Surgery for thyroid Hürthle cell tumours--a single institution experience

Area of Science:

• Endocrinology
• Oncology
• Surgical Pathology

Background:

• Hürthle cell tumours (HCT) are rare thyroid neoplasms.
• Distinguishing between Hürthle cell adenoma (HCA) and Hürthle cell carcinoma (HCC) is crucial for management.
• Limited data exists on the clinical characteristics and outcomes of HCT.

Purpose of the Study:

• To report a single-institution series of patients diagnosed with Hürthle cell tumours.
• To analyze the clinical features, management, and outcomes of Hürthle cell adenoma and carcinoma.
• To identify factors influencing prognosis in Hürthle cell tumours.

Main Methods:

• Retrospective review of medical records from January 1982 to December 2002.
• Inclusion of 199 patients with Hürthle cell tumours (88 HCC, 111 HCA).
• Analysis of disease duration, tumour size, gender distribution, surgical procedures, and complications.

Main Results:

• Hürthle cell carcinoma (HCC) cases presented with significantly longer disease duration and larger tumour size (4.8 cm vs 3.8 cm) compared to Hürthle cell adenoma (HCA).
• A significant gender disparity was observed in HCT, with women outnumbering men 7:1 (p < 0.01).
• Hemithyroidectomy was common for HCA (80%), while total thyroidectomy was standard for HCC (87%). Temporary laryngeal nerve palsy and hypoparathyroidism occurred in 2.27% and 3.41% of HCC patients, respectively. Four HCC patients relapsed, and two died from the disease.

Conclusions:

• Hürthle cell carcinoma, when treated with radical total thyroidectomy, demonstrates a favorable prognosis.
• Early and accurate diagnosis and appropriate surgical intervention are key for managing Hürthle cell tumours.
• Further research into risk stratification and adjuvant therapies for aggressive HCC may be warranted.