Follicular Thyroid Carcinoma (FTC)

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • The second most common type of thyroid cancer is:
    • Follicular thyroid carcinoma (FTC)
  • Fundamentally all follicular carcinomas are:
    • RAS-like tumors
  • There profile is different from classic PTC because:
    • They do not have BRAF mutations:
      • Most of them have RAS and RAS-like mutations
  • Yoo S.K et al, from Korea showed that the genetic profile of follicular carcinomas:
    • Is very similar to follicular adenomas because they are related tumors
    • Most FTC originate from a FA and eventually break through the capsule and become carcinomas
  • In encapsulated follicular variant of PTC:
    • Their molecular profile is much closer to a FA and FTC than to classic PTC
  • Infiltrative follicular variant of PTC:
    • Has a molecular profile that is more like classic PTC than FTC
  • The biologic difference between follicular pattern RAS-like tumors and classic PTC:
    • Is the infiltrative growth pattern (Figure)
    • The difference between these tumors:
      • Is not only phenotypically based on gross pattern, but also based on biological and clinical differences;
        • Because follicular pattern RAS-like tumors:
          • Retain avidity to radioactive iodine
        • BRAF-like tumors (classic PTC and infiltrative follicular variant of PTC):
          • Have the classic features of PTC
          • They are infiltrative
          • They spread to lymph nodes first and later to distant sites
          • They lose the expression of genes associated with thyroid differentiation
        • RAS-like tumors (FA, FTC, NIFTP, and invasive encapsulated follicular variant of PTC):
          • May or may not have nuclear features of PTC
          • They are encapsulated
          • They spread to distant sites (rarely to lymph nodes)
          • They retain expression of genes associated with thyroid differentiation

Graph exemplifying the difference between follicular pattern RAS-like tumors and classic PTC,
which is the infiltrative growth pattern.
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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