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A Patient with a Large Minimally Invasive Follicular Thyroid Cancer

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Thyroid Cancer

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Abstract

Follicular thyroid cancer (FTC) is a differentiated thyroid cancer, representing 5.5 % of all thyroid cancers. FTC is histologically subclassified according to its degree of invasiveness into either a minimally invasive follicular cancer (MIFC) or a widely invasive follicular thyroid cancer (WIFC). According to the World Health Organization (WHO), MIFC presents with unequivocal invasion of the blood vessels within or immediately outside of the tumor capsule and/or invasion that fully penetrates the thickness of the capsule, whereas WIFC is characterized by widespread infiltration of blood vessels and/or surrounding parenchyma and tissue. However, the diagnostic criteria for MIFC are still controversial which has led to differing recommendations as to the appropriate extent of treatment for patients with MIFC, ranging from thyroid lobectomy alone to total thyroidectomy and postoperative radioactive iodine ablation (RAI).

Several studies have shown compromised disease-free survival and cause-specific mortality of WIFC as compared to MIFC. Tumor size ≥4 cm, patient age ≥45 years, presence of vascular invasion, and nodal and distant metastases have been identified as negative prognostic factors. Current practice guidelines are inconsistent in their recommendations about optimal management approach for MIFC.

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Authors and Affiliations

  1. Section of Endocrine Surgery, Division of Surgical Oncology, Department of Surgery Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI, 53226, USA

    Tracy S. Wang MD, MPH

  2. Duke Clinical Research Institute, Duke University, 2400 Pratt St, Durham, NC, 27705, USA

    Paolo Goffredo MD

  3. Section of Endocrine Surgery, Dept of Surgery, Endocrine Neoplasia Diseases Group, Duke Cancer Institute and Duke Clinical Research InstituteDuke Cancer Institute and Duke Clinical Research Institute, Duke University, DUMC #2945, Durham, NC, 27710, USA

    Julie Ann Sosa MD, MA

Authors
  1. Tracy S. Wang MD, MPH
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  2. Paolo Goffredo MD
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  3. Julie Ann Sosa MD, MA
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Corresponding author

Correspondence to Tracy S. Wang MD, MPH .

Editor information

Editors and Affiliations

  1. Johns Hopkins University, Baltimore, Maryland, USA

    David S. Cooper

  2. Department of Internal Medicine, University of Rome, Rome, Roma, Italy

    Cosimo Durante

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Wang, T.S., Goffredo, P., Sosa, J.A. (2016). A Patient with a Large Minimally Invasive Follicular Thyroid Cancer. In: Cooper, D., Durante, C. (eds) Thyroid Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-22401-5_10

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  • DOI: https://doi.org/10.1007/978-3-319-22401-5_10

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-22400-8

  • Online ISBN: 978-3-319-22401-5

  • eBook Packages: MedicineMedicine (R0)

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