Thyroid Follicular Epithelial Cell–Derived Cancer: New Approaches and Treatment Strategies

Research ArticleContinuing Education Julie Bolin Journal of Nuclear Medicine Technology September 2021, 49 (3) 199-208; DOI: https://doi. org/10. 2967/jnmt...

AbstractThyroid follicular epithelial cell–derived cancer includes papillary carcinoma, follicular carcinoma, Hürthle cell carcinoma, poorly differentiated thyroid cancer, and anaplastic thyroid carcinoma. Although the incidence of thyroid cancer has increased over the past 30 years, there has n...

THE BASICSThyroid cancer includes 6 main types: papillary, follicular, Hürthle cell, medullary, poorly differentiated, and anaplastic. Clinicians often categorize the 6 main types of thyroid cancer on the basis of the origination cell type (follicular epithelial cell vs. parafollicular C cell) an...

PRESERVATION OF CELL TYPEDifferentiated thyroid cancer represents most (90%–95%) types of thyroid cancer and includes papillary, follicular, and Hürthle cell carcinomas (HCCs) (6). Cellular differentiation is a central aspect in the histopathologic classification for thyroid follicular epithelia...

OVERVIEW OF FOLLICULAR EPITHELIAL CELL–DERIVED THYROID CANCERSPTCPTC is the most commonly occurring form of differentiated thyroid cancer and accounts for 80%–85% of all thyroid cancer (17). Patients are often asymptomatic but may have cervical lymphadenopathy, hoarseness, and dysphagia. Risk ...

GENETIC CHANGES INVOLVED IN THYROID CARCINOGENESISTable 1 defines abbreviations used in discussing the genetics of thyroid carcinogenesis. TABLE 1Genetic AbbreviationsMAPK PathwayIn recent years, there have been multiple studies evaluating the genetic alterations and molecular mechanisms underlying ...

NON-MAPK GENETIC MUTATIONSTERT MutationsA genetic alteration in TERT has been associated with increased aggressiveness and poor patient prognosis. Telomerase is the enzyme involved in telomere elongation, whose main function is preservation of chromosome integrity and genomic stability. Telomeres ...

ASSESSMENT AND TREATMENTThyroid cancers of follicular epithelial cell origin exhibit highly variable clinical manifestations ranging from microcarcinomas with very low tumor-specific morbidity or mortality to very aggressive thyroid carcinomas such as anaplastic carcinoma. Diagnostic workup and sta...

CONCLUSIONThorough evaluation of decades’ worth of data on thyroid carcinoma incidence, treatment, and outcomes have called into question the most appropriate management of patients with follicular epithelial cell–derived thyroid carcinoma. The 2015 ATA guidelines called for a more conservative...

DISCLOSURENo potential conflict of interest relevant to this article was reported. ...

FootnotesPublished online July 9, 2021. ...

REFERENCES1. ↵2. ↵3...

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