Prognostic Indications for Hürthle Cell Cancer

Abstract

Hürthle cell carcinoma (HCC) has been reported to have variable clinical behavior. The objective of this study was to determine the important prognostic factors in patients with HCC. It was a retrospective investigation of 33 patients with HCC treated in our institution from 1976 to 2002. The average age of our 33 patients with HCC was 55.2 years (range 20-82 years; 23 women, 10 men). Fifteen patients (45.5%) presented with a T2 tumor, 7 (21.2%) with a T3 tumor, and 8 (24.2%) with a T4 tumor; the tumor stage was unknown in three patients. Coexisting papillary carcinoma occurred in six patients (18%), 9% of whom presented with metastatic disease. Twelve patients (36.4%) had metastases, four of whom (12.2%) had persistent HCC, and 8 (24.2%) developed recurrent HCC (range 1-9 years). Eight of these twelve patients (66.7%) died from the HCC. The average follow-up time was 5.5 years (range 1-16 years). Altogether, 3 of 23 women and 5 of 10 men died from their HCC ( p < 0.05). Of the 22 patients with T2-T3 tumors, 5 (22.7%) developed metastases and 1 patient died; 5 of 8 patients (62.5%) with T4 tumors developed metastases and died ( p < 0.01). Patients who were treated by less than total thyroidectomy had a worse prognosis by univariate analysis ( p < 0.01) but not by multivariate analysis. Survival time for patients with persistent disease was shorter than for those with recurrent disease ( p < 0.05). Multivariate analysis, however, revealed no difference for extent of operation or those with persistent and recurrent disease. The cause-specific survivals were 74% and 49% at 5 and 10 years, respectively. Disease-free survivals were 65.0% and 40.5% at 5 and 10 years, respectively. Our findings show that gender and stage of disease influence the prognosis of patients with HCC.

A Unique Case of Bilateral Hürthle Cell Adenoma in an Adolescent

“…By definition, HCN are composed of 75% or more HC and are subclassified as benign (HCA, based on complete fibrous encapsulation and compression of the thyroid parenchyma around the adenoma) or malignant (HCC, based on the presence of capsular invasion, vascular invasion, extrathyroidal tissue invasion, nodal involvement, or distant metastasis) [13,14,15]. HC may also be present in a variety of nonneoplastic conditions such as Hashimoto's thyroiditis, nodular goiter, long-standing Graves' disease, irradiated thyroids, aging thyroids, thyroglossal duct cyst, and other thyroid neoplasms [13,16].…”

Successful Treatment of Hurthle Cell Thyroid Carcinoma with Lung and Liver Metastasis Using Docetaxel and Cisplatin

“…The clinical role of radioactive iodine treatment is largely limited to post-surgical ablation. But many patients have actually received the treatment for metastatic disease, recurrent lesions or small residuals after surgery, and have had a satisfactory effect (8,12), and it has been reported that although radioactive iodine treatment has no survival benefit, it shows better outcomes for adjuvant ablation therapy (13). Hormone withdrawal and recombinant human TSH stimulation have been used with variable success rates.…”

“…The peak age of incidence is 50 -60 years (3,6,7). About 20 -30% of the cases had metastatic extension at the time of initial treatment (3,8).…”

Fatores preditores de malignidade em neoplasias de células de Hurthle

“…A neoplasia de célula de Hurthle é infreqüente em crianças e adolescentes, ocorrendo geralmente entre a 5 a e 6 a décadas de vida 15 . Lopez-Penabad et al também observaram uma clara diferença de idade em sua série, entre os adenomas e carcinomas, sendo os últimos nove anos mais velhos 4 .…”