Management of follicular and Hürthle cell neoplasms of the thyroid gland.

Management of follicular and Hürthle cell neoplasms of the thyroid gland is a common clinical problem. A diagnosis of follicular or Hürthle cell carcinoma cannot be made from a fine-needle aspiration biopsy alone because it requires histologic demonstration of capsular or vascular invasion. Thyroid lobectomy and isthmusectomy is adequate treatment of benign follicular or Hürthle cell adenoma and minimally invasive follicular carcinoma. Total thyroidectomy, radioiodine ablation, and thyrotropin-suppressive doses of thyroid hormone is advocated for the invasive subtype of follicular carcinoma and all Hürthle cell carcinomas. Monitoring of serum thyroglobulin levels postoperatively is important for detection of recurrent disease.