Follicular thyroid carcinoma clinical aspects

Abstract

Several excellent general reviews regarding follicular thyroid carcinoma (FTC) are recommended (1-4). Similarly to papillary thyroid carcinoma (PTC), follicular carcinoma is also a relatively well-differentiated thyroid cancer. Together, both types of tumor represent the most common malignancy of the endocrine system (5). Controversies exist over how aggressively to approach the early management of PTC (i.e., subtotal vs total thyroidectomy) or whether to administer radioiodine ablation, but this debate is significantly less of an issue with well-differentiated FTC. This is so because there is general recognition that FTC behaves in a more aggressive manner, with the propensity to invade both the thyroid capsule and blood vessels and show up as metastases in sites distant from the neck. Hence, in order to identify and treat such metastases with radioiodine, there is greater justification for ensuring that there are no remaining normal thyroid follicular cells in the neck that would be competing for the tracer isotope. Thus, total thyroidectomy and radioiodine ablation may be justified by data that indicate a somewhat worse prognosis for FTC than PTC, but either tumor may be fully curable if caught at an early stage. © 2006 Humana Press Inc.