THYROID CANCER 101: Follicular Thyroid Cancer

THYROID CANCER 101: Follicular Thyroid Cancer

THYROID CANCER 101: Follicular Thyroid Cancer
THYROID CANCER 101: Follicular Thyroid Cancer FTC
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Isthmus FTC Nodule= FNA microfollicular neoplasm
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Microfollicles with no colloid in the background.
Suspicious for FTC.
Surgery= blood vessel invasion.
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FTC is different than papillary cancers.
They travel far away to lungs and bones by going through the capsule and into blood vessels.
Thyroid. 2013 Aug; 23(8): 1015–1021.
Article summary and Comments:
Richard Guttler MD,FACE,ECNU
thyroid.com
1. Follicular cancer is less common than papillary in the USA.
2. Incidence rates (IR),  incidence rate ratios (IRR)
 3. These findings reveal increases in more aggressive tumors in women in addition to small and localized tumors.
4. Males largest increase was observed for regional and smaller size tumors.
5. Thyroid cancer rates are not largely due to improvements in detection.
6. Follicular thyroid cancer is more aggressive mainly because it can metastasize via vascular invasion, as opposed to papillary thyroid cancer that spreads via the lymphatics .
7. The ability to spread through the vasculature means that follicular thyroid cancer more often presents with metastasis outside of the neck (distant metastasis)
8. The most common site of distant metastasis in both papillary and follicular thyroid cancer is the lung.
9. However, ∼11% of patients with follicular thyroid cancer compared to 2–3% of patients with papillary thyroid cancer have metastases beyond the lungs.
10. Radiation exposure almost uniformly causes papillary but not follicular thyroid cancer
11.Iodine deficiency is associated with follicular but not papillary thyroid cancer risk.
12. 6410 follicular thyroid cancer cases (IR=0.88 per 100,000 person years) were diagnosed among residents of the nine SEER registries compared to 45,942 papillary thyroid cancer cases (IR=6.21).
13. Newly diagnosed follicular thyroid cancers are larger in size and have more regional metastasis than in the past.
14. In general, as a population becomes iodine sufficient, the number of follicular thyroid cancer cases decreases.
15.  In the United States, salt manufacturers have been adding iodine to table salt since the 1920s.
16. Improved detection techniques are not solely responsible for the significant rise in follicular thyroid cancer.
FTC metastatic to the brain.
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