Aggressiveness of Therapy and Prognosis of Patients with Hürthle Cell Papillary Thyroid Carcinoma

Abstract

Hürthle cell papillary thyroid carcinoma (HCPTC) has been studied separately from other types of thyroid carcinoma in relatively few studies. The aim of our study was to determine the factors associated with the survival of patients with HCPTC in Slovenia, an iodine-deficient region. A total of 1552 patients with thyroid carcinoma were seen at our institute during the period of 1976-2003; of them, 42 patients (33 females, 9 males; age 10-85 years, median 56.5 years) had histopathologically verified HCPTC. The data on the patients' gender, age, disease history, extent of disease, morphologic characteristics, therapy, locoregional control, disease-free interval, and survival were collected. The statistical correlation between possible prognostic factors and the disease-free interval and survival was analyzed by chi2 test and log rank analysis. The tumor diameter ranged from 1 to 9 cm (median, 3 cm). Extrathyroid tumor growth was found in 19 patients, lymph node metastases in 13 patients, and distant metastases in 2 patients. Primary treatment consisted of total or near-total thyroidectomy (39 patients), lobectomy (2 patients), radioiodine ablation of the thyroid remnant (37 patients), external irradiation (14 patients), and chemotherapy (3 patients). Locoregional recurrence was diagnosed in four patients, and dissemination in 1 patient during the follow-up period of 0.75-20 years (median, 5.5 years). Three patients died of thyroid carcinoma during the follow-up period. The 5-year and 10-year survivals were 94% and 87%, respectively. The 5-year and 10-year disease-free intervals were 93% and 81%, respectively. The factors correlated with the survival were: age, extrathyroid tumor growth, primary tumor stage, and regional and distant metastases. Although extrathyroidal tumor growth was found in 45% of the patients with HCPTC, our patients had a favorable prognosis. Long-term survival and locoregional control of disease are likely after the radical tumor resection, radioiodine ablation of the thyroid remnant, and external irradiation.

Successful Treatment of Hurthle Cell Thyroid Carcinoma with Lung and Liver Metastasis Using Docetaxel and Cisplatin

“…Clinically, female-to-male predominance ranges from 2:1 to 5:1 (6). The peak age of incidence is 50 -60 years (3,6,7). About 20 -30% of the cases had metastatic extension at the time of initial treatment (3,8).…”

“…Metastases to liver are unusual. We got two reported cases of liver metastasis (metastasis) (7,21): one of the patients, who showed solitary liver metastasis, was treated with hepatic lobectomy and got good clinical conditions, and the other received chemotherapy, surgical resection and external irradiation and achieved a complete locoregional control, but ultimately died of liver metastasis 5 years after the treatment. For our patient, we preferred chemotherapy because the metastatic disease was extensive and was not accessible to surgical resection or radiation.…”

Hürthle Cell Thyroid Carcinoma Metastatic to the Sigmoid Colon

“…The reported rates of occurrence of distant metastases range from 6% to 20% of cases, higher in FTC than in papillary thyroid carcinoma (1-3). Predictive factors of metastases include age at diagnosis, tumor size, extracapsular involvement, and presence of a poorly differentiated component (1)(2)(3)7,8). Lung and bone are the most common sites of metastases in patients with DTC (3)(4)(5)(6).…”

“…However, distant metastases occur in 10-15% of cases, predominantly in lung and bone, especially in older patients exhibiting poorly differentiated forms or advanced stages (1)(2)(3)(4)(5)(6)(7)(8). We report a case history of follicular thyroid carcinoma (FTC) metastasized to sigmoid colon.…”

Une masse frontale associée à une altération de l’état général

“…1) L'â ge du patient au moment du diagnostic notamment au delà de 45 à 50 ans et les sujets jeunes de moins de 16 ans sont de mauvais pronostic [6]. 2) Le type histologique : le pronostic est pé joratif en cas de carcinome peu diffé rencié ou invasif et dans certains types de cancers à petites cellules de Hurthle [7]. 3) L'é tendue de la tumeur : le risque de rechute et/ou de dé cè s augmente avec la taille de la tumeur.…”