The incidence of thyroid cancer in young children and adolescents has risen over the past twenty years. For males, the rate per 1,000,000/persons rose from 2.77 in 1990 to 9.63 in 2009. For females, the rate per 1,000,000/persons rose from 18.35 in 1987 to 50.99 in 2009. With the increased incidence of pediatric thyroid cancer, Otolaryngologists are more commonly seeing younger patients with thyroid nodules and concern for malignant disease. In addition, a delay in management or inappropriate management may lead to worse outcomes for a disease that traditionally has a high 5-year survival rate. A team-based approach can lead to streamlined processes for timely diagnosis, evidence-based treatment decisions, and adherence to current guidelines. This panel will highlight specific aspects of caring for children with thyroid nodules in a case-based format, drawing on the expertise of pediatric otolaryngologists and a pediatric endocrinologist. Panelists will briefly review current literature supporting a multi-disciplinary team approach for pediatric thyroid patients as well as highlights from the 2015 American Thyroid Association (ATA) guidelines. The focus of this panel will be challenging patient scenarios that fall outside of standard practice and ATA recommendations. This will include laboratory evaluation, imaging modalities, and biopsy methods, in addition to medical and surgical treatment algorithms. In addition, each patient scenario will illustrate models of how different institutions across the country practice team-based care. Special focus will be placed on emerging concepts in the field of pediatric thyroid diseases, including oncogene analysis, targeted therapies, and best practice for surveillance in the treatment of thyroid cancer. We will conclude with a review of gaps in the 2015 ATA guidelines and potential research opportunities.