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Submitted: 14 May 2008 Modified: 12 April 2018
HERDIN Record #: PCHRD051408030540

A systematic overview on controversies in the diagnosis and management of follicular carcinoma of the thyroid.

1Edgardo R. Cortez,
2Isaac David E. Ampil II
U.E.R.M. Memorial Medical Center,

Abstract

The diagnosis and management of well-differentiated thyroid cancer, especially follicular cancer, remains controversial. Since clinical trials are impractical and unavailable, we comprehensively searched and appraised the literature for the best available evidence to determine whether follicular cancer can be differentiated from adenoma by frozen section, the predictors of aggressive tumor behavior, the role of total thyroidectomy in improving prognosis, the incidence of complications following total thyroidectomy and the adjuvant therapeutic modalities that can control the disease. From level 2 evidence, we found that frozen section using multiple sectioning of the nodule can accurately differentiate benign adenoma from follicular carcinoma. Age, tumor size and extent of disease were the most consistent predictors of risk. Total thyroidectomy decreased recurrence but had equivocal effect on survival. The incidence of permanent complications following thyroidectomy ranged from 5-7 percent in tertiary centers. Postoperative thyroid stimulating hormone (TSH) suppression and radioactive iodine (RAI) therapy seemed to improve survival. (Author)

1.
Publication Type:
Journal
Publication Sub Type:
Announcements
Title:
St. Luke's Medical Journal
Frequency:
Semi-Annual
Publication Date:
January-June 2005
Volume:
3
Issue:
1
Page(s):
3-10
Publisher:
St. Luke's Medical Center

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