Figure 2.

Pathways in the development, progression, metastasis, and de-differentiation of follicular neoplasms of the thyroid. The initiating event may be a gain mutation or re-arrangement in the genes that regulate the transmembrane tyrosine kinase receptors or involve intracellular kinases. The MARK, PI3K/AKT/mTOR and RET pathways are involved in the early phase of tumorigenesis. The RAS mutation is an upstream event for FTC, FA, FVPTC, and rarely PTC. RAF mutations are seen more frequently in PTC. The p53, Wnt, PTEN, TERT, and other mutations or rearrangements occur later as WDTC progresses towards PDTC or ATC. (Created using BioRender.com accessed on 13 February 2023).