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Follicular Thyroid Cancer
Sunday, 01 March 2009 12:18


What is thyroid follicular carcinoma?  What can I expect?


Follicuar carcinoma accounts for 10-15% of thyroid cancers.  This cancer is more aggressive and more likely to spread as compared with papillary carcinoma.  However, the prognosis is still very good.


Overall death rate from follicular carcinoma is 15%.  Follicular carcinoma has a poorer prognosis then papillary carcinoma.  However, overall it is still very treatable and normal life expectancy is possible depending on the stage of cancer.


Follicular carcinoma usually presents between 45-55 years of age. Women are more common than men to get follicular cancer, 3:1 ratio.  Follicular carcinoma has a lower tendency to spread to the lymphatic system compared to papillary carcinoma.   However, follicular carcinoma has a greater tendency to spread into blood vessel and spread throughout the body.   Common sites for follicular metastasis are lung, bond, liver and brain. 


If the fine needle aspiration pathology report is follicular carcinoma a total thyroid removal surgery is often recommended.  If pathology results are suspicious for follicular thyroid cancer typically half of the thyroid is removed and analyzed.  If no cancer is found, excellent!  You can go on with the rest of your life with confidence that you do not have thyroid cancer.  However, if follicular cancer is found then a second surgery must be done to completely remove the thyroid.   There is also an option to have the nodule tested by pathology while one is still in the operating room.  If this is the case then one may only have to have one surgery.  Your doctor will discuss the options available.


If the pathology returns as follicular carcinoma than a total thyroid removal surgery is conducted.  Radioactive iodine treatment should be considered and thyroid hormone replacement therapy needs to be initiated.



There are three main criteria for prognosis:


1.  Patient’s Age - the older one is the worse the prognosis (great then 45 years old)

2.  Cancer size - the larger the cancer the worse the prognosis (greater than 4 cm)

3.  Amount of capsular and vascular invasion - the more vascular invasion the worse the prognosis


The 10 year survivor rate is 85%.2   Recurrence rate is about 30% after initial surgery.  Typically, recurrences occur within the first 10 years of initial diagnosis.2


The overall prognosis of follicular carcinoma is very good.  Though, statistically slightly less than papillary carcinoma, one with follicular carcinoma can live a normal long life. 

Last Updated on Friday, 17 February 2012 11:29

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