The thyroid gland is a small but important human organ. And when the doctor discovers any neoplasm in the structure of the thyroid gland, panic begins. But if you are diagnosed with a follicular thyroid tumor, the prognosis for survival is encouraging and optimistic.
Some anatomy of the thyroid gland
The organ consists of 2 lobes – right, left and isthmus. The size and weight of the organ depend on the gender and age of the patient.
Thyroid tissue is made up of several types of cells:
- Follicular bladder.
Follicles in the thyroid gland are composed of thyrocytes – epithelial cells and colloid cells that produce hormones.
- A network of small vessels-capillaries around the follicle.
- The connective tissue is the stroma.
- Areas of interfollicular epithelium that are presumably involved in the reproduction of thyrocytes .
- Solitary C-cells producing the hormone calcitonin.
Normally, the cells of the follicular epithelium are round in shape and small in size from 7.5 to 9 microns. Inside – foamy cytoplasm and islands of colloidal tissue.
Causes of the development of a follicular tumor
The neoplasm of the follicular type can be benign – adenoma or malignant – carcinoma. It is impossible to distinguish them without additional examination .
There are the following reasons for the development of a tumor in the thyroid gland:
- lack of iodine in the body. More often, neoplasms of the follicular type occur in people living in areas that are deficient in this microelement;
- decrease in general immunity;
- exposure to ionizing radiation;
- heredity;
- stress and bad habits;
- multinodular , macro- and microfollicular goiter – an increase in the organ due to the accumulation of colloid or hyperplasia of the cells of the organ;
- inflammatory process in the thyroid gland – follicular thyroiditis.
The main patients with follicular neoplasms are women aged 40 to 60 years. In men, these tumors are rare.
Symptoms of a follicular tumor
This pathology does not manifest itself for a long time.
With the growth of the neoplasm, symptoms similar to papillary cancer are observed:
- voice change;
- sensation of a foreign body in the throat;
- pain syndrome;
- often accompanied by symptoms of thyrotoxicosis – irritability, weight loss, fatigue, poor heat tolerance;
- arrhythmia;
- the presence of metastases.
This type of cancer spreads metastases through the bloodstream. They are found in the lung tissues, ribs, spine and complement the picture with coughing up blood, breathing problems, and general weakness. Infiltrates are found in the lungs.
Diagnostic measures
Examination of the patient is carried out according to WHO recommendations and consists of several stages:
- Conversation with an endocrinologist, visual and manual examination of the thyroid gland.
- Analysis for hormones TSH, T3, T4. Thyrotoxicosis is more common in patients with follicular cancer than in those with papillary carcinoma.
- Ultrasound examination of the organ.
Modified thyroid follicles on ultrasound look like a neoplasm of a rounded shape, increased echogenicity . A discontinuous hypoechoic rim is revealed along the periphery. The mutated follicle in the thyroid gland has a homogeneous structure and an excessive number of blood vessels along the membrane. In the advanced stage, the tumor grows into neighboring organs – the trachea, larynx.
It is difficult to clearly diagnose follicular cancer on ultrasound, since the picture is similar to benign follicular adenoma of the organ and resembles changes in the follicle in the thyroid gland like nodular euthyroid goiter or enlarged tissue cells – macrofollicles .
- Fine needle biopsy to determine the nature of the neoplasm. With a benign node in the samples there will be follicular epithelium mixed with colloid. In 10% of cases, the results of the study will be considered suspicious. In conclusion, the doctor will note “follicular neoplasia” – a precancerous condition.
- If follicular cancer is suspected, an MRI or CT scan is additionally prescribed to rule out or confirm the presence of distant metastases. Additionally, scanning with iodine or technetium is indicated, since metastases are visualized on x-rays only in the advanced stages of cancer.
Medical tactics
Treatment of a follicular tumor depends on the degree of malignancy and the stage of the disease.
Follicular cancer stages:
- 1 and 2 – the neoplasm is differentiated, there are no metastases either in the nearest tissues or in distant organs;
- 3 – the tumor has gone beyond the thyroid gland;
- 4 – metastases in the nearest lymph nodes and distant organs.
With adenomas less than 1 cm in diameter, surgery is not performed, and the patient is under dynamic observation. If a benign tumor is large enough, compresses neighboring organs, blood circulation is disturbed, then a partial removal of the thyroid gland is performed. Healthy tissues are left.
If the biopsy study showed neoplasia, then a partial resection of the organ is performed with the control of a cytologist during the operation. When confirming the diagnosis after express analysis, a complete removal of the organ is recommended.
If during the intervention the diagnosis is called into question, then only the affected lobe of the thyroid gland is removed. The neoplasm is sent for histology. When confirming the diagnosis of “follicular cancer”, the patient is recommended to remove the remnants of the organ and a course of radioiodine therapy .
In the presence of distant metastases in the lungs or bone tissues, their removal is indicated.
After surgery, patients are prescribed hormone replacement therapy. The dosage is selected individually.
Survival prognosis
The life expectancy of a patient after follicular cancer depends on the age and stage of the disease, the presence of distant metastases.
For this type of neoplasm, the survival period is 5 years:
- the first stage – 100%;
- the second – 98%;
- third – 80%;
- fourth – 30%.
In the presence of bone metastases, the survival rate is only 27%. The average life of such a patient is no more than 4.5 years after the discovery of the tumor.