title: Hurthle cell tumours of the thyroid. Personal experience and review of the literature.
abstract: Hurthle cell carcinoma represents about 5% of differentiated thyroid carcinomas. The prognosis of the malignant type of the tumour is still under debate as some Authors have reported that Hurthle cell adenoma occasionally behaves like Hurthle cell carcinoma. Aim of the present study was to evaluate previously reported data and personal experience on the clinical and pathological features of patients affected by Hurthle cell tumour that may predict disease progression and death. In the literature, factors potentially associated with decreased survival were identified and include: age, disease stage, tumour size, extra-glandular invasion, lymph node disease, distant metastases, extensive surgery, radioiodine treatment. From 1992 to 2003, the Authors identified 28 patients affected by Hurthle cell tumour, 9 with Hurthle cell adenoma and 19 with Hurthle cell carcinoma. Of these, 22 were females and 6 males. Mean age of patients affected by adenoma was 49.7 years (range 30-72) vs. 49.3 years (range 15-72) in Hurthle cell carcinoma patients. In all patients, total thyroidectomy was performed. At histology, 9 adenomas, 5 "minimally invasive" and 14 invasive carcinomas were found. Post-operatively, in Hurthle cell carcinoma patients, TNM staging showed 9 patients with stage I, 5 stage II, 4 stage III and one stage IVa (UICC, 2002). All invasive carcinomas underwent (131)I therapy (91-585 mCi). One Hurthle cell carcinoma patient received external beam radiotherapy. The mean follow-up period was 62 months (range 6-324). Relapse was not observed in any of the cases with adenoma. Only one Hurthle cell carcinoma patient showed distant lung metastases at 60 months' follow-up. In conclusion, Hurthle cell carcinoma was not found to present a more aggressive behaviour than follicular carcinoma, when risk factors, including extent of tumour invasion, were taken into account. None of the patients with Hurthle cell adenoma showed a relapse or death caused by the tumour.
authors.affiliation: Endocrinology Unit, Regina Elena National Cancer Institute, Rome.
authors.forename: A
authors.initials: A
authors.lastname: Barnabei
authors.forename: E
authors.initials: E
authors.lastname: Ferretti
authors.forename: R
authors.initials: R
authors.lastname: Baldelli
authors.forename: A
authors.initials: A
authors.lastname: Procaccini
authors.forename: G
authors.initials: G
authors.lastname: Spriano
authors.forename: M
authors.initials: M
authors.lastname: Appetecchia
mesh_terms: D018249:Adenoma, Oxyphilic; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000175:diagnosis
references.citation: Diagn Cytopathol. 2004 Nov;31(5):307-12
references.pmid: 15468114
references.citation: Surgery. 1998 Dec;124(6):967-74
references.pmid: 9854570
references.citation: Laryngoscope. 2002 Dec;112(12):2178-80
references.pmid: 12461336
references.citation: World J Surg. 1988 Aug;12(4):488-95
references.pmid: 3048000
references.citation: J Clin Oncol. 2001 May 15;19(10):2616-25
references.pmid: 11352953
references.citation: ORL J Otorhinolaryngol Relat Spec. 2001 Jul-Aug;63(4):243-9
references.pmid: 11408821
references.citation: Arch Otolaryngol Head Neck Surg. 2003 Feb;129(2):207-10
references.pmid: 12578450
references.citation: Ann Surg Oncol. 2008 Oct;15(10):2842-6
references.pmid: 18665423
references.citation: J Clin Endocrinol Metab. 1995 Oct;80(10):2946-53
references.pmid: 7559879
references.citation: World J Surg. 2001 Sep;25(9):1160-3
references.pmid: 11571953
references.citation: Endocrinol Metab Clin North Am. 1995 Dec;24(4):761-801
references.pmid: 8608779
references.citation: Am J Surg Pathol. 2001 Jul;25(7):911-7
references.pmid: 11420462
references.citation: Semin Diagn Pathol. 1985 May;2(2):101-22
references.pmid: 3843689
references.citation: Cancer. 1998 Dec 15;83(12):2638-48
references.pmid: 9874472
references.citation: J Clin Endocrinol Metab. 1985 Oct;61(4):773-8
references.pmid: 2993348
references.citation: Surgery. 1996 Dec;120(6):1000-4; discussion 1004-5
references.pmid: 8957486
references.citation: Am J Pathol. 2002 May;160(5):1857-65
references.pmid: 12000737
references.citation: Surg Gynecol Obstet. 1974 Oct;139(4):555-60
references.pmid: 4479589
references.citation: Virchows Arch. 2000 Aug;437(2):107-15
references.pmid: 10993269
references.citation: Mayo Clin Proc. 1984 Dec;59(12):851-5
references.pmid: 6503367
references.citation: Surg Oncol Clin N Am. 1998 Oct;7(4):893-910
references.pmid: 9735140
references.citation: Otolaryngol Head Neck Surg. 2009 May;140(5):715-9
references.pmid: 19393417
references.citation: Cancer. 1989 Mar 1;63(5):908-11
references.pmid: 2914297
references.citation: Cancer. 2003 Mar 1;97(5):1186-94
references.pmid: 12599224
references.citation: Surgery. 1995 Dec;118(6):1131-6; discussion 1136-8
references.pmid: 7491533
references.citation: Diagn Cytopathol. 2009 Aug;37(8):600-6
references.pmid: 19526577
references.citation: Eur J Surg Oncol. 2009 Mar;35(3):230-4
references.pmid: 18722077
references.citation: Surg Clin North Am. 1995 Jun;75(3):395-403
references.pmid: 7747248
references.citation: Arch Surg. 1988 Jul;123(7):849-54
references.pmid: 3382350
references.citation: Curr Treat Options Oncol. 2001 Aug;2(4):331-5
references.pmid: 12057113
references.citation: Appl Immunohistochem Mol Morphol. 2004 Dec;12(4):329-37
references.pmid: 15536332
references.citation: Endocr J. 2004 Jun;51(3):265-77
references.pmid: 15256771
references.citation: Acta Pathol Jpn. 1992 May;42(5):305-15
references.pmid: 1636432
references.citation: Cancer. 1991 Nov 1;68(9):1944-53
references.pmid: 1913544
references.citation: Surgery. 2003 Dec;134(6):881-9; discussion 889
references.pmid: 14668719
references.citation: Cancer. 1986 Apr 15;57(8):1613-7
references.pmid: 3948132
references.citation: Folia Histochem Cytobiol. 2004;42(3):165-8
references.pmid: 15493577
references.citation: Surg Gynecol Obstet. 1985 May;160(5):409-13
references.pmid: 3992444
references.citation: World J Surg. 2000 Aug;24(8):898-906
references.pmid: 10865033
references.citation: Mayo Clin Proc. 1991 Jan;66(1):11-22
references.pmid: 1988751
references.citation: Ann Surg. 1998 Apr;227(4):542-6
references.pmid: 9563543