Older Age and Larger Tumor Size Predict Malignancy in Hürthle Cell Neoplasms of the Thyroid

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• 作者：Yi Wei Zhang BS (1)
  David Yu Greenblatt MD ; MSPH (1)
  Daniel Repplinger BS (1)
  Anna Bargren BS (1)
  Joel T. Adler BA (1)
  Rebecca S. Sippel MD (1)
  Herbert Chen MD ; FACS (1)
  
• 关键词：Hürthle cell neoplasms ; Hürthle cell carcinoma ; Hürthle cell adenoma ; Malignant thyroid neoplasms ; Thyroid surgery ; Fine ; needle aspiration biopsy
• 刊名：Annals of Surgical Oncology
• 出版年：2008
• 出版时间：October 2008
• 年：2008
• 卷：15
• 期：10
• 页码：2842-2846
• 全文大小：194KB
• 参考文献：1. Chen H, Udelsman R. (2005) Hurthle cell adenoma, carcinoma. In: Clark OH, Duh QY (eds). / Textbook of endocrine surgery, 2nd edition. W. B. Saunders, Philadelphia PA, pp 123-
  2. Chen H, Nicol TL, Zeiger MA, et?al. Hurthle cell neoplasms of the thyroid: are there factors predictive of malignancy? / Ann Surg 1998;227:542- CrossRef
  3. Gosain AK, Clark OH. Hurthle cell neoplasms. Malignant potential. / Arch Surg 1984;119:515-
  4. Azadian A, Rosen IB, Walfish PG, et?al. Management considerations in Hurthle cell carcinoma. / Surgery 1995;118:711-. discussion 714- CrossRef
  5. Greenblatt DY, Woltman T, Harter J, et?al. Fine-needle aspiration optimizes surgical management in patients with thyroid cancer. / Ann Surg Oncol 2006;13:859-3 CrossRef
  6. Chen H, Nicol TL, Udelsman R. Follicular lesions of the thyroid. does frozen section evaluation alter operative management? / Ann Surg 1995;222:101- CrossRef
  7. McHenry CR, Sandoval BA. Management of follicular and hurthle cell neoplasms of the thyroid gland. / Surg Oncol Clin North Am 1998;7:893-10
  8. Elliott DD, Pitman MB, Bloom L, et?al. Fine-needle aspiration biopsy of hurthle cell lesions of the thyroid gland: a cytomorphologic study of 139 cases with statistical analysis. / Cancer 2006;108:102- CrossRef
  9. Rosen IB, Luk S, Katz I. Hurthle cell tumor behavior: dilemma and resolution. / Surgery 1985;98:777-3
  10. Arganini M, Behar R, Wu TC, et?al. Hurthle cell tumors: a twenty-five-year experience. / Surgery 1986;100:1108-5
  11. Carcangiu ML, Bianchi S, Savino D, et?al. Follicular Hurthle cell tumors of the thyroid gland. / Cancer 1991;68:1944-3 CrossRef
  12. McDonald MP, Sanders LE, Silverman ML, et?al. Hurthle cell carcinoma of the thyroid gland: prognostic factors and results of surgical treatment. / Surgery 1996;120:1000-. discussion 1004- CrossRef
  13. Besic N, Hocevar M, Zgajnar J, et?al. Aggressiveness of therapy and prognosis of patients with Hurthle cell papillary thyroid carcinoma. / Thyroid 2006;16:67-2 CrossRef
  14. Sanders LE, Silverman M. Follicular and Hurthle cell carcinoma: predicting outcome and directing therapy. / Surgery 1998;124:967-4
  15. Watson RG, Brennan MD, Goellner JR, et?al. Invasive Hurthle cell carcinoma of the thyroid: natural history and management. / Mayo Clin Proc 1984;59:851-
  16. Besic N, Vidergar-Kralj B, Frkovic-Grazio S, et?al. The role of radioactive iodine in the treatment of Hurthle cell carcinoma of the thyroid. / Thyroid 2003;13:577-4 CrossRef
  17. Callcut RA, Selvaggi SM, Mack E, et?al. The utility of frozen section evaluation for follicular thyroid lesions. / Ann Surg Oncol 2004;11:94- CrossRef
  18. Ron E, Modan B, Preston D, et?al. Thyroid neoplasia following low-dose radiation in childhood. / Radiat Res 1989;120:516-1 CrossRef
  19. Thompson NW, Dunn EL, Batsakis JG, et?al. Hurthle cell lesions of the thyroid gland. / Surg Gynecol Obstet 1974;139:555-0
  20. Johnson TL, Lloyd RV, Burney RE, et?al. Hurthle cell thyroid tumors an immunohistochemical study. / Cancer 1987;59:107-2 CrossRef
  21. Taneri F, Tekin E, Salman B, et?al. Huerthle cell neoplasms of the thyroid: predicting malignant potential. / Endocr Regul 2000;34:19-1
  22. Lopez-Penabad L, Chiu AC, Hoff AO, et?al. Prognostic factors in patients with Hurthle cell neoplasms of the thyroid. / Cancer 2003;97:1186-4 CrossRef
  23. Giorgadze T, Rossi ED, Fadda G, et?al. Does the fine-needle aspiration diagnosis of “Hurthle-cell neoplasm/follicular neoplasm with oncocytic features-denote increased risk of malignancy? / Diagn Cytopathol 2004;31:307-2 CrossRef
  24. Pisanu A, Sias L, Uccheddu A. Factors predicting malignancy of Hurthle cell tumors of the thyroid: influence on surgical treatment. / World J Surg 2004;28:761- CrossRef
  25. Melck A, Bugis S, Baliski C, et?al. Hemithyroidectomy: the preferred initial surgical approach for management of Hurthle cell neoplasm. / Am J Surg 2006;191:593- CrossRef
  26. Paunovic I, Krgovic K, Tatic S, et?al. Surgery for thyroid Hurthle cell tumours–a single institution experience. / Eur J Surg Oncol 2006;32:458-1 CrossRef
  27. Gauger PG, Reeve TS, Delbridge LW. Intraoperative decision making in follicular lesions of the thyroid: is tumor size important? / J Am Coll Surg 1999;189:253- CrossRef
  28. McHenry CR, Thomas SR, Slusarczyk SJ, et?al. Follicular or Hurthle cell neoplasm of the thyroid: can clinical factors be used to predict carcinoma and determine extent of thyroidectomy? / Surgery 1999;126:798-02. discussion 802-
  29. Sugino K, Ito K, Mimura T, et?al. Hurthle cell tumor of the thyroid: analysis of 188 cases. / World J Surg 2001;25:1160-
  30. Chao TC, Lin JD, Chen MF. Surgical treatment of Hurthle cell tumors of the thyroid. / World J Surg 2005;29:164- CrossRef
  31. Alaedeen DI, Khiyami A, McHenry CR. Fine-needle aspiration biopsy specimen with a predominance of Hurthle cells: a dilemma in the management of nodular thyroid disease. / Surgery 2005;138:650-. discussion 656- CrossRef
  32. Papotti M, Torchio B, Grassi L, et?al. Poorly differentiated oxyphilic (Hurthle cell) carcinomas of the thyroid. / Am J Surg Pathol 1996;20:686-4 CrossRef
  33. Erickson LA, Jin L, Goellner JR, et?al. Pathologic features, proliferative activity, and cyclin D1 expression in Hurthle cell neoplasms of the thyroid. / Mod Pathol 2000;13:186-2 CrossRef
  34. Hoos A, Stojadinovic A, Singh B, et?al. Clinical significance of molecular expression profiles of Hurthle cell tumors of the thyroid gland analyzed via tissue microarrays. / Am J Pathol 2002;160:175-3
  35. Finley DJ, Zhu B, Fahey TJ 3rd Molecular analysis of Hurthle cell neoplasms by gene profiling. / Surgery 2004;136:1160- CrossRef
  
• 作者单位：Yi Wei Zhang BS (1)
  David Yu Greenblatt MD, MSPH (1)
  Daniel Repplinger BS (1)
  Anna Bargren BS (1)
  Joel T. Adler BA (1)
  Rebecca S. Sippel MD (1)
  Herbert Chen MD, FACS (1)
  
  1. Section of Endocrine Surgery, Department of Surgery, University of Wisconsin, H4/750 Clinical Science Center, 600 Highland Avenue, Madison, WI, 53792, USA
  

文摘

Background Hürthle cell neoplasms (HCNs) are rare tumors of the thyroid gland. The definitive treatment for Hürthle cell carcinoma (HCC) is total thyroidectomy, while thyroid lobectomy is adequate for Hürthle cell adenoma (HCA). However, differentiating HCC from HCA either before or during surgery is a challenge. The purpose of this study was to identify factors that predict malignancy in patients with HCN. Methods Between May 1994 and January 2007, 1,199 patients underwent thyroid surgery at an academic medical center. Medical records of 55 consecutive patients who underwent thyroid resections for the preoperative diagnosis of HCN were reviewed. Results Of the 55 patients with HCN, 46 (84%) had adenomas and 9 (16%) had carcinomas. Patients with HCC were significantly older than those with HCA (66?±?6?years versus 53?±?2?years, P?=?0.01). Patients with carcinoma also had significantly larger thyroid nodules (4.5?±?0.7?cm versus 2.5?±?0.2?cm, P?<?0.001). All HCNs less than 2?cm in diameter were benign. The malignancy rate increased with nodule size: 18% of nodules measuring 2-?cm, and 44% of those larger than 4?cm were HCC. One patient with HCC had recurrence of the disease, but there were no disease-related deaths. Conclusion Advanced patient age and larger nodule size are two important factors that predict malignancy in patients with HCN. In patients with these and other known risk factors for HCC, total thyroidectomy should be considered.