Title: Hurthle Cell Tumours of the Thyroid- Personal Experience with Review of the Literature

Authors: Dr Sreeramulu PN, Dr Nemalidinne Keerthi, Dr Srinivasan D

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i7.217

Abstract

Hurthle cell carcinoma represents about 4-5% 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 very rarely behaves like Hurthle cell carcinoma. Aim of this present study is to evaluate previously reported data and experience on the clinical and pathological features of patients affected by Hurthle cell tumour that may predict disease progression and death. In the literature, the factors potentially associated with decreased survival are: age, disease stage, tumour size, extra-glandular invasion, lymph node invasion, distant metastases, surgery, radioiodine treatment. From 2005 to 2016, we 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 the 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 stage showed 9 patients with stage I, 5 stage II, 4 stage III and one stage IVa. All invasive carcinomas underwent I131therapy (91-585 mCi). One Hurthle cell carcinoma patient received external beam radiation. The mean follow-up period was 62 months (range 6-324). Relapse was not observed in the patients with adenoma. Only 1 Hurthle cell carcinoma patient showed distant lung metastases at 60 months’ follow-up. In the 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.Patients with Hurthle cell adenoma did not showed a relapse or death caused by the tumour.

Keywords: Thyroid • Hurthle cell adenoma • Hurthle cell carcinoma.

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Corresponding Author

Dr Nemalidinne Keerthi

Junior Resident, Department of General Surgery

Sri Devaraj Urs Medical College and Research Centre, Tamaka, Kolar