Hurthle cell tumor of the thyroid: Analysis of 188 cases

We reviewed 188 cases of Hurthle cell tumor of the thyroid (HCT) between 19 82 and 1996. There were 160 women and 28 men with a mean age of 51.8 years. Thirty-one of the patients had cancer, and the others had adenoma. Age, si ze of the primary tumor, and preoperative thyroglobulin level were not sign ificantly different in the cancer and adenoma patients. The gender ratio, h owever, was significantly different (p < 0.05). Recurrent HCT was observed in three patients with adenoma. Two patients had subcutaneous recurrence (s uspected implantation), and the other patient had recurrence in the residua l thyroid gland. All patients with recurrence of adenoma underwent partial lobectomy at the initial operation. Three cancer patients had recurrent dis ease. Locoregional recurrence was observed in one patient and distant metas tases in two patients (lung in one, lung and bone in one). One of the patie nts with distant metastasis died from the disease, and the other is alive w ith the disease. Tumor implantation was observed in patients with adenoma, so intraoperative handling of the tumor requires care. It also means that t his tumor, even though benign, is aggressive in terms of proliferative acti vity. All patients with Hurthle cell tumor should be treated by total lobec tomy at least. The outcome of the cancer patients was not as poor as in pre vious reports.