Chen H Y, Benjamin L B, Chen M F
Department of General Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC.
Int Surg. 1996 Apr-Jun;81(2):168-70.
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.
许特耳细胞肿瘤是一种罕见的甲状腺肿瘤。关于许特耳细胞肿瘤患者的恰当治疗，近期报道较少。我们回顾了1988年至1994年经病理证实为许特耳细胞肿瘤的患者。总共有26例患者：4例为许特耳细胞癌，另外22例为许特耳细胞腺瘤。只有1例许特耳细胞癌患者为男性，其余均为女性。除1例有骨转移病变的患者外，所有患者均表现为无痛性颈部肿块。癌患者肿瘤的平均大小为3.7厘米，腺瘤患者为2.3厘米。5例患者有多发腺瘤。癌患者的平均年龄为49.5岁，腺瘤患者为45.1岁。所有患者均无低剂量辐射暴露史。唯一有骨转移的癌患者放射性碘摄取呈阳性。建议腺瘤患者行甲状腺叶切除术，癌患者行甲状腺全切除术。这些患者均无手术并发症。许特耳细胞腺瘤患者未发生局部复发或转移。1例腺瘤患者死于低分化甲状腺癌。我们的结论是，大多数许特耳细胞肿瘤在性别上以女性居多。癌患者似乎比腺瘤患者年龄更大，肿瘤尺寸也更大，但未发现有鉴别意义的点。通过包膜或血管侵犯进行病理诊断对于区分良性和恶性肿瘤是准确的。在随访期间，良性腺瘤未发生复发或转移。腺瘤患者行甲状腺叶切除术即可，癌患者行甲状腺全切除术。所有这些患者都需要长期随访。
