ABSTRACT
Background: HYrthle cells can be found in non malignant thyroidal diseases such as Basedow Graves and Hashimoto diseases. When HYrthle cells comprise more the 75 percent of cellularity, they become a neoplasm. There are malignant variants of these neoplasms, constituted by follicular and papillary HYrthle cell carcinomas. Aim: To report a 41 years experience with HYrthle cell carcinomas of the thyroid. Material and methods: A retrospective review of all patients operated for a thyroid carcinoma and selection of those patients with HYrthle cell carcinoma of the thyroid. Results: Twenty two patients (21 female, mean age 48 years old) with HYrthle cell carcinoma of the thyroid were selected. Total or near total thyroidectomy was the treatment of choice in 20 and 19 received 131I. Metastatic involvement of cervical lymph nodes was found in five patients and they underwent modified cervical lymph node dissection. During follow up, only one patient died of the disease. We did not find higher incidences of local recurrences, distant metastases or mortality rates, compared to well differentiated thyroid carcinomas. Conclusions: HYrthle cell carcinomas of the thyroid and well differentiated thyroid carcinomas have similar biological behaviors. Their treatment should be similar, including total or near total thyroidectomy plus modified cervical node dissection when there is lymph node involvement. Radioactive iodine therapy and suppressive levothyroxin therapy should follow
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Thyroid Neoplasms/surgery , Adenoma, Oxyphilic/surgery , Thyroidectomy , Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/pathology , Goiter , Adenoma, Oxyphilic/diagnosis , Adenoma, Oxyphilic/pathology , Iodine Radioisotopes/therapeutic useABSTRACT
We report 5 cases of insular carcinoma of the thyroid. Most patients were females (80 percent) with an age range of 28 to 75 years. Treatment consisted of total or near total thyroidectomy plus modified cervical lymph node dissection in cases with lymph node metastasis. This was followed by radioiodine therapy and external radiation therapy in patients with residual disease. None of the patients had distant metastasis. However, three patients with involvement of the perithyroid soft tissue died within 4 years of the diagnosis. The other two patients are alive without evidence of disease. This type of thyroid carcinoma has an aggresive clinical course with frequent extension to the adjacent soft tissue associated to poor outcome
Subject(s)
Humans , Female , Male , Adult , Middle Aged , Thyroid Neoplasms/diagnosis , Carcinoma , Thyroidectomy , Thyroid Neoplasms/surgery , Thyroid Neoplasms/pathology , Thyroid Neoplasms/radiotherapy , Follow-Up Studies , Iodine Radioisotopes/therapeutic use , Radioisotope TeletherapyABSTRACT
Fine needle aspiration biopsy (FNAB) is the most usuful preoperative work up method for patients with nodular goiter. We analyze 173 patients that underwent FNAB and were subsequently operated. The sample obtained with FNAB was processed both for cytological and histological study, using methods developed at the hospital. The preoperative diagnosis reached was compared with that obtained with the surgical piece. Results showed that the the histological analysis of the FNAB sample improved the sensitivity of the method, when compared with the cytological study, from 68,5 percent to 87.8 percent (p<0,035) without modifying specificity (100 percent for both methods). It is concluded that FNAB with histological study of the sample has a high diagnostic yield and is exempt of complications