While carcinoma of the thyroid gland is not common in children, when it does occur it is usually papillary. Papillary carcinoma is a very slow-growing neoplasm with an excellent cure rate. When it occurs in the thyroid, the treatment of choice is subtotal thyroidectomy. However, the best treatment of TGD papillary carcinoma is unclear. This is because between 11% and 33% of the cases reported have also had a second focus of tumor in the thyroid gland.3,4 These second foci are often not detectable by either physical examination or nucleotide scans. Weiss and Orlich3 believed that because papillary thyroid carcinoma has a prolonged course, in the absence of objective suspicion of a thyroid mass, only long-term follow-up is warranted. In contrast, Heshmati et al4 recommended thyroidectomy on all patients with TGD carcinoma. However, the youngest patient in their series was aged 17 years and, therefore, they allow for a different approach in younger children. Given the excellent cure rate for papillary thyroid carcinoma, further treatment for this child should be limited to regular physical examinations and periodic imaging.