Endocrine Abstracts

Introduction: Oncocytic tumors of the thyroid gland are rare (3-10 %). They are usually benign. Hurthle cell (oncocytic) carcinoma is uncommon: 5 % of thyroid carcinomas. Our aim is to describe the diagnostic, therapeutic and prognostic features of Hurthle cell carcinomas.

Materials and Methods: We report 3 cases of Hurthle cell carcinoma treated in our department between 1988 and 2021.

Results: Our series included 35 cases of oncocytic tumors. Hurthle cell carcinoma was noted in 3 cases. The mean age was 50 years [35 – 67 years]. All patients consulted for anterior neck mass with compressive symptoms. Ultrasonography showed a unique thyroid nodule in all cases: EUTIRADS 4 in 2 cases and EUTIRADS 5 in one case. The mean size was 4,1 cm. Thyroid-stimulating hormone (TSH) serum level was normal in all cases. Fine needle aspiration (FNA) result was “nondiagnostic” in all cases. Surgical treatment consisted of a thyroid lobectomy in all cases. The intraoperative examination was benign in all cases. The postoperative histological examination confirmed the diagnosis of Hurthle cell carcinoma; it was associated with papillary microcarcinoma in 1 case. All patients underwent totalization of the thyroidectomy with unilateral central neck dissection. No lymph node or distant metastases were noted. A complement by radioactive iodine was indicated in all cases. The evolution was favorable in all cases after a mean follow-up of 6.5 years.

Conclusion: The benignity or malignancy of oncocytic tumors cannot be confirmed by cytology. The diagnosis of malignant oncocytic tumor is usually made on postoperative histological exam. Surgery is the mainstay of treatment of Hurthle cell carcinomas. Responses to treatment with radioactive iodine are much lower when compared to other types of thyroid carcinomas. Hurthle cell carcinomas are more aggressive.