the anterior neck muscles, raising suspicion of follicular carcinoma. Right thyroid lobectomy and central neck dissection were performed. Three years postoperatively, computed tomography revealed suspected pulmonary metastasis. Completion thyroidectomy was performed followed by RAI. One year has passed since the two rounds of postoperative RAI. Neither tumor recurrence nor elevated thyroglobulin (Tg) levels were observed.
