{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:17:44Z","timestamp":1787962664211,"version":"build-2784847793"},"reference-count":23,"publisher":"Walter de Gruyter GmbH","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n Pediatric thyroid cancers are rare, with papillary thyroid carcinoma (PTC) being the most common type. The diffuse sclerosing variant (DSV) is a rarer subtype associated with frequent recurrence and extensive lymphatic involvement. Among 51 pediatric patients treated for thyroid carcinoma at our tertiary center over a 20-year period, three were diagnosed with DSV-PTC. We present this retrospective case series to highlight its clinical course and diagnostic challenges.<\/jats:p>\n <\/jats:sec>\n \n Case presentation<\/jats:title>\n \n Three patients (aged 8\u201317) presented with neck swelling; one also exhibited high fever and neck pain. While thyroid function tests were normal, serum thyroglobulin levels were significantly elevated. Imaging revealed diverse presentations: a solitary nodule, diffuse enlargement mimicking an abscess, and diffuse inflammation. Following fine-needle aspiration confirmation of PTC, all patients underwent total thyroidectomy and central and bilateral lymph node dissection. Histopathology confirmed DSV-PTC in all cases. Every patient presented with diffuse lymph node metastasis; two showed extrathyroidal extension, and one had distant pulmonary metastasis. Genetic analysis identified a\n BRAF<\/jats:italic>\n V600E<\/jats:sup>\n alteration in one case and\n RET<\/jats:italic>\n translocations in the other two, confirmed by fluorescence\n in situ<\/jats:italic>\n hybridization (FISH) after negative broad next-generation sequencing (NGS) panels. All patients required revision surgery for residual tissue followed by radioactive iodine (RAI) therapy. At follow-up (13\u201328\u00a0months), outcomes ranged from stable disease and additional RAI requirement to complete remission without relapse.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Although based on a small case series, our findings suggest that DSV-PTC can behave aggressively in pediatric patients and can mimic benign inflammatory conditions, leading to potential diagnostic delays. Early recognition and a comprehensive multimodal approach, including extensive surgery and RAI, appear vital for managing this challenging variant.<\/jats:p>\n <\/jats:sec>","DOI":"10.1515\/jpem-2026-0260","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:57:21Z","timestamp":1787961441000},"source":"Crossref","is-referenced-by-count":0,"title":["A rare, invasive, and challenging cancer in childhood: diffuse sclerosing variant of papillary thyroid carcinoma"],"prefix":"10.1515","author":[{"given":"\u015eafak","family":"Demirta\u015f","sequence":"first","affiliation":[{"name":"Department of Pediatric Endocrinology, Faculty of Medicine , Ankara University , Ankara , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeynep","family":"\u015e\u0131klar","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Faculty of Medicine , Ankara University , Ankara , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elif","family":"\u00d6zsu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Faculty of Medicine , Ankara University , Ankara , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zehra","family":"Aycan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Faculty of Medicine , Ankara University , Ankara , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirmen","family":"K\u0131z\u0131lcan \u00c7etin","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Faculty of Medicine , Ankara University , Ankara , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sema Nilay","family":"Abseyi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Faculty of Medicine , Ankara University , Ankara , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130lkyaz","family":"T\u00fcrktan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Faculty of Medicine , Ankara University , Ankara , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merih","family":"Berbero\u011flu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Faculty of Medicine , Ankara University , Ankara , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"2026082823565095300_j_jpem-2026-0260_ref_001","doi-asserted-by":"crossref","unstructured":"Rivkees, SA, Bauer, AJ. 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