endocrine and metabolic disorders
Thyroid Cancers
Follicular Thyroid Carcinoma
Follicular carcinoma, including the Hürthle cell variant, accounts for about 10% of thyroid cancers. It is more common among older patients and in regions of iodine deficiency. It is more malignant than Papillary Thyroid Carcinoma , spreading hematogenously with distant metastases. Treatment requires near-total thyroidectomy with postoperative radioiodine ablation of residual thyroid tissue as in treatment for papillary carcinoma. Metastases are more responsive to radioiodine therapy than are those of papillary carcinoma. Thyroid-stimulating hormone–suppressive doses oflevothyroxineare given after treatment. Serum thyroglobulin measurements and neck ultrasongraphy should be done periodically to detect recurrent or persistent disease. 