Management of thyroid Hurthle cell neoplasms: a single centre experience and literature review

Aim. We report our experience on the management of Hurthle cell neoplasms (HCNs) of the thyroid and a review of the literature in order to describe the most relevant clinical, diagnostic, biologic and therapeutic aspects. Materials and Methods. We retrospectively reviewed the clinical records of 15 consecutive patients with HCN. The male/female ratio was 1:4 and the mean age was 53.8 years. Fourteen patients underwent total thyroidectomy and one patient lobectomy. Two patients were lost to follow up. The mean follow up time was 54 months. Results. Eleven Hurthle cell adenomas and 4 carcinomas were found. At the time of initial surgical evaluation 9 patients (60%) were symptomatic, with hyperthyroidism and dysphagia being the most frequent manifestations. Only in 6 (40%) cases the diagnosis was obtained by preoperative fine needle aspiration biopsy. Among patients with Hurthle cell adenoma and carcinoma the mean age was 51 and 62 years respectively and the mean lesion size 1.6 and 3.8 cm respectively. No cases of death or recurrence were registered. Conclusions. Clinical manifestations are similar to those for other differentiated thyroid neoplasms. Patients with Hurthle cell carcinoma presented a mean age and a mean tumor size greater than those with Hurthle cell adenoma. Our data suggest that adenomas have not a malignant potential; nevertheless surgical resection is necessary to obtain a precise evaluation of eventual infiltrative events. Surgical resection is also the treatment of choice for the treatment of carcinomas with total thyroidectomy representing the best surgical option.