Introduction Papillary thyroid carcinoma (PTC) diagnosed at a pediatric age (≤ 18 years), compared with its adult presentation, is associated with larger primary tumors, more extrathyroidal extension, and an increased prevalence of both locally and distantly metastatic (stage II) disease.1 Depending on the series, up to 25% of patients with pediatric PTC will develop pulmonary metastases.2-6 Stage II PTC diagnosed during childhood is enriched for oncogenic fusion genes primarily involving...