Carcinoma de células de Hurthle del tiroides: experiencia en 41 años / Hurthle cell carcinoma of the thyroid: a 41 years experience

RESUMO

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