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Follicular and Hürthle Cell Carcinoma

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Management of Thyroid Nodules and Differentiated Thyroid Cancer

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Abstract

Follicular neoplasms are uncommon thyroid tumors with several histologic subtypes, such as follicular adenoma, Hürthle cell adenoma, and minimally invasive and widely invasive follicular and Hürthle thyroid carcinoma. The diagnosis of a malignant follicular thyroid tumor is based on the presence of capsular and/or vascular invasion on histologic examination. In this chapter, we review the clinical, radiographic, and pathological characteristics of follicular and Hürthle cell carcinoma. The role of molecular diagnostic assays to distinguish benign tumors from malignant counterparts is still limited. The difference in tumor behavior between follicular and Hürthle cell carcinoma is discussed. Although controversies related to the optimal management of these tumors remain due to their rarity, this chapter includes the management of minimally invasive follicular thyroid carcinoma based on clinicopathological risk factors. We summarize the treatments of widely invasive follicular and Hürthle cell carcinoma, including the role of lymphadenectomy in treating these tumors. Postoperative management methods, such as the use of radioactive iodine ablation, thyroid-stimulating hormone (TSH) suppression therapy in follicular and Hürthle cell carcinoma, as well as surveillance for recurrent disease, are included. Lastly, we provide the summary of the outcome that shows shorter survival in patients with Hürthle cell carcinoma, as compared with those with follicular and papillary thyroid carcinoma.

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Author information

Authors and Affiliations

  1. Endocrine Oncology Branch, National Cancer Institute, Maryland, MD, USA

    Naris Nilubol MD

  2. Department of Surgery, Rush University Medical Center, Chicago, IL, USA

    Xavier Keutgen MD

  3. Endocrine Oncology Branch, National Cancer Institute, National Institute of Health, Bethesda, MD, USA

    Electron Kebebew MD

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  1. Naris Nilubol MD
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  2. Xavier Keutgen MD
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  3. Electron Kebebew MD
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Correspondence to Naris Nilubol MD .

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Editors and Affiliations

  1. Endocrine Surgery, Department of Surgery, Duke University Medical Center Duke Cancer Institute, Durham, North Carolina, USA

    Sanziana A. Roman

  2. Department of Surgery, Duke University Medical Center Duke Cancer Institute, Durham, North Carolina, USA

    Julie Ann Sosa

  3. Division of Surgical Oncology and Endocrine Surgery, Vanderbilt Endocrine Surgery Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA

    Carmen C. Solórzano

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Nilubol, N., Keutgen, X., Kebebew, E. (2017). Follicular and Hürthle Cell Carcinoma. In: Roman, S., Sosa, J., Solórzano, C. (eds) Management of Thyroid Nodules and Differentiated Thyroid Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-43618-0_24

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