It typically occurs in women and in an older age group than papillary (i.e. 40-60 years of age).
Unlike papillary it metastasises late to lymph nodes, with only 5-10% of patients having nodal metastases at the time of diagnosis. Haematogenous spread is however much more common with 20% or so of patients having distant haematogenous metastases at presentation.
- the Ras oncogene is positive in a significant proportion of individuals
Fine needle aspiration (FNA)
Cannot differentiate between a follicular thyroid adenoma and a follicular thyroid carcinoma. Surgical resection is necessary.
- lesions are typically hypoechoic
- usually lacks cystic change 2
Follicular thyroid cancer typically concentrates pertechnetate, but not radioiodine.
Treatment and prognosis
Treatment tends to revolve around local surgical treatment and radioactive iodine.
Prognosis is not as favorable as papillary, but better than anaplastic, and depends on the presence and extent of distal metastatic disease. In local disease 90% 10 year survival can be expected, whereas with distant disease that figure drops to approximately 50%.
Differentiation of follicular carcinoma from follicular adenoma of the thyroid cannot be made on cytology alone, and requires examination of the surgical specimen looking for extra capsular spread.
Ultrasound - neck and thyroid
- ultrasound (introduction)
neck and thyroid ultrasound
- Graves disease
- Hashimoto thyroiditis
- multinodular goitre
- thyroid nodules
- fine needle aspiration (FNA)
- postoperative assessment after thyroid cancer surgery
- lymph node levels of the neck
- parathyroid glands
- thyroid gland
- 1. Robbins SL, Kumar V, Abbas AK et-al. Robbins and Cotran pathologic basis of disease. W.B. Saunders Company. (2010) ISBN:1416031219. Read it at Google Books - Find it at Amazon
- 2. Sillery JC, Reading CC, Charboneau JW et-al. Thyroid follicular carcinoma: sonographic features of 50 cases. AJR Am J Roentgenol. 2010;194 (1): 44-54. doi:10.2214/AJR.09.3195 - Pubmed citation