Children are young and parents are concerned about invasive surgery and slow recovery time. Many people have heard of lumpectomy; is lumpectomy possible for medullary thyroid cancer in children? Is this surgery open or minimally invasive? Lumpectomy is an option for some of the adult thyroid surgeries with no incision in the neck. For pediatric total thyroidectomy, however, it is an open procedure both domestically and internationally. Why can’t pediatric medullary thyroid cancer be operated by lumpectomy? It is mainly because of the delicate situation of the surgery. Traditional lumpectomy is a two-dimensional operation, which is not as delicate as open surgery under magnification. Children’s thyroid glands are much smaller than those of adults, and open surgery is safer in order to ensure that the patient’s parathyroid glands are not accidentally cut and that the patient does not develop hypocalcemia after surgery. Can medullary thyroid cancer in children develop lymph node metastasis? Medullary thyroid carcinoma has a high rate of lymph node metastasis, about 50%~70% of patients will have lymph node metastasis. The rate of lymph node metastasis varies with different stages. stage I patients have no lymph node metastasis. Does the patient need to have lymph node dissection during surgery? Lymph node dissection is recommended in the United States. In China, for children with no lymph node metastasis in stage I, only the lymph nodes around the thyroid need to be cleared and prophylactic lymph node dissection is done. The surgical incision is only 4 to 5 centimeters.