; Kim, Hyeung Kyoo2
; Lee, Jeonghun3
; Soh, Euy Young4
1 Department of Surgery, Ajou University Medical Center, Suwon-si, Republic of Korea
2 Department of Surgery, Ajou University Medical Center, Suwon-si, Republic of Korea
3 Department of Surgery, Ajou University Medical Center, Suwon-si, Republic of Korea
4 Department of Surgery, Ajou University Medical Center, Suwon-si, Republic of Korea
Follicular variant papillary thyroid carcinoma (FVPTC) is known to have a good prognosis, but distant metastases were reported in some reports. The aim of this study is to find the clinicopathologic variables associated with aggression of FVPTC.
We retrospectively reviewed medical records of all patients with FVPTC between January 2006 and April 2016 in Ajou University Medical Center. A total of 488 patients underwent thyroidectomy. By exclusion of patients who diagnosed with other thyroid carcinoma and received primary surgery at other hospitals, 364 patients enrolled.
364 patients included 56 males (15.4%) and 308 females (84.6%), with the mean age of 47.7±11.4 years (range, 14-82 years). The mean follow-up period was 44.4 months (range, 0.3-123.9 months). The mean tumor size was 11.9±10.8mm (range, 1-80mm). 355 patients (97.5%) underwent central or lateral lymph node dissection while thyroidectomy, 74 out of the 355 patients (20.8%) had lymph node metastasis (LNM). Tumor size, lymphovascular permeation, and extrathyroidal extension were significantly correlated with LNM (p=0.01, p<0.001, and p<0.001, respectively). 4 patients (1.1%) had distant metastasis during follow-up period. In 3 patients, distant metastasis was found on whole body scan and eliminated by radioactive iodine (RAI) ablation. Tumor size was significantly correlated with distant metastasis (p=0.043).
FVPTC is known to have a good prognosis, but aggressive instances definitely exist. Especially in the case of infiltrative FVPTC, there is a need for more attention. Whole body scan and postoperative stimulated thyroglobulin before RAI ablation may be helpful to discern distant metastasis.
- Baloch ZW, LiVolsi VA. Encapsulated follicular variant of papillary thyroid carcinoma with bone metastases. Mod Pathol. 2000;13:861-865.