We reviewed histopathologically 19 cases of childhood thyroid cancer occurring between 1991 and 1994 among 14,396 screening subjects in Gomel, Republic of Belarus, the region most severely radio-contaminated by the Chernobyl nuclear power plant accident in 1986. The patients were 13 girls and 6 boys with a mean age of 10.6 years. The mean age at the time of the accident was 3.2 years. Mean tumor diameter was 16 mm, and all cases were papillary carcinoma with various amounts of solid component. Psammoma bodies and stromal fibrosis were encountered to some extent in almost all cases. The tumors were highly prone to local invasion and regional lymph-node metastasis. No morphological evidence for radiation-induced cancer was obtained in these cases. 137Cs levels were relatively high in the patients' bodies and in the soil at the places of domicile. However, there was no dose-response relationship between cancer prevalence and radioactivity. These facts suggest that the incidence of aggressive pediatric thyroid cancer is extremely high in Gomel, where most of the children were exposed to a low level of radioactivity over a long time after the accident. At present, however, no definite conclusion can be drawn on the relationship between cancer occurrence and radioactive contamination.