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World Journal of Surgery

, Volume 29, Issue 2, pp 164–168 | Cite as

Surgical Treatment of Hurthle Cell Tumors of the Thyroid

  • Tzu-Chieh Chao
  • Jen-Der Lin
  • Miin-Fu Chen
Article

Abstract

Hurthle cell tumors are relatively rare thyroid tumors and their management and prognosis is controversial. We retrospectively review 135 Hurthle cell adenomas and 28 Hurthle cell carcinomas of the thyroid surgically treated at our institute. No significant difference was found between the adenoma and carcinoma groups in patient age, gender, and tumor size. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of fine-needle aspiration cytology (FNAC) in detecting malignancy were 87.5%, 19.3%, 31.2%, 18.6%, and 88.0%. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of frozen section in detecting malignancy of the thyroid gland were 40.0%, 100.0%, 92.9%, 100.0%, and 92.0%. Most of the adenomas were treated with procedures no less invasive than lobectomy/isthmusectomy. Meanwhile, most of the carcinoma patients underwent total thyroidectomy. Operative morbidity occurred in six patients (3.8%), including transient recurrent laryngeal nerve palsy in three patients, damage to the external branch of the superior laryngeal nerve in two patients, and transient hypocalcemia in one patient. No recurrence of Hurthle cell adenomas was noted. Five adenoma patients died of causes unrelated to their Hurthle cell tumors, but no carcinoma patients died during the follow-up period. In conclusion, clinical factors and FNAC are not helpful in the differentiation between adenoma and carcinoma. Unilateral Hurthle cell adenoma can be treated by lobectomy/isthmusectomy, and Hurthle cell carcinoma can be treated by total thyroidectomy with minimal operative morbidity.

Keywords

Adenoma Total Thyroidectomy Multinodular Goiter Subtotal Thyroidectomy Permanent Section 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

This work was supported in part by a grant (Contract No. BMRP 072) from Chang Gung Memorial Hospital, Taoyuan, Taiwan.

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Copyright information

© Société Internationale de Chirurgie 2005

Authors and Affiliations

  1. 1.Division of General Surgery, Department of SurgeryChang Gung University College of Medicine, and Chang Gung Memorial Hospital at LinkouKweishanTaiwan
  2. 2.Division of Metabolism and Endocrinology, Department of Internal MedicineChang Gung University College of Medicine, and Chang Gung Memorial HospitalKweishan, TaoyuanTaiwan

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