Recurrent thyroid nodule: spindle epithelial tumor with thymus like differentiation (SETTLE).

Thyroid nodules are uncommon in childhood and recurrent thyroid nodules even rarer. Spindle epithelial tumor with thymus-like differentiation (SETTLE), a rare and distinctive low-grade neoplasm is amongst the differential diagnosis of solitary thyroid nodule in children. We describe a boy who underwent completion thyroidectomy for SETTLE in the thyroid remnant four years after initial lobectomy was performed for the same diagnosis. Patients with SETTLE are to be closely followed as multifocality may manifest and be detected later.