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Research points to a high prevalence of multifocal disease in children with papillary thyroid carcinoma (PTC), with age and tumour stage possible risk factors for this diagnosis. Maisie Shindo, from Oregon Health & Science University in Portland, USA, and colleagues report their findings in JAMA Otolaryngology – Head & Neck Surgery from a cohort study of 212 patients aged up to 18 years who underwent thyroidectomy at one of five US hospitals between 2010 and 2020.