Bone Metastasis is common in which thyroid tumor -
Ans is C ie. Huhle cell tumor A thyroid cancer (Papillary, Follicular, Anaplastic) spreads by all the three 3 routes Hematogenous - Lymphatic and - Direct * Papillary spreads mainly by --> lymphatic route* * Anaplastic mainly by --> direct* (anaplastic Ca is characterized by extensive local invasion) * Follicular spreads mainly by --> Hematogenous route* (to lung, bones and CNS) So Bone metastasis is common in Follicular Ca but Huhle cell is a subtype of follicular Ca which is more invasive and metastasizes more frequently to bones. "One subtype of Follicular Ca, the Huhle cell turner, tends to be more invasive, to metastasize frequently to bone, and to have an unourable clinical course." - Harrison, I4/e, p2031 Also remember More about Huhle cell Ca Histopathologically Huhle cell Ca are dominated by cells with abundant, granular, eosinophilic cytoplasm (Huhle cells). Huhle cells have this eosinophilic appearance because of an abundance of mitochondria in the cytoplasm. They differ from follicular carcinomas in that they are more often multifocal and bilateral (-- 30%) usually do not take up RAL are more likely to metastasize to local nodes and distant sites. and are associated with a higher moality rate. Management is similar to that of follicular neoplasm (explained ahead) with lobectomy and isthmectomy being sufficient for unilateral Huhle cell adenomas. when Huhle cell neoplasms are found to be invsive on intraoperative, frozen section or definitive paraffin section histology, the total thyroidectomy is performed. These patients should also undergo routine central neck node removal and modified radical neck dissection when lateral neck nodes are palpable (similar to patients with medullary carcinoma). Although RAI scanning and ablation usually are ineffective, they probably should be considered for ablation of any residual normal thyroid tissue and, occasionally, for ablation of tumors, because there is no other good therapy.
Follicular
Papillary
Huhle cell tumour
Anaplastic