Multidisciplinary treatment of follicular thyroid carcinoma with hepatic and pulmonary metastases: a case report and literature review.

PURPOSE: To determine the clinical diagnostic features, molecular basis, and comprehensive treatment strategies for a case of follicular thyroid carcinoma (FTC) with hepatic and pulmonary metastases that developed 8 years after surgery for a Follicular Tumor of Uncertain Malignant Potential (FT-UMP), and to provide a basis for long-term follow-up and individualized treatment of such borderline tumors.

BACKGROUND

FTC is the second most common subtype of differentiated thyroid cancer. Currently, the diagnosis and management of distant FTC metastases remain a critical challenge, particularly when they occur in rare locations, such as the liver.

CASE PRESENTATION: This article reports the case of a 56-year-old male patient. Within 8 years after the resection of the well-differentiated follicular neoplasm of FT-UMP, a single mass in the lateral lobe of the left liver and multiple nodules in both lungs were detected in the patient. Following a multidisciplinary team (MDT) discussion, the decision was made to perform a robot-assisted hepatectomy. Pathology confirmed the diagnosis of FTC metastasis. Subsequently, we formulated a comprehensive treatment plan including total thyroidectomy, radioactive iodine (RAI) therapy with 131I and endocrine treatment. Active surveillance was adopted for the lung metastases. Twelve months of follow-up showed no signs of recurrence.

CONCLUSIONS

This case highlights that for patients with FT-UMP, continuous monitoring is also crucial for the early detection of metastasis. In complicated cases with liver and lung metastases from FTC, MDT collaboration is essential to formulate individualized treatment plans integrating multidisciplinary expertise and multimodal therapies.