Hurthle cell carcinoma of the thyroid. A 41 years experience

Background: Hurthle cells call be found in non malignant thyroidal diseases such as Basedow Graves and Hashimoto diseases. When Hurthle cells comprise more the 75% of cellularity, they become a neoplasm. There are malignant v ariants of these neoplasms, constituted by follicular and papillary, Hurthl e cell carcinomas. Aim: To report a 41 years experience with Hurthle cell c arcinomas of the thyroid. Material and methods: A retrospective review of a ll patients operated for a thyroid carcinoma and selection of those patient s with Hurthle cell carcinoma of the thyroid. Results: Twenty two patients (21 female, mean age 48 years old) with Hurthle cell carcinoma of the thyro id were selected. Total or near total thyroidectomy was the treatment of ch oice in 20 and 19 received I-131. Metastatic involvement of cervical lymph nodes was found in five patients and they underwent modified cervical lymph node dissection. During follow up, only one patient died of the disease. W e did not find higher incidences of local recurrences, distant metastases o r mortality rates, compared to well differentiated thyroid carcinomas. Conc lusions: Hurthle cell carcinomas of the thyroid and well differentiated thy roid carcinomas have similar biological behaviors. Their treatment should b e similar, including total or near total thyroidectomy plus modified cervic al node dissection when there is lymph node involvement. Radioactive iodine therapy and suppressive levothyroxin therapy should follow.