Antecedentes: dada su baja incidencia, diferencia citológica con el CFT, mayor diseminación linfática, escasa avidez por el I131 y menor sobrevida que el CFT, el carcinoma de células de Hürthle (CCH) es una entidad polémica y controvertida. Objetivo: informar la experiencia de dos centros oncológicos en el manejo de pacientes con diagnós-tico histológico de CCH. Material y métodos: el tratamiento quirúrgico preferido fue tiroidectomía total en 89,4%; en el 42% se agregó linfadenectomía laterocervical, II-IV en 6 casos y II-V con resección del músculo esternocleidomastoideo, vena yugular interna y nervio recurrente en 2. En 1 de estos se realizó resección de pared traqueal y traqueostomía. La congelación intraquirúrgica confirmó el diagnóstico en el 23%. El 31,5% de los pacientes no recibió tratamiento ablativo con yodo radiactivo. Resultados: tres pacientes fueron reintervenidos por recurrencias locorregionales. Dos evolucionaron con metástasis (mts) a distancia. En 3 se efectuó radioterapia externa ante enfermedad irresecable y 1 recibió inhibidores de tirosina quinasa. Conclusiones: el manejo de los pacientes con CCH, por su baja frecuencia y falta de evidencia de alta calidad, continúa presentando aspectos controvertidos. Se requieren estudios clínicos multicéntricos que incluyan mayor número de pacientes y prolongado tiempo de seguimiento para evaluar el impacto de las diferentes terapéuticas, así como profundizar en el conocimiento de la biología molecular de esta patología. RESUMEN ABSTRACTBackground: in view of its low incidence, cytological difference with follicular cells carcinoma (FCC), higher lymphatic spread, little 131I avidity and less specific survival than FCC, Hürthle Cells Carcinoma (HCC) is a polemic and controversial issue. Objective: to report experience of two oncologic Hospitals in the management of patients with histologic diagnosis of CCH. Material and methods: treatment of choice was total thyroidectomy in 89.4%. In 42% lateral neck dissection was done, II-IV in 6 patients and II-V in 2 patients with resection esternocleidomatoid muscle, internal yugular vein and recurrent nerve. In 1 of these, resection of tracheal wall and tracheostomy was done. Intraoperative frozen sections confirmed diagnosis in 23%. 31.5% did not received therapeutic ablative dosis of I 131. Results: 3 patients were surgically treated for local regional disease. 2 of them developed distant metastases. 3 received radiotherapy and 1 tirosin kinase inhibitors. Conclusions: given its low incidence and absence of high quality evidence, management of HCC is controversial. Other multicentric trials with more patients and follow up are required for evaluation of different therapies, as well as better study about molecular biology of this pathology.
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