Management considerations in Hürthle cell carcinoma.
Management considerations in Hürthle cell carcinoma.
复制标题
Hürthle 细胞癌的治疗注意事项。
DOI：
10.1016/s0039-6060(05)80039-x
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发表时间：
1995
期刊：
影响因子：
3.8
通讯作者：
S. Asa
中科院分区：
文献类型：
--
作者：
Abbas Azadian;I. Rosen;P. Walfish;S. Asa
背景Hürthle细胞瘤仍是诊断和治疗的难点。方法1984~1993年共收治47例甲状腺肿瘤患者，术后确诊为Hürthle细胞瘤。复习手术病理所见。结果31例患者均为非肿瘤性Hürthle细胞结节。在16个肿瘤中有11个(69%)是恶性肿瘤，影响到11名女性和5名男性，年龄从22岁到86岁不等。两名患者死于癌症，死亡率为18%；一名患者带病存活。操作并不复杂。影响预后的因素包括肿瘤大小>4 cm、女性>60岁、手术病理证实包膜完全性侵犯。结论只要排除桥本氏甲状腺炎，细针吸取细胞学检查提示Hürthle细胞病变可作为手术指征。我们的外科实践(I.B.R.)是对所有Hürthle细胞肿瘤进行全甲状腺切除，以及颈静脉结节取样和辅助放射碘治疗癌症。严格的组织学解释是可能的，也是必要的，以真正评价Hürthle细胞肿瘤的发病率和行为。癌症死亡率为18%，高于我们高分化甲状腺癌组的死亡率(2%)。
BackgroundHürthle cell tumors still pose issues concerning diagnosis and management.MethodsFrom 1984 to 1993 forty-seven patients underwent thyroidectomy, and they were diagnosed after operation to have presumptive Hürthle cell tumors. The surgical pathologic findings were reviewed. In the neoplastic group the chart was reviewed for clinical features and outcome.ResultsThirty-one patients had nonneoplastic Hürthle cell nodules. Eleven (69%) of the 16 tumors were malignant affecting 11 women and five men ranging in age from 22 to 86 years. Two patients died of cancer for a 18% rate; one patient is alive with disease. Operations were uncomplicated. Factors for adverse outcome include tumor size greater than 4 cm, woman older than 60 years of age, and complete capsular invasion on surgical pathologic findings.ConclusionsFine-needle aspiration biopsy demonstration of Hürthle cell lesion is an indication for operation, providing Hashimoto's thyroiditis is excluded. Our surgical practice (I.B.R.) is to perform total thyroidectomy for all Hürthle cell neoplasms, as well as jugular node sampling and adjuvant radioiodine for cancer. Stringent histologic interpretation is possible and necessary for true appreciation of Hürthle cell tumor incidence and behavior. Cancer mortality of 18% is greater than the rate (2%) of our well-differentiated thyroid cancer group.