What are the possible complications of follicular thyroid carcinoma (FTC)?

Updated: Jun 18, 2020
  • Author: Luigi Santacroce, MD; Chief Editor: Neetu Radhakrishnan, MD  more...
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If it is neglected, FTC may produce symptoms due to the compression and/or infiltration of the surrounding tissues, and it may metastasize to lung and bone.

Surgical treatment of FTC may cause complications, partially because of the variable anatomy of the neck. Complication rates, especially with total thyroidectomy, are lower in the hands of experienced surgeons. [32]  Possible complications include the following:

Radioiodine administration may have the following consequences:

  • Radiation thyroiditis and transient thyrotoxicosis in patients who have undergone simple lobectomy

  • Sialoadenitis, because radioiodine is taken up by the salivary glands

  • Nausea, anorexia, and headache (uncommon)

  • Pulmonary fibrosis in patients with large lung metastases

  • Brain edema in patients with brain metastases (this may be prevented by glucocorticoid treatment)

  • Permanent sterility and transient oligospermia or menstrual irregularities

  • Teratogenesis and spontaneous abortions

  • A slight increase in the risk of leukemias or breast and bladder carcinomas.

In a study of 438 patients with thyroid cancer, similar outcomes were achieved with low-dose radioiodine plus thyrotropin alfa treatment and high-dose radioiodine treatment, and low-dose treatment was associated with a lower rate of adverse events. [34]

The most frequent sites of metastasis are lung and bone, followed by the brain and the liver; metastasis to other sites occurs less frequently. Metastatic potential seems to be a function of primary tumor size; however, metastases without thyroid pathology identified on physical examination may be found in patients with microscopic FTC.

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