Endocrine Abstracts

Background: Hürthle cell carcinoma or oncocytic carcinoma of the thyroid gland is an unusual and relatively rare type of differentiated thyroid cancer. It accounts for only about 3–10% of all differentiated thyroid cancers. Its diagnosis as well as its management remains a subject of controversies.

Aim: The purpose of this paper is to describe clinical presentation as well as the difficulties we can affront within the diagnosis and the treatment of this entity.

Method: We report a case of hurtle cell carcinoma of thyroid gland operated and followed in ENT department of Farhat Hached hospital.

Observation: A 54 year old male with no medical history who undergone thyroidectomy in 2012 for enormous goiter which size have been increasing for 3 years. The anatomopathological examination objectivated oncocytic adenoma on multinodular goiter. the patient was lost to follow up. He presented 5 years later with swelling of the right base of the neck, associated to multiple firm swollen cervical lymph nodes, dyspnea and hemoptysis. A cervico thoracic ct scan showed glottic and supra glottic laryngeal tumor with locoregional extension to thyroid and lungs. An histologic re evaluation redressed the diagnosis to concocytic variant of follicular thyroid carcinoma. The patient has undergone a tumorectomy with an histological examination confirming the diagnosis. A radioiodine therapy and hormone suppressive treatment were completed. Unfortunately the patient was lost to follow up again.

Conclusion: Oncocytic carcinoma is rare with metastatic potential. There are no standard guidelines for its optimal management as few institutions have extensive experience with Hürthle cell neoplasms.