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Abstract：
Background The most common endocrine tumor is thyroid cancer. Follicular thyroid carcinoma (FTC) accounts for 5-10% of all thyroid cancers. Patients with FTC frequently present with more advanced diseases and a higher occurrence of distant metastases because of the propensity of vascular invasion. FTC is mainly treated with surgery while radioactive iodine (RAI) therapy is the main adjuvant therapy according to the American Thyroid Association guidelines. Methodology This was a retrospective observational study of FTC patients aged 18 and above conducted at a tertiary care hospital in Karachi from January 01, 2010 to December 31, 2019. Results A total of 404 patients with thyroid carcinoma were sorted, of which 40 (10.1%) were FTC cases. Overall, 50% of the patients were in the age group of 41-60 years, and the female-to-male ratio was 1.5:1. The majority of patients (60%) presented with neck swelling, followed by bone and lung metastasis in 20% and compressive symptoms in another 20%. On fine needle aspiration cytology (FNAC), 50% had Bethesda category III-IV nodules while 10% had Bethesda category II. Overall, 50% had a total thyroidectomy while 50% had a lobectomy followed by a completion thyroidectomy. On histopathology, 23 (57.5%) patients had minimally invasive FTC while 17 (42.5%) had widely invasive FTC. A total of 17 (42.5%) patients had received RAI 30-100 mCi while 10 (25%) received more than 100 mCi. Conclusions FTC can present with both local or metastatic symptoms. The atypical presentation of metastatic FTC should be considered, diagnosed, and managed early to limit mortality and morbidity. Ultrasound is the best diagnostic investigation of choice followed by FNAC. Surgery is the mainstay of treatment and should be followed by RAI in select cases. Thus, understanding the trend of FTC and proper planning and utilization of the resources will help developing countries in effectively treating the FTC.
摘要：
背景：最常见的内分泌肿瘤是甲状腺癌。滤泡性甲状腺癌（FTC）占所有甲状腺癌的5-10％。由于血管浸润的倾向，FTC患者通常会出现更晚期的疾病和更高的远处转移发生率。根据美国甲状腺协会指南，FTC主要通过手术治疗，而放射性碘（RAI）治疗是主要的辅助治疗。方法2010年1月1日至2019年12月31日在卡拉奇某三级护理医院进行的18岁及以上FTC患者的回顾性观察性研究。结果共筛选出404例甲状腺癌患者,其中40例（10.1%）为FTC病例。总的来说,50％的患者年龄在41-60岁之间，男女比例为1.5:1。大多数患者（60％）表现为颈部肿胀，其次是骨和肺转移的20％和压缩症状的另外20％。细针穿刺细胞学（FNAC），50％的人患有贝塞斯达III-IV类结节，而10％的人患有贝塞斯达II类结节。总的来说,50％的人进行了全甲状腺切除术，而50％的人进行了肺叶切除术，然后进行了完整的甲状腺切除术。在组织病理学上，23例（57.5%）患者接受微创FTC，17例（42.5%）患者接受广泛侵入性FTC。共有17例（42.5％）患者接受了RAI30-100mCi，而10例（25％）接受了超过100mCi。结论FTC可同时出现局部或转移症状。应考虑转移性FTC的非典型表现，诊断，并及早管理以限制死亡率和发病率。超声是FNAC之后的最佳诊断检查。手术是治疗的主要手段，在某些情况下应进行RAI。因此，了解FTC的趋势以及对资源的适当规划和利用将有助于发展中国家有效地对待FTC。
