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Papillary and Follicular Thyroid Cancer

and their variants, including Hurthle cell, tall cell, and others

Overview
Prognosis

Free Handbook: Thyroid Cancer Basics   
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These pages offer information for everyone interested in learning more about papillary, follicular, and oncocytic thyroid cancers, as well as their variants, including sclerosing, tall cell, and others.

About 95% of people with thyroid cancer have these types of thyroid cancer. They are called differentiated thyroid cancer.

We invite you to read these pages and to explore the further free support services, information, publications, and educational events that are available for patients, families, friends, and health care professionals.

Click on the topics listed at the left for detailed information.

Overview

  • Papillary and follicular thyroid cancers are referred to as differentiated thyroid cancer, which means that the cancer cells look and act in some respects like normal thyroid cells.
  • Papillary and follicular thyroid cancers account for more than 90% of all thyroid cancers. They tend to grow very slowly.
  • Their variants include columnar, diffuse sclerosing, follicular variant of papillary, Hürthle cell, and tall cell. Two other variants (insular and solid/trabecular) are considered to be intermediate between differentiated thyroid cancer and poorly differentiated thyroid cancer. The variants tend to grow and spread more than typical papillary cancer.
  • If detected early, most papillary and follicular thyroid cancers can be treated successfully. Their treatment and management are similar and are based on staging and individual risk levels.
  • Papillary thyroid cancer is the most common type of thyroid cancer. It accounts for about 80% of all thyroid cancers. Papillary thyroid cancer generally grows very slowly, but can often spread to lymph nodes in the neck. It also can spread elsewhere in the body.
  • The most common variant of papillary is the follicular variant (not to be confused with follicular thyroid cancer). It also usually grows very slowly. Other variants of papillary thyroid cancer (columnar, diffuse sclerosing, and tall cell) are not as common and tend to grow and spread more quickly.
  • Follicular thyroid cancer accounts for about 10-15% of all thyroid cancers. Treatment will be discussed later in this booklet. Hürthle cell thyroid cancer is a variant of follicular.
  • Follicular thyroid cancers usually do not spread to the lymph nodes, but in some cases can spread to other parts of the body, such as the lungs or bones.
  • Treatment for follicular thyroid cancer is similar to treatment for papillary. Hürthle cell cancer (also known as oncocytic or oxyphilic) is less likely than other differentiated thyroid cancer to absorb radioactive iodine, which is often used for the treatment of differentiated thyroid cancer.
  • A protein called thyroglobulin (abbreviated Tg) is used as a marker for whether all of the differentiated thyroid cancer has been successfully removed. Determining the Tg level in your blood by periodic testing will help your doctors determine how well you are doing with your treatment. Some patients produce anti-thyroglobulin antibodies (TgAb), which are not harmful but which mask the reliability of the Tg value.

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Prognosis

Although a cancer diagnosis of any kind can be scary, the most common forms of differentiated thyroid cancer (papillary and follicular) have a very high long-term survival rate (over 90%), especially when diagnosed early.

While the prognosis for most people with thyroid cancer is very good, the rate of recurrence or persistence can be up to 30%, and recurrences can occur even decades after the initial treatment.

Therefore, it is important that you have regular follow-up examinations to detect whether the cancer has recurred. Health monitoring should continue throughout your lifetime.

The additional sections in the Papillary, Follicular, and Variants part of this web site cover the following topics and are linked below as well on the left side of the page:

For more about prognosis in thyroid cancer, see

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Last updated: August 18, 2024