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Management considerations in Hürthle cell carcinoma
A Azadian1, I B Rosen, P G Walfish
1Department of Surgery, Mount Sinai Hospital, University of Toronto, Ontario, Canada.
Surgery
|October 1, 1995
Summary
Hürthle cell tumors present diagnostic challenges. This study found 18% cancer mortality, with larger tumors and capsular invasion indicating adverse outcomes for these thyroid neoplasms.
Area of Science:
- Endocrinology
- Surgical Pathology
- Oncology
Background:
- Hürthle cell tumors of the thyroid present diagnostic and management difficulties.
- Accurate diagnosis and treatment are crucial for patient outcomes.
Purpose of the Study:
- To review the clinical features and outcomes of patients diagnosed with Hürthle cell tumors post-thyroidectomy.
- To identify factors associated with adverse outcomes in Hürthle cell tumors.
Main Methods:
- Retrospective review of 47 patients undergoing thyroidectomy for presumptive Hürthle cell tumors (1984-1993).
- Surgical pathologic findings were analyzed.
- Clinical features and outcomes were reviewed for the neoplastic group.
Main Results:
- Of 16 tumors, 11 (69%) were malignant. The cancer mortality rate was 18%.
- Adverse outcome factors included tumor size >4 cm, female sex with age >60, and complete capsular invasion.
- Nonneoplastic Hürthle cell nodules were found in 31 patients.
Conclusions:
- Fine-needle aspiration biopsy of Hürthle cell lesions warrants surgical intervention, excluding Hashimoto's thyroiditis.
- Total thyroidectomy, jugular node sampling, and adjuvant radioiodine are recommended for Hürthle cell neoplasms and cancer.
- Stringent histologic interpretation is vital for understanding Hürthle cell tumor behavior and incidence.