Total thyroidectomy for Hurthle cell neoplasm of the thyroid
S. R. Gundry, R. E. Burney, N. W. Thompson and R. Lloyd
The treatment of Hurthle cell neoplasms of the thyroid is controversial
because of a lack of information about their clinical behavior and
long-term follow-up. We reevaluated our experience of the past 33 years and
compared our early experience with the more aggressive surgical approach
used during the past ten years. We treated 62 patients with Hurthle cell
neoplasm from 1949 through 1982. Twenty-six patients had benign neoplasms
and 35 had malignant neoplasms proven by capsular or vascular invasion or
nodal metastasis. Fourteen deaths were directly attributable to recurrent
or metastatic disease, three among those with benign lesions. An aggressive
surgical approach, involving total thyroidectomy or early-completion total
thyroidectomy following lobectomy for all tumors histologically malignant
or larger than 2 cm, resulted in a lower recurrence rate (21% v 59%) and
fewer operations per patient (1.7 v 2.9) than in patients having other
operations.
