Follicular carcinoma of the thyroid

From Ganfyd

This form of thyroid cancer is an adenocarcinoma. Rarely it may synthesise T3 and T4 leading to hyperthyroidism. The incidence is around 15% and is higher in areas of iodine deficiency.

Clinical Features

History

• Occurs in young to middle aged patients
  • More common type of thyroid tumour in older population
  • Peak incidence 40-60 years
  • Rare before the age of 30
• Ask about bone pain - 10% present with bony metastasis

Pathology

Macroscopic

• rounded capsule

Microscopic

• invasion
  • capsule
  • blood vessels
  • surrounding glands
• compact follicles
  • little colloid

Spread

• via blood to
  • bone
  • lung

Treatment

• total thyroidectomy
• +/-radio-iodine

Prognosis

• good in absence of metastases
  • rnages 50-100% at 5 years depending on presence/absence of mets.
• 85% survival at 10 years