A patient with follicular carcinoma, Hürthle cell type, who developed subglottic extension and uncontrollable hemoptysis is presented. In consideration of the patient's age a conservative therapeutic program was instituted with a definite response to I131 therapy despite poor radioactive iodine (RAI) uptake by the tumor. Laryngectomy and thyroidectomy were eventually required to control hemoptysis; the patient remains socially functional and asymptomatic after a 30-month period. The two-year period of weekly office visits and temporizing treatment as occurred in this patient cannot be recommended. It seems appropriate to advocate surgical treatment including laryngectomy for follicular carcinoma, Hürthle cell type, localized to the laryngotracheal area without regard for the age of the patient.
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