The thyroid is a brownish-red gland situated in the front of the neck. An isthmus, a cordlike tissue, connects its two lobes. Various thyroid conditions are prone to develop in the gland due to various reasons that include poor nutrition, genetics and hereditary factors, irradiation and age. Accumulation of a surplus mass or what is known as thyroid nodules are a common thyroid condition that may turn out to be malignant at times. The incidence of thyroid cancer is more common in those who have undergone X-Ray treatments in early life, suggesting increased susceptibility to damage from radiation exposure.
Follicle cells in the thyroid form sac-like structures that uptake iodine from the blood to produce thyroid hormones. The actual secretion of these hormones is done by the single layer of epithelial cells that surround thyroid follicles. Follicular thyroid carcinoma is one of the four types of thyroid cancer, which originates in these epithelial cells. It is also one of the two well-differentiated thyroid cancers and represents 10 to 20% of cancerous lesions.
A vast majority of follicular nodules are benign. However, there is a need to establish or rule out malignancy, as follicular thyroid cancer is aggressive and tends to metastasize to the lungs and lymphatic system. Diagnosis involves examination of thyroid tissue obtained for biopsy, because fine needle aspiration is unable to provide definite evidence of invasion in the follicles or blood vessels.
Surgery is not only the preferred choice, but the only option for treating this type of cancer. There are two types of thyroid surgeries: partial thyroidectomy (removal of one entire thyroid lobe) or total thyroidectomy. Total or near total excision of the thyroid gland is recommended considering the aggressive nature of follicular thyroid cancer. Although its success rates are a subject matter of controversy, the surgeon may opt for minimally invasive surgery if the nodule is small in size.
Regardless of the type of surgery, patients are almost always advised postoperative radioiodine ablation. Although long-term prognosis of follicular thyroid cancer is extremely good, patients are advised regular tests for checking recurrence of the disease. Studies suggest that ultrasound of the neck in conjunction with thyroglobulin as tumor marker gives better results in finding recurrence.