Hürthle Cell Tumors

Belchetz, Greg; Cheung, Carol C.; Freeman, Jeremy L.; Rosen, Irving B.; Witterick, Ian J.; Sylvia, L.

doi:10.1001/archotol.128.3.237

Cited by 43 publications

(4 citation statements)

References 21 publications

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“…The diagnosis of oncocytic follicular adenoma has been questioned, since some authors have found that oncocytic follicular lesions called benign subsequently behave in a malignant fashion (20). This may be attributed to failure to recognize the nuclear atypia of malignancy in these neoplasms (12,18,21,22), but also partly to common challenges in the identification of invasive growth in follicular neoplasms (23)(24)(25)(26).…”

Section: Thyroid Follicular Nodular Disease and Adenomasmentioning

confidence: 99%

“…As in nononcocytic tumors, these neoplasms are classified as (i) minimally invasive oncocytic carcinoma (tumor capsular invasion only), (ii) angioinvasive encapsulated oncocytic carcinoma (angioinvasion with no widely invasive growth), and (iii) widely invasive oncocytic carcinoma (often angioinvasive) (31). Oncocytic lesions that have nuclear atypia but lack invasion fall into the category of Non-Invasive Follicular Tumor with Papillary-like nuclei (NIFTP) (35); however, this remains controversial since it has been reported that oncocytic tumors with follicular architecture and nuclear atypia that lack overt invasion in sections examined can metastasize (12,18,(20)(21)(22).…”

Section: Follicular-patterned Differentiated Thyroid Carcinomasmentioning

confidence: 99%

“…To date, oncocytic classical variant papillary thyroid carcinomas have not been shown to behave differently than other classical variant papillary carcinomas (47). They tend to be infiltrative; they metastasize to lymph nodes and they harbor BRAFV600E mutations or RET/PTC gene rearrangements (21,22,48).…”

Section: Papillary Thyroid Carcinomamentioning

confidence: 99%

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Oncocytic Change in Thyroid Pathology

Sylvia

Mete

2021

Front. Endocrinol.

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Oncocytes are cells that have abundant eosinophilic cytoplasm due to the accumulation of mitochondria; they are also known as oxyphils. In the thyroid they have been called Hürthle cells but this is a misnomer, since Hürthle described C cells; for this reason, we propose the use of “oncocyte” as a scientific term rather than an incorrect eponym. Oncocytic change occurs in nontumorous thyroid disorders, in benign and malignant tumors of thyroid follicular cells, in tumors composed of thyroid C cells, and intrathyroidal parathyroid proliferations as well as in metastatic lesions. The morphology of primary oncocytic thyroid tumors is similar to that of their non-oncocytic counterparts but also is complicated by the cytologic features of these cells that include both abundant eosinophilic cytoplasm and large cherry red nucleoli. The molecular alterations in oncocytic thyroid tumors echo those of their non-oncocytic counterparts but in addition feature mitochondrial DNA mutations as well as chromosomal gains and losses. In this review we emphasize the importance of recognition of the spectrum of oncocytic thyroid pathology. The cell of origin, morphologic features including architecture, nuclear atypia and invasive growth, as well as high grade features such as mitoses and necrosis, enable accurate classification of these lesions. The molecular alterations underlying the pathological entity are associated with genetic alterations associated with oncocytic change. The arbitrary cut-off of 75% oncocytic change to classify a lesion as an oncocytic variant brings another complexity to the classification scheme of tumors that frequently have mixed oncocytic and non-oncocytic components. This controversial and often confusing area of thyroid pathology requires thoughtful and cautious investigation to clarify accurate diagnosis, prognosis and prediction for patients with oncocytic thyroid lesions.

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Section: Thyroid Follicular Nodular Disease and Adenomasmentioning

confidence: 99%

Section: Follicular-patterned Differentiated Thyroid Carcinomasmentioning

confidence: 99%

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Oncocytic Change in Thyroid Pathology

Sylvia

Mete

2021

Front. Endocrinol.

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“…Additionally, many have proposed different morphologic characteristics to distinguish between benign and malignant Hurthle cell tumors [3]. Recent molecular studies have shed light on the distinct oncogenic features of Hurthle cell carcinomas, suggesting that they represent a separate pathological entity from both Hurthle cell adenomas and follicular cell carcinomas [4,5]. The accurate preoperative diagnosis of these tumors is essential for appropriate management decisions.…”

Section: Introductionmentioning

confidence: 99%

Unraveling the Enigma: A Five-Year Comprehensive Analysis of Hurthle Cell Tumors in South India's Tertiary Care Center

Sulaiman,

Chirukandath,

Krishnan

et al. 2024

Cureus

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Background: Hurthle cell tumors of the thyroid gland constitute a rare and enigmatic group of neoplasms, characterized by the presence of Hurthle cells exhibiting abundant eosinophilic cytoplasm and numerous mitochondria. Despite their low incidence, they pose diagnostic challenges and display diverse clinical outcomes. This study aims to provide a comprehensive analysis of the clinicopathological profile of Hurthle cell tumors within a tertiary care center in South India. Methods: Through a retrospective approach, we analyzed cases of Hurthle cell tumors diagnosed and treated at a tertiary care center over a five-year period. Clinical, radiological, and histopathological data were meticulously collected and scrutinized. The study focused on examining demographic details, presenting symptoms, imaging features, cytological findings, surgical management, and postoperative outcomes of the patients. Results: A total of 32 cases of Hurthle cell tumors were identified during the study period. The majority of patients were female (84%), with a mean age of 49.6 years for Hurthle cell carcinoma. Thyroid enlargement and neck mass were the most common presenting complaints. Fine-needle aspiration cytology showed characteristic features suggestive of Hurthle cell tumors in 33% of cases. Total thyroidectomy remains the mainstay surgical approach. Histopathological evaluation confirmed 62.5% of cases as benign adenomas and 37.5% as malignant carcinomas. Among malignant cases, 67% showed capsular invasion and 33% demonstrated vascular invasion. Of the patients, 33.3% received adjuvant radiotherapy. The overall survival rate was 100%. In our study, we found that thyroid nodules larger than 3 cm demonstrated a higher propensity for Hurthle cell carcinoma. Conclusion: Our findings support the multidisciplinary approach in managing Hurthle cell tumors, with a focus on tailored treatment plans for each patient based on individual characteristics. By recognizing the female predominance, assessing nodule size, and employing a combination of thyroidectomy and ablative therapy, clinicians can optimize patient care and contribute to better long-term prognosis and quality of life for those affected by Hurthle cell tumors. Continued research and collaborative efforts are necessary to advance our understanding and refine treatment strategies, paving the way for improved outcomes and enhanced patient management in the future.

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