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Significance of an insular component in follicular thyroid carcinoma with distant metastasis at initial presentation

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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.

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Authors and Affiliations

  1. Department of Research and Laboratory Medicine, Noguchi Thyroid Clinic and Hospital Foundation, 6-33 Noguchi-nakamachi, 874-0932, Oita, Japan

    Hiroto Yamashita MD, PhD

  2. Department of Radiology, Noguchi Thyroid Clinic and Hospital Foundation, Japan

    Yasushi Noguchi MD

  3. Department of Surgery, Noguchi Thyroid Clinic and Hospital Foundation, Japan

    Shiro Noguchi MD, PhD, Hiroyuki Yamashita MD, PhD, Shinya Uchino MD, PhD, Shinn Watanabe MD & Takahiro Ogawa MD, PhD

  4. Department of Internal Medicine, Noguchi Thyroid Clinic and Hospital Foundation, Japan

    Tsukasa Murakami MD

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  1. Hiroto Yamashita MD, PhD
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  2. Yasushi Noguchi MD
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  3. Shiro Noguchi MD, PhD
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  4. Hiroyuki Yamashita MD, PhD
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Correspondence to Hiroto Yamashita MD, PhD.

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Yamashita, H., Noguchi, Y., Noguchi, S. et al. Significance of an insular component in follicular thyroid carcinoma with distant metastasis at initial presentation. Endocr Pathol 16, 41–48 (2005). https://doi.org/10.1385/EP:16:1:041

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