What are the risks associated with medullary thyroid cancer surgery in pediatric patients compared to adult surgery? Pediatric patients, especially those who are only one or two years old, have an overall organ that is 1/2 the size of an adult or even smaller. The purpose of surgery for medullary thyroid cancer is to remove the thyroid gland but preserve the parathyroid glands. In adults, the parathyroid gland is the size of a green bean; in children, it is about the size of a grain of rice. Preserving the parathyroid glands is the key step in the surgery to ensure that the patient does not suffer from calcium deficiency after surgery. During pediatric thyroid surgery, the surgeon will wear a headlamp with a surgical magnifying glass to magnify the thyroid gland 2 to 3 times to prevent injury to the recurrent laryngeal nerve and parathyroid glands and to avoid causing hoarseness and hypocalcemia. Also the instruments used for pediatric surgery are more delicate. What is the minimum age for surgery for hereditary medullary thyroid cancer? The issue of RET gene mutations in hereditary medullary thyroid cancer was mentioned earlier. The risk varies from one mutation site to another, and the timing of surgery varies as well. The latest risk level of medullary thyroid cancer is divided into three levels: intermediate risk, high risk, and highest risk. There is no specific scheme in China. According to the American scheme, the highest risk children are operated around one year old; high risk children are operated within five years old, and medium risk children are operated after the onset of disease according to the onset of disease. In the Chinese Academy of Medical Sciences Cancer Hospital, children are usually a little older when they have surgery, mostly between the ages of 7 and 12, and fewer children within 5 years of age. Will there be scars on the neck of the child after surgery? Open surgery will leave a scar of 4-5 cm in the lower middle of the neck, but the scar is less visible in children than in adults. The earlier the surgery is done, the less visible the scar will be. The scar is less visible 1 to 2 years after surgery.