Hurthle cell tumor.

Hurthle cell tumor is rare type of thyroid tumor. There are few recent reports about the proper management of patients with Hurthle cell tumors. We reviewed our patients from 1988 to 1994 with pathological proof of Hurthle cell tumor. There were 26 patients in total: four cases were Hurthle cell carcinoma and the other twenty-two cases were Hurthle cell adenoma. Only one patient with Hurthle cell carcinoma is male and all the others were female. All of them except one with metastatic bone lesion presented with painless neck mass. The mean size of the tumor in carcinoma patients is 3.7 cm and in adenoma patient 2.3 cm. Five patients had multiple adenoma. The mean age of carcinoma patients is 49.5 years and the adenoma patients 45.1 years. No patient had a history of exposure to low dose radiation. The only carcinoma patient with bone metastases has positive radioactive iodine uptake. Lobectomy is advised for adenoma patients and total thyroidectomy for carcinoma patients. There were no operative complications in these patients. No local recurrence or metastases occurred in those patients with Hurthle cell adenoma. One patient with adenoma died of poorly differentiated thyroid carcinoma. Our conclusion is that most Hurthle cell tumors have a gender preponderance toward female. Carcinoma patients seem to be older than adenoma patients and tumor size is larger, but no discriminative point can be found. Pathological diagnosis with capsular or vascular invasion is accurate for differentiating benign from malignant tumors. No benign adenoma tumor had recurrence or metastases during follow up. Lobectomy is adequate for adenoma patients and total thyroidectomy for carcinoma patients. All of these patients need long term follow-up.