Potential utility of sentinel node biopsy in the original surgical assessment of Hurthle cell tumors of the thyroid: 23-year institutional review of Hurthle cell neoplasms

Background and Objectives: Great difficulty still exists in determining the potential malignancy of Hurthle cell tumors of the thyroid gland. Indicati ons for the extent of resection vary greatly in the reported literature. Se ntinel node biopsy has shown its usefulness as a prognostic indicator in bo th melanoma and breast cancer. The feasibility of using it as an integral p art of Hiirthle cell tumor surgery was investigated and is discussed. Methods: Eleven patients diagnosed with Hiirthle cell tumors between the ye ars of 1975 and 1998 were reviewed. The last three patients had sentinel no de biopsy with isosulfan blue dye as an integral part of their procedure. Results: Sentinel node biopsy was accomplished without difficulty or compli cation in our last three patients. Two patients were considered to be benig n by frozen section and final pathology. Their sentinel nodes were benign. One patient was considered malignant on both frozen and final pathology. Hi s sentinel nodes as well as central node dissection revealed no lymphatic s pread. Conclusions: Malignancy of Hiirthle cell tumors of the thyroid is difficult to determine even on final pathological examination. The addition of nodal sampling may add valuable prognostic information. Sentinel node biopsy wit h isosulfan blue dye, although not previously reported for these tumors, ap pears to be a logical next step in the evolution of surgical management. (C ) 1999 Wiley-Liss, Inc.