Ultrasound-guided fine needle aspiration (FNA) is the standard presurgical diagnostic procedure in the evaluation of pediatric thyroid nodules. Its use in adults with nodular thyroid disease, proven to be safe and reliable in the medical decision-making for surgical management, paved the way for its implementation in pediatric patients. Herein, we present an updated review on the use of FNA in the management of pediatric thyroid nodules marking the 30th anniversary of an initial report. FNA is now established as the presurgical diagnostic modality in the evaluation of children with thyroid nodules. In this updated review, we present recent data on the prevalence of pediatric thyroid cancer, advances in diagnostic techniques and cytopathologic evaluation, and updates regarding surgical decision-making and monitoring frequency of thyroid nodules in children. We surmise that going forward, malignancy risk assessment approaches will integrate ultrasound findings, FNA cytopathology, and molecular testing in children with thyroid nodules to determine risk stratification and surgical planning.

fine needle aspiration

pediatric

thyroid malignancy

thyroid nodules

differentiated thyroid carcinoma

fine needle aspiration

thyroid imaging reporting and data system

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