Follicular Thyroid Carcinoma In A Developing Country: A Retrospective Study Of 10 Years

Background: In Pakistan thyroid cancer accounts for 1.2% of all cancers. Follicular Thyroid Carcinoma (FTC) constitutes 5%–10% of all thyroid cancers. FTC is classified into minimally and widely invasive tumors. Relatively few studies addressed follicular carcinoma patients across the world & no study on characteristics of follicular thyroid carcinoma in Pakistan. Aims: The aim of our study was to determine the demographic, clinico-pathological and radiological features of follicular thyroid carcinoma. Methods: A retrospective observational study (January 2010-December 2019) was conducted in department of Medicine and Surgery at our hospital. All patients of age 18 years and above admitted with diagnosis of FTC on histopathology were included. Out of 404 patients of thyroid cancers 40 (10.1%) fulfilled FTC inclusion criteria. Results: 50% of patients were in age group of 41–60 years. F:M ratio was 1.5:1. 24 patients (60%) had neck swelling. 8 (20%) each had compressive symptoms and metastasis Pre-operative thyroglobulin level was done in 6 out of 8 metastatic patients (75%) in which it was elevated. 50% FNAC were reported Bethesda category 3–4. Lymph node dissection done in 10 patients, of which 7 patients had metastasis. Minimally invasive FTC accounted for 23 (57.5%) and 17 (42.5%) widely invasive. Lympho-vascular invasion was present in 26 patients (65%). 60% patients had clinical stage 1, 25% stage 2 and 15% stage 4 disease. 42.5% (17 patients) received RAI 30-100 mCi. 10 patients (25%) received more than 100 mCi out of which 8 had metastatic disease. Conclusions: FTC usually presents with neck swelling followed by compressive symptoms and metastasis. Lymph node whenever evident are mostly involved. Thyroidectomy followed by RAI is treatment of choice. Angioinvasive follicular carcinoma of thyroid, an incidental finding in the background: of multinodular goitre: a case report