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Follicular thyroid cancer looks like a benign nodule on a needle biopsy, so the diagnosis is usually made only after surgery. It spreads through the bloodstream rather than to neck nodes, is treated like papillary cancer with surgery and radioactive iodine, and has a good outlook when caught early.
Follicular thyroid cancer is separated from a benign follicular adenoma only by invasion of the capsule or blood vessels, which a fine-needle biopsy cannot show; a follicular result on biopsy therefore leads to diagnostic lobectomy, and molecular tests on the aspirate now help decide who needs it. RAS mutations and the PAX8-PPARG fusion are common, and TERT promoter mutations mark aggressive disease. Minimally invasive tumours are cured by lobectomy; widely invasive tumours receive total thyroidectomy and radioactive iodine, which also treats the lung and bone metastases the disease favours. Oncocytic (Hurthle cell) carcinoma, once a follicular variant, is a separate entity in the 2022 WHO classification and takes up iodine poorly. Iodine-refractory disease is treated as in papillary cancer with lenvatinib or sorafenib.
Averages across everyone diagnosed, often years ago. A median is the middle of a group: half the people counted lived longer than the figure shown, and some lived far longer. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.
Site decides cause and behaviour: HPV drives oropharyngeal cancer, EBV drives nasopharyngeal cancer, tobacco drives oral and laryngeal cancer; all drain into the neck node levels that surgeons and radiotherapists map.
Same organ: Acinic cell carcinoma of the salivary glands, Carcinoma ex pleomorphic adenoma, Multiple endocrine neoplasia type 1 (MEN1), Multiple endocrine neoplasia type 2 (MEN2A and MEN2B), Hyperparathyroidism-jaw tumour syndrome (CDC73-related parathyroid carcinoma), Oropharyngeal cancer (tonsil and base of tongue), Laryngeal and hypopharyngeal cancer, Oral cavity cancer (mouth and tongue), Head and neck squamous cell carcinoma, Nasopharyngeal carcinoma, Salivary gland cancers, Papillary thyroid cancer, Medullary thyroid cancer, Anaplastic thyroid cancer, Thyroid cancer, Nasal cavity and paranasal sinus cancers (including esthesioneuroblastoma), NUT carcinoma (midline carcinoma with NUTM1 rearrangement), Parathyroid carcinoma, Multiple endocrine neoplasia syndromes (MEN1, MEN2, MEN4), HPV-positive oropharyngeal cancer, HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer), Recurrent or metastatic head and neck squamous cell carcinoma, Hypopharyngeal cancer, Adenoid cystic carcinoma, Salivary duct carcinoma, Mucoepidermoid carcinoma, Oral tongue and floor of mouth cancer, Buccal mucosa and gingivobuccal cancer (oral cancer in India), Lip cancer, Locoregionally advanced nasopharyngeal carcinoma (stage III to IVA), Recurrent and metastatic nasopharyngeal carcinoma, Esthesioneuroblastoma (olfactory neuroblastoma), Sinonasal undifferentiated carcinoma (SNUC) and SWI/SNF-deficient sinonasal carcinoma
Molecular testing of the aspirate; diagnostic lobectomy when suspicious.
Lobectomy alone in most cases; completion surgery and iodine only for high-risk features.
Total thyroidectomy, radioactive iodine, TSH suppression; bone metastases may need surgery or radiotherapy.
Lenvatinib or sorafenib; clinical trials of redifferentiation.
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The follicular and papillary thyroid cancer pages' recommendations for lobectomy, selective iodine and surveillance of microcarcinoma follow this guideline.
Lenvatinib is the first-choice kinase inhibitor for progressive iodine-refractory papillary and follicular thyroid cancer, reserved for symptomatic or rapidly progressing disease because of its toxicity.
Sorafenib is an approved option for iodine-refractory thyroid cancer, now usually used after or instead of lenvatinib depending on tolerability.
Query for this cancer: (TITLE:"Follicular thyroid cancer" OR ABSTRACT:"Follicular thyroid cancer" OR TITLE:"Follicular thyroid carcinoma" OR ABSTRACT:"Follicular thyroid carcinoma" OR TITLE:"FTC" OR ABSTRACT:"FTC" OR TITLE:"Oncocytic Hurthle cell carcinoma" OR ABSTRACT:"Oncocytic Hurthle cell carcinoma") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Follicular thyroid cancer, not a curated reading list.
The targets of this cancer's medicines and the ones linked to it directly.
Cases by country, the UK and NHS pathway and other country lenses, the expert centres with trials on record, and the centres named on this cancer's subtypes.
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Sudden severe abdominal pain, a hard or very tender abdomen, or abdominal pain with vomiting and fever. Boxed warning for gastrointestinal perforation on bevacizumab.
Fainting, near-fainting, or an irregular or racing heartbeat; several kinase inhibitors prolong the QT interval and the labels require ECG and electrolyte monitoring.
Take without food (1 hour before or 2 hours after).
Known QT prolongation. Avoid other QT-prolonging drugs where possible; check ECG and correct potassium and magnesium before and during treatment.
Possible QT prolongation. Check ECG and electrolytes; review other QT-prolonging drugs.
Reduce in severe renal impairment.
See all on the product pages:LenvatinibSorafenib·Printable cards in the navigator
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