Predictive factors for malignancy in Hürthle-cell thyroid neoplasia. Effect of surgical treatment

The aim of this study has been to evaluate factors predicting malignancy in patients with Hürthle cell neoplasms. Medical records from 36 patients who underwent thyroidectomy for Hürthle cell neoplasms between January 1998 and December 2002 were analyzed. Of the 36 patients, 19 had carcinomas and 17 had adenomas, resulting in a 52.7% prevalence of malignancy. Both fine-needle aspiration and intraoperative frozen section had low sensitivities in cancer detection (22.2% and 33.3% respectively). Hürthle cell carcinomas were significantly larger than adenomas (30.3 mm +/- 3.9 vs 17.6 mm +/- 2.3, P = 0.012), however 42% of carcinomas had a diameter between 10 and 20 mm. Size of Hürthle cell tumors is predictive of malignancy, but it is not the only factor to make surgical decision effective. Because of these uncertainties, authors believe that total thyroidectomy is the treatment of choice of all Hürthle cell neoplasms.