I would like to ask you about encapsulated follicular variant of papillary thyroid cancer. I have a young female 28 yo recently diagnosed with a 2.3 cm nodule left lobe with the above pathology confirmed by Dr. LiVolsi. She will have completion thyroidectomy and my question is how aggressive one should be with this form of PTC ; since some reports from Dr. Tuttle mention that this may be a different and less aggressive cancer. Do you recommend radio iodine therapy if she has cancer confined to one lobe and no lymph nodes? Thank you very much for your time.
Mandana Ahmadian, MD
Certainly the patient's youth and the histology suggest a high probability of cure by surgery alone. However, 131-Iablation is neither difficult nor arduous for the patient, and has several advantages. It may slightly improve her chance of recurrence free survival, and it definitely makes the results of isotope scanning and TG assay more easily interpreted during follow-up. So I would be for it.
L De Groot, MD