[Hürthle cell neoplasms: diagnostic and therapeutic evaluations]

Hürthle neoplasms have a low incidence, moreover diagnosis and clinical course are still unclear. As for follicular neoplasms the differential diagnosis between adenoma and cancer is possible only by the means of definitive histologic examination (capsule's infiltration, angioinvasiviness). The Authors analyze their experience about the treatment of 15 patients observed during 1986 and 1990 and work out a review of the literature. Hürthle neoplasms are similar to follicular neoplasms for many aspects: diagnosis based on the definitive histology, metastases via blood route, need for long-term follow up. Moreover they are considered as a unique pathological entity, biologically more aggressive than follicular neoplasms and the patients are considered as a "class at high risk". Total lobectomy and isthmectomy is the treatment of choice because an accurate diagnostic evaluation is impossible before surgery. In case of cancer a total thyroidectomy associated with lymphadenectomy reduces the incidence of local relapse. Long term survival is not influenced by surgical treatment. Independent prognostic variables are the capsule's infiltration and the growth's pattern only.