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Significance of an insular component in follicular thyroid carcinoma with distant metastasis at initial presentation
Authors:Dr Hiroto Yamashita MD  PhD  Yasushi Noguchi MD  Shiro Noguchi MD  PhD  Hiroyuki Yamashita MD  PhD  Shinya Uchino MD  PhD  Shinn Watanabe MD  Takahiro Ogawa MD  PhD  Tsukasa Murakami MD
Institution:(1) Department of Research and Laboratory Medicine, Noguchi Thyroid Clinic and Hospital Foundation, 6-33 Noguchi-nakamachi, 874-0932 Oita, Japan;(2) Department of Radiology, Noguchi Thyroid Clinic and Hospital Foundation, Japan;(3) Department of Surgery, Noguchi Thyroid Clinic and Hospital Foundation, Japan;(4) Department of Internal Medicine, Noguchi Thyroid Clinic and Hospital Foundation, Japan
Abstract:Risk factors for distant metastasis were studied in 82 patients with follicular thyroid carcinoma (FTC). Metastases to either the lung or bone existing at the time of presentation were confirmed by I-131 radio-iodine uptake in 10 patients. FTC with an insular component was found in eight patients. Univariate analysis of 14 possible risk factors showed 7 to be statistically significant: insular component, poorly differentiated carcinoma, trabecular component, serum thyroglobulin level before surgery, patient age at the time of presentation, solid component, and vascular invasion (ranked by p values). After further analysis of the interrelation of the factors and of the logistic regression curves, we concluded that presence of an insular component and patient age were the only independent risk factors. Distant metastasis was not detected in any of the 27 patients ≤49 yr old. Among the 55 older patients (≥50 yr old), 5 of the 49 (10%) without an insular component and 5 of the 6 (83%) with an insular component had distant metastasis. The remaining older patient with an insular component but without distant metastasis showed a gradual increase in thyroglobulin levels after total thyroidectomy.
Keywords:Thyroid  follicular carcinoma  distant metastasis  insular carcinoma
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