Follicular thyroid cancerFrom Wikipedia, the free encyclopediaJump to: navigation, search Follicular thyroid cancer Classification and external


Gross pathological section of a follicular thyroid adenoma (tumor at the bottom). ICD-10 C73. ICD-9 193 OMIM 188470 eMedicine med/804 MeSH D013964

Follicular thyroid cancer accounts for 15% of thyroid cancer which occurs more commonly in women of over 50 years old. Thyroglobulin (Tg) can be used as a tumor marker for well-differentiated follicular thyroid cancer.

Contents [hide] 1 Classification 2 Treatment 2.1 Initial treatment 2.2 Finding disease recurrence 3 Hurthle cell variant 4 Prognosis 5 Associated mutations 6 References

[1] [edit] TreatmentTreatment is usually surgical. Follicular carcinoma tends to metastasize to lung and bone via the bloodstream. However. Some physicians favor administering the maximum safe dose (calculated based on a number of factors). Thyroidectomy is invariably followed by radioiodine treatment at levels from 50 to 200 millicuries following two weeks of a low iodine diet (LID). HMGA2 has been proposed as a marker to identify malignant tumors. it is common to carry out hemithyroidectomy to distinguish between follicular adenoma and follicular carcinoma on histopathological examination. while others favor administering smaller doses. When needed. a low iodine . followed by radioiodine. I-131 is used for ablation of the thyroid tissue.[2] [edit] Finding disease recurrenceSome studies have shown that thyroglobulin (Tg) testing combined with neck ultrasound is more productive in finding disease recurrence than full.or whole-body scans (WBS) using radioactive iodine. which may still be effective in ablating all thyroid tissue. In both cases. If fine needle aspiration cytology (FNAC) suggests follicular neoplasm. Features sine qua non for the diagnosis of follicular carcinoma are capsular invasion and vascular invasion by tumor cells. This way total thyroidectomy is not carried out unnecessarily. Minimally invasive thyroidectomy has been used in recent years in cases where the nodules are small. whole body scans consist of withdrawal from thyroxine medication and/or injection of recombinant human Thyroid stimulating hormone (TSH). current protocol (in the USA) suggests a small number of clean annual WBS are required before relying on Tg testing plus neck ultrasound. [edit] Initial treatmentIf follicular cells are found on cytological testing. proceeding to completion thyroidectomy and postoperative radioiodine ablation where carcinoma is confirmed. thyroid lobectomy should be performed to establish the histopathological diagnosis. Papillary thyroid carcinoma commonly metastasizes to cervical lymph nodes. Occasionally treatment must be repeated if annual scans indicate remaining cancerous tissue.[edit] ClassificationIt is impossible to distinguish between follicular adenoma and carcinoma on cytological grounds.

71% for stage III.3)(q13.p25) regimen must also be followed to optimize the takeup of the radioactive iodine dose.Hurthle cell thyroid cancer is often considered a variant of follicular cell carcinoma. is produced in cell culture from genetically engineered hamster cells. commercial name Thyrogen. [edit] Hurthle cell variant Micrograph of a Hurthle cell neoplasm. Recombinant human TSH. Full body nuclear medicine scan follows using a gamma camera.[7] Also. unilateral hemithyroidectomy is performed for non-invasive disease. a nuclear hormone receptor contributing to terminal differentiation of cells.[7] Thus. follicular thyroid carcinomas seem to arise by two distinct and virtually nonoverlapping molecular pathways. NRAS. Low dose radioiodine of a few millicuries is administered. and the gene encoding peroxisome proliferator-activated receptor γ 1 (PPARγ1).[5] By overall cancer staging into stages I to IV. and KRAS. and 50% for stage IV. most notably HRAS. permitting juxtaposition of portions of both genes.[7] Tumors tend carry either a RAS mutation or a PAX8-PPARγ1 fusion.[6] [edit] Associated mutationsApproximately one-half of follicular thyroid carcinomas have mutations in the Ras subfamily of oncogenes. follicular thyroid cancer has a 5-year survival rate of 100% for stages I and II.[7] . The PAX8-PPARγ1 fusion is present in approximately one-third of follicular thyroid carcinomas.[3][4] Hurthle cell forms are more likely than follicular carcinomas to be bilateral and multifocal and to metastasize to lymph nodes. and only rarely are both genetic abnormalities present in the same case. specifically those cancers with a t(2. Like follicular carcinoma. and total thyroidectomy for invasive disease [edit] PrognosisThe overall 5-year survival rate for follicular thyroid cancer is 91%. a gene important in thyroid development. and the 10-year survival rate is 85%. a chromosomal translocation specific for follicular thyroid carcinomas is one between paired box gene 8 (PAX-8). Scan doses of radioactive iodine may be I131 or I123.

PMID 18070728. "Thyroid and Parathyroid Cancers" in Pazdur R.^ a b c d Chapter 20 in: Mitchell. (2007). 7. PMID 17943974. D'Avanzo A. Wagman LD.^ Numbers from National Cancer Database in the US. ISBN 1-4160-29737. 11 ed.06. Grünwald. Gr ‫ں‬unwald. Biersack. 2008. Abbas. Lamont JP..amjsurg. PMID 17653588. J. Kebebew E. doi:10. Richard Sheppard. 2. World J Surg 31 (9): 1743–50.^ cancer. Duh QY. (2005). Vinay.. [hide]v · d · eTumors: endocrine gland neoplasia (C73–C75/D34–D35. Lustig R. H. Am J Surg 195 (4): 457. F.^ Kushchayeva Y. Vassilopoulou-Sellin R. "Upregulation of HMGA2 in thyroid carcinomas: A novel molecular marker to distinguish between benign and malignant follicular neoplasias". Thyroid cancer. Klemke M. 4.^ Hegazy MA. Khater AA. (Note:Book also states that the 14% 10-year survival for anaplastic thyroid cancer was overestimated 6. ISBN 3-540-22309-6. Robbins Basic Pathology. In turn citing: AJCC Cancer Staging Manual (7th ed). Camphausen KA. et al. "Comparison of clinical characteristics at diagnosis and during follow-up in 118 patients with Hurthle cell or follicular thyroid cancer". 193–194/226– 227) Pancreas/ islets of Langerhans neuroendocrine tumors/islet cell carcinoma: α:Glucagonoma · β:Insulinoma · δ:Somatostatinoma · G:Gastrinoma · VIPoma Hypothalamic/ pituitary axes +parathyroid Pituitary Pituitary adenoma: Prolactinoma · ACTH-secreting pituitary adenoma · GH-secreting pituitary adenoma . Setit AE. 3. Kumar.[edit] References1. Genes Chromosomes Cancer 47 (1): 56–63.2007. Clark OH (2007).001. doi:10.1007/s00268-007-9147-7.^ Belge G.20505. 8th edition.1002/gcc. et al. 5. Abul K. Berlin: Springer. Nelson. Hoskins WJ (Eds) Cancer Management: A Multidisciplinary Approach. (2008). doi:10. Fausto. from Page 10 in: F.^ Hu MI. Philadelphia: Saunders. "Minimally invasive videoassisted thyroidectomy for small follicular thyroid nodules". Meyer > Thyroid Cancer By the American Cancer Society.1016/j.

Craniopharyngioma Pituicytoma Thyroid Thyroid cancer (malignant): epithelial cell /carcinoma (Papillary. sysi/epon proc. Neuroblastoma) · see also Paraganglioma Gonads see genital neoplasia Pinealoma Pinealoblastoma · Pineocytoma MEN 1 · 2A · 2B M: END anat/phys/devp/horm noco(d)/cong/tumr. Follicular/Hurthle cell) · parafollicular cell (Medullary) · Anaplastic Benign: Thyroid adenoma · Struma ovarii Parathyroid Parathyroid adenoma · Parathyroid carcinoma Adrenal tumor adrenal cortex (Adrenocortical adenoma. Adrenocortical carcinoma) adrenal medulla (Pheochromocytoma. drug (A10/H1/H2/H3/H5) ." Categories: Otolaryngology | Thyroid disease | Oncology | Types of cancer | Thyroid cancer .Retrieved from "http://en.

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