Abstract

Pediatric well-differentiated thyroid carcinoma (WDTC) is unique in a sense that, despite presentation as an advanced aggressive disease, there is excellent long-term survival. The American Thyroid Association (ATA) published elaborate guidelines for the treatment of WDTC in 2015, which have been in use since then. Although the ATA published new guidelines in 2025 regarding the management of WDTC, they apply to the adult population >18 years of age. There is a significant paradigm shift in the ATA 2025 Guidelines, which use a more risk-adapted approach, de-escalation of radioiodine therapy and more integration of molecular testing; however, there are no formal guidelines that specifically address pediatric population in the ATA 2025 guidelines. Although the ATA 2015 Guidelines remain well anchored in the clinical setting for the treatment of pediatric WDTC, this manuscript critically reviews the key differences between the ATA 2015 pediatric guidelines and emerging concepts introduced in ATA 2025 adult guidelines, highlighting the evolving trends towards risk-adapted and more individualized patient care.

Key words: Well differentiated thyroid carcinoma, American thyroid association (ATA), paediatric thyroid cancer, risk stratification, management strategies