7year-old girl who had complaint of a swollen and enlarged feeling of her cervical mass for a few months.Swellings were gradually progressed in size.The patient had family history including thyroidal nodules from grandmothers.Radiation exposure history from her mom whom is radiologist.On examination,there was significant right side cervical lymphadenopathy and thyroid gland was palpable.Cervical examination by ultrasonography revealed a diffusely enlarged left thyroid tumor showing heterogenous pattern,in which blood flow was augmented by Doppler.Endocrine examination showed that euthyroid.CT showed enlargement of left thyroidal lesion.Based on the results of FNA specimen,“The Bethesda System-I Non-Diagnostic” was assessed.On Sep.2024.16,Total thyroidectomy,Selective neck dissection and Intra- Operative Frozen Section analysis was performed, and pathological diagnosis of papillary thyroid carcinoma left lobe pT3N1bMx was made on the basis of examination of the resected thyroid lesion.17 lymph nodes showed metastasis out of 32 nodes retrieved. Radioiodine ablation with I131 recommended 4wks after surgery.The thyroglobulin level is monitored.Thyroxine replacement was 1.5μg/kg/day.