ABSTRACT
A patient with follicular thyroid cancer has bone pain at various sites. Factors associated with a poor prognosis with this malignancy include all of the following except:
a. Advanced age b. Female sex c. Size of the primary tumor d. Presence of distant metastases e. Higher histologic grade
• About 20% of all thyroid cancers are follicular type
• Follicular thyroid cancer spreads preferentially by the hematogenous route and may rarely present with thyrotoxicosis
• Other types of thyroid cancers include the following:
Papillary cancer: 50%-60% of all thyroid cancers, usually spreads to lymph nodes and has the best prognosis
Anaplastic carcinoma: has the worst prognosis, typically presents in elderly individuals as a rapidly growing thyroid mass
Medullary carcinoma: develops in childhood and usually begins as C-cell hyperplasia. It is also the most common manifestation of multiple endocrine neoplasia (type IIA)
• Poor prognostic factors include the following:
Advanced age Male sex Higher histologic grade Size and invasiveness of tumor Presence of distant metastases
• Unlike follicular type, anaplastic and medullary thyroid carcinoma tissue do not readily pick up iodine 131
• Thyroid hormone therapy may be useful for tumor suppression
