Follicular thyroid carcinoma

Follicular thyroid carcinoma
Updated: 12/13/2018
© Jun Wang, MD, PhD

General features
  • More common in women, peak age older than papillary CA
  • Risk factors: radiation exposure, iodine deficiency, older age, PTEN mutation
  • Usually excellent prognosis
  • Indicators of poor prognosis:
    • Distant metastases
    • Age > 45 years
    • Extensive vascular invasion,
    • Poorly differentiated or widely invasive tumors, etc
Clinical features
  • Painless nodule or mass in neck or cervical node
Radiologic features
  • Usually cold on scan
Pathological features
  • Usually solitary
  • Encapsulated nodule, focally hemorrhagic
  • Follicular differentiation
  • NO papillary nuclear features
  • Evidence of invasion
  • Hurthle cell variant: more than 75% hurthle cell changes
Marker
  • Positive for thyroglobulin, TTF1
  • Negative for calcitonin
Molecular abnormality
  • PTEN
  • PAX8
  • RAS/PI3K
Treatment
  • Total thyroidectomy
  • Radioactive iodine


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