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Follicular neoplasms can be benign or malignant tumors in the thyroid gland, causing symptoms such as a visible lump, hoarse voice, or difficulty swallowing. Diagnosis is made through biopsy and surgery may be necessary to determine malignancy. Treatment may include surgery, replacement of thyroid hormones, and radioactive iodine. The outlook is often good, with a cure possible in most cases.
A neoplasm is a tumor, or growth, and a follicular neoplasm arises from what are called follicular cells within the thyroid gland. The thyroid gland sits in front of the windpipe in the neck, and a large tumor can cause symptoms such as a hoarse voice or difficulty swallowing. Follicular lesions, or growths, can be nodules that are part of a noncancerous or benign enlargement of the thyroid gland, known as a goiter. In other cases, they may be benign tumors called thyroid adenomas or malignant or cancerous tumors known as thyroid carcinomas.
Growths in the thyroid gland may not be obvious at first, but could lead to symptoms such as a visible lump in the neck or problems with speech or swallowing. It can be difficult to distinguish between the different types of follicular neoplasm. A diagnostic test known as fine needle aspiration can be used to take a sample of cells, known as a biopsy, and the cells can then be studied under a microscope.
Even then, it may not be possible to know whether a follicular neoplasm is benign or malignant unless an operation is performed, allowing the surgeon to view the entire growth. Inspection of the outer shell, or capsule, allows you to see if the tumor behaves like thyroid cancer by spreading to invade surrounding tissue. When there is a risk that a follicular neoplasm could be malignant, all or part of the thyroid gland may need to be removed for further examination.
If follicular cancer is found, further surgery may not be needed as the tumor will already have been removed. Where the tumors have been found to be adenomas or benign nodules, treatment may only be needed if a lump is large enough to cause symptoms or if it produces excessive amounts of thyroid hormones. After surgery, the thyroid hormones previously produced by the gland may need to be replaced, as they regulate energy levels, temperature, and other important functions. This is achieved by taking drugs containing synthetic or natural thyroid hormone; treatment is lifelong. Taking thyroid hormones after the cancer has been removed has another benefit in that it discourages the growth of remaining thyroid tissue, reducing the risk of the cancer returning.
Other possible treatments for follicular thyroid cancer include taking radioactive iodine. Iodine is absorbed by thyroid cells and its radioactivity destroys them. This treatment is used after the thyroid gland has been removed, in order to remove any remaining thyroid tissue or in cases where the cancer has spread to other parts of the body. The outlook for someone with follicular cancer is often good, because most are benign, and even when follicular cancer is discovered, a cure is possible with treatment in most cases.
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