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NCCN Guidelines for Patients



Thyroid Cancer, Version 1.2017


Treatment guide

Follicular and H


rthle cell thyroid cancer

Follicular and Hürthle cell

thyroid cancer

Follicular thyroid cancer is another type of

differentiated thyroid cancer. It is the next most

common type after papillary. About 5 out of 100

people with thyroid cancer are diagnosed with this

type. Follicular thyroid cancer is slow growing and if

the cancer spreads, it usually goes to distant parts of

the body like the lungs or bones.

Hürthle cell thyroid cancer is also another type of

differentiated thyroid cancer. It accounts for a small

number of people diagnosed with thyroid cancer.

It is considered to be a type of follicular thyroid

cancer. Both follicular and Hürthle cell can be hard

to diagnose by FNA. Sometimes molecular testing is

needed and is more likely to be helpful to diagnose

the follicular variety. This is most helpful for FNA

results that are of “undetermined significance.” Your

doctor can also consider removing a lobe of the

thyroid or the whole thyroid gland to further examine

for cancer.

Hürthle cell can be an aggressive type of thyroid

cancer. It can grow into the blood vessels or grow

large, over 4 cm. This type usually spreads in the

neck or to distant parts of the body. It is often treated

the same way as follicular thyroid cancer. The only

difference is this type can spread to the local lymph

nodes so treatment may involve removing those

lymph nodes.

Hürthle cell thyroid cancer does not usually take up

iodine. Thus, RAI therapy may not work as well as

it does for other thyroid cancer types. Surgery is the

treatment for follicular and Hürthle cell thyroid cancer.

Primary treatment

Surgery is usually the primary (first)

treatment. It will help your doctor learn

more about the type of thyroid cancer.

If you have cancer, you may have further

treatment after surgery. If there is no

cancer after surgery, your doctor may

watch you closely to see if there is any


Learn more about surgery and other

treatment for thyroid cancer in Part 4,

Overview of cancer treatments