Oncology Medical News about Follicular neoplasm; thyroid nodule; near-total thyroidectomy; thyroglobulin

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Diagnostic and therapeutic strategies for minimally and widely invasive follicular thyroid carcinomas
Surgical Oncology, 07/14/09

Huang CC et al. - In a trial to investigate diagnostic and therapeutic strategies that will enable easy differentiation between minimally invasive follicular carcinoma (MIFC) and widely invasive follicular carcinoma (WIFC), it was concluded that both WIFC and MIFC are difficult to diagnose on the basis of preoperative examinations and frozen sections. Pts diagnosed with MIFC had responded positively to treatment; however, for pts diagnosed with WIFC to become disease-free, early diagnosis and aggressive surgical therapies in combination with 131I therapy were required.

Methods

234 follicular thyroid carcinoma cases were reviewed to compare diagnostic and therapeutic characteristics between the minimally and the widely invasive types.

Results

89 pts were diagnosed with MIFC and 145 were diagnosed with WIFC.
Low diagnostic accuracy from preoperative cytology and frozen sections resulted in 60 pts undergoing subtotal thyroidectomies and 57 cases required a second operation for complete thyroidectomy.
Pts in the MIFC group were younger, and had small-sized tumors, lower postoperative thyroglobulin levels, lower recurrent rates, and lower cancer mortality rates than those in the WIFC group.
Diagnostic accuracy from frozen sections in the WIFC group was relatively better.
After a mean follow-up period of 9.0 ± 0.4 yrs, 41 of 234 (17.5%) pts with follicular thyroid carcinoma had died due to thyroid cancer.
All MIFC pts remained disease-free or had a recurrence-free status.

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