Hurthle cell carcinoma is a rare thyroid cancer histologically related to the well-differentiated malignancies of the thyroid gland. This report presents the evaluation of 30 years experience in treating 17 patients (out of 549 thyroid cancer patients) with Hurthle cell carcinoma. All 17 patients were treated surgically. Six patients (35.3%) died of their thyroid disease. Survival rates for 10 and 15 years were 63.7% and 25%, respectively. These rates are above those of high-grade malignancies and below those of low-grade malignancies of the thyroid gland. Nonsurgical treatment, including radioactive iodine therapy, is disappointing; thus, initial radical surgery is recommended as the treatment of choice.
Four cases of pure squamous cell carcinoma and two cases of mixed squamous cell and glandular carcinoma are reported. Obviously, there is a possibility that squamous cell carcinoma of the thyroid gland develops from the existing squamous cells or as a result of metaplasia of follicular cells. Metastases and direct extension of squamous cell carcinoma in the thyroid gland are much more frequent and must be excluded before the diagnosis can be established. Although the gross and microscopic pathology of these lesions presents no unusual features, follicles lined by metaplastic squamous cells offer strong presumptive evidence of a primary thyroid neoplasm. These tumors are comparatively radioresistant and biologically highly malignant. The treatment of choice is radical surgical resection, and these neoplasms must be treated more aggressively in the initial stage.
Four hundred and twenty seven idiopathic peripheral facial palsy (IPFP) patients admitted to the Otolaryngology Department of the Soroka Medical Center in southern Israel between 1978 and 1982 were characterized and analyzed by age, sex and season of illness. An average annual incidence rate of 33.6 patients per 100,000 inhabitans was calculated which is considered to be the highest incidence reported so far, and may be explained by the very high coverage of the "Sick Fund" insurance in the region and by the warm arid climate that prevails in the area. Knowledge of the demographic characteristics of the patients and the population in the catchment area, allowed the calculation of age-specific incidence rates and it was found that this rate increases with age, reaching a peak of 68.2/100,00 in the older age group (greater than 65 years of age). Peak morbidity in young patients (less than 30 years of age) occurs in the winter while elderly patients lack seasonal variability.
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