HÜRTHLE-CELL CARCINOMA OF THE THYROID: CLINICOPATHOLOGIC FEATURES AND SURGICAL OUTCOMES AT A SINGLE INSTITUTION
Abstract
Background: Hürthle cell carcinoma (HCC) is a rare differentiated thyroid malignancy with variable biological behavior. This study evaluates clinicopathologic features, treatment patterns, and long-term outcomes in patients managed at a single tertiary institution.
Methods: We retrospectively reviewed medical records of patients with histologically confirmed HCC between January 2005 and December 2020. Demographics, tumor characteristics, surgical treatment, adjuvant radioactive iodine (RAI) therapy, recurrence, and survival were analyzed. Outcomes were compared with reported retrospective series and discussed in the context of current ATA guidelines.
Results: Forty-eight patients were identified (mean age, 58.7 ± 11.4 years; female-to-male ratio, 2.2:1). Mean tumor size was 38.5 ± 14.2 mm. Minimally invasive disease was present in 29 patients (60.4%), and widely invasive disease in 19 (39.6%). Total thyroidectomy was performed in 36 patients (75%), and lobectomy in 12 (25%). RAI therapy was administered to 30 patients (62.5%), predominantly in widely invasive cases. Median follow-up was 104 months (range, 24–192 months). Recurrence occurred in 8 patients (16.7%), with a median time to relapse of 78 months. Five- and ten-year overall survival (OS) rates were 91.3% and 81.5%, respectively. Disease-specific survival (DSS) was 95.6% at 5 years and 90.2% at 10 years. Ten-year disease-free survival (DFS) was 82.1%.
Conclusions: Our results support existing evidence that minimally invasive HCC carries an excellent prognosis, while widely invasive tumors have a higher risk of recurrence. Long-term follow-up is essential, given the potential for late recurrence. These findings are consistent with current ATA guidelines recommending risk-tailored treatment and surveillance strategies.
References
WHO Classification of Tumours Editorial Board. Endocrine and Neuroendocrine Tumours. 5th ed. Lyon, France: International Agency for Research on Cancer; 2022. WHO Classification of Tumours; online.
DeLellis RA, Lloyd RV, Heitz PU, Eng C. Pathology and genetics of tumours of endocrine organs.3rd ed. Lyon, France: IARC; 2004. WHO Classification of Tumours; online.
Ahmadi S, Stang M, Jiang XS, Sosa JA. Hürthle cell carcinoma: current perspectives. Onco Targets Ther. 2016;9:6873–84. doi: 10.2147/OTT.S119980.
Lopez-Penabad L, Chiu AC, Hoff AO, Schultz P, Gaztambide S, Ordoñez NG, et al. Prognostic factors in patients with Hürthle cell neoplasms of the thyroid. Cancer. 2003;97(5):1186–94. doi: 10.1002/cncr.11176.
McFadden DG, Sadow PM. Genetics, diagnosis, and management of Hürthle cell thyroid neoplasms. Front Endocrinol (Lausanne). 2021;12:696386. doi: 10.3389/fendo.2021.696386.
Stojadinovic A, Hoos A, Ghossein RA, Urist MJ, Leung DHY, Spiro RH, et al. Hürthle cell carcinoma: a 60-year experience. Ann Surg Oncol. 2002;9(2):197–203. doi: 10.1007/BF02557374.
Jin M, Kim ES, Kim BH, Kim HK, Kang YE, Jeon MJ, et al. Clinicopathological characteristics and disease-free survival in patients with Hürthle cell carcinoma: a multicenter cohort study in South Korea. Endocrinol Metab (Seoul). 2021;36(5):1078–85. doi: 10.3803/EnM.2021.1151.
Oluic B, Paunovic I, Loncar Z, Djukic V, Diklic A, Jovanovic M, et al. Survival and prognostic factors for survival, cancer-specific survival and disease-free interval in 239 patients with Hurthle cell carcinoma: a single-center experience. BMC Cancer. 2017;17(1):371. doi:10.1186/s12885-017-3370-x.
Chiapponi C, Hartmann MJM, Schmidt M, Faust M, Bruns CJ, Schultheis AM, et al. Hürthle cell carcinoma: single center analysis and considerations for surgical management based on the recent literature. Front Endocrinol (Lausanne). 2022;13:904986. doi:10.3389/fendo.2022.904986.
Besic N, Schwarzbartl-Pevec A, Vidergar-Kralj B, Crnic T, Gazic B, Marolt Music M. Treatment and outcome of 32 patients with distant metastases of Hürthle cell thyroid carcinoma: a single-institution experience. BMC Cancer. 2016;16:162. doi: 10.1186/s12885-016-2179-3.
Zhou X, Zheng Z, Chen C, Zhao B, Cao H, Li T, et al. Clinical characteristics and prognostic factors of Hürthle cell carcinoma: a population-based study. BMC Cancer. 2020;20(1):407. doi: 10.1186/s12885-020-06915-0.
Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016 ;26(1):1–133. doi:10.1089/thy.2015.0020.
Kim MJ, Shin JH, Hahn SY, Oh YL, Kim SW, Kim TH, et al. Ultrasonographic characteristics of Hürthle cell neoplasms: prediction of malignancy. Ultrasonography. 2022;41(4):689-97. doi: 10.14366/usg.21264.
Copyright (c) 2026 Sanamed
This work is licensed under a Creative Commons Attribution 4.0 International License.
Journal Sanamed is published under an Open Access license. All its content is available free of charge. Users can read, download, copy, distribute, print, search the full text of articles, as well as establish HTML links to them, without having to seek the consent of the author or publisher.
The right to use content without consent does not release the users from the obligation to give the credit to the journal and its content in a manner described under CC BY.