Encapsulated thyroid carcinoma of follicular cell origin Journal Article
| Authors: | Xu, B.; Ghossein, R. |
| Article Title: | Encapsulated thyroid carcinoma of follicular cell origin |
| Abstract: | Encapsulated carcinomas of follicular cell origin are subject to considerable controversies. This group includes an encapsulated/well-circumscribed (E/WC) follicular variant of papillary carcinoma (FVPTC) and encapsulated follicular and Hurthle cell carcinoma (EFC, EHC respectively). FVPTC usually presents as an E/WC tumor and less commonly as an infiltrative neoplasm. E/WC FVPTC rarely metastasizes to lymph nodes, whereas infiltrative tumors often present with cervical nodal metastases. Many studies revealed FVPTC in general to be genetically close to the follicular adenomas (FA)/EFC group of tumors. This is particularly true for the E/WC FVPTC which has a high rate of RAS and lack BRAFV600E mutations. Infiltrative FVPTC has an opposite molecular profile closer to classical papillary carcinoma than to FA/EFC (BRAFV600E > RAS mutations). Noninvasive E/WC FVPTCs are extremely indolent even if treated with lobectomy alone. While EFC and EHC with capsular invasion only have an excellent outcome, those with extensive (≥4 foci) lymphovascular invasion (LVI) have a significant rate of distant recurrence. The prognosis of those with focal LVI seems good, but more studies are needed to confirm their behavior. In EHC, those with extensive/significant LVI have a different RNA expression profile than those with less LVI. EHC appear to recur earlier, are less RAI avid, and have a different mutation profile than EFC. Noninvasive E/WC FVPTC should be treated conservatively. There is therefore a need to reclassify the E/WC FVPTC in order to prevent overtreatment. In view of their molecular and behavioral differences, EHC should not be considered a subset of EFC. © 2015, Springer Science+Business Media New York. |
| Keywords: | review; cancer recurrence; outcome assessment; gene expression profiling; mutational analysis; oncocytoma; gene rearrangement; lobectomy; thyroid papillary carcinoma; b raf kinase; oncogene ras; braf gene; follicular carcinoma; thyroid follicular carcinoma; thyroid parafollicular cell; hürthle cell carcinoma; tumor invasion; papillary thyroid carcinoma; cancer prognosis; lymph vessel metastasis; ovary follicle cell; human; priority journal; encapsulated thyroid carcinoma of follicular cell origin |
| Journal Title: | Endocrine Pathology |
| Volume: | 26 |
| Issue: | 3 |
| ISSN: | 1046-3976 |
| Publisher: | Springer Nature |
| Date Published: | 2015-09-01 |
| Start Page: | 191 |
| End Page: | 199 |
| Language: | English |
| DOI: | 10.1007/s12022-015-9376-5 |
| PROVIDER: | scopus |
| PUBMED: | 26003547 |
| DOI/URL: | |
| Notes: | Export Date: 2 September 2015 -- Source: Scopus |
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