Hürthle cell carcinoma of the thyroid gland with extensive tumor necrosis: a case report

Hürthle cell neoplasm of the thyroid gland is rarely associated with tumor necrosis. We report a case of Hürthle cell carcinoma of the thyroid gland with extensive necrosis. An 82-year-old man had had a right neck mass for more than 10 years. Approximately two to three weeks before he was hospitalized, this neck mass became progressively enlarged. An 131I scan could not demonstrate the right lobe of the thyroid gland, while the contralateral lobe was unremarkable. A 99mTc-sestamibi scan showed increased uptake on the lesion side. Fine needle aspiration cytology showed necrosis with macrophages in the initial aspirate, and the secondary aspirate appeared suspicious for a Hürthle cell tumor. The patient had a total thyroidectomy, and the pathology proved to be Hürthle cell carcinoma with tumor necrosis.