Surgical management of follicular cancer

Abstract

Follicular thyroid cancers are derived from follicular epithelium within the thyroid gland, accounting for about 10% of all thyroid cancers, but this percentage seems to be decreasing (1). Follicular thyroid cancers differ from the more common follicular adenomas because the follicular cells in the cancers invade the vessels, capsule, or both. Most follicular thyroid cancers have a microfollicular histological pattern, and some are associated with RAS and PAX8/PPARγ mutations. These tumors are usually unifocal and encapsulated. In contrast to papillary thyroid cancers that often metastasize to regional lymph nodes, follicular thyroid cancers infrequently involve the lymph nodes (<10% of patients) but more frequently hematogenously metastasize to lung and bones (2). Follicular thyroid tumors that contain papillary elements are considered to be papillary thyroid cancer, as are follicular variants of papillary thyroid cancer (FVPTC) (3). © 2006 Humana Press Inc.