J Korean Surg Soc.
2000 May;58(5):629-634.
H rthle Cell Neoplasm of the Thyroid Gland
- Affiliations
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- 1Department of Surgery, Seoul National University College of Medicine.
Abstract
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PURPOSE: H rthle cell neoplasm of the thyroid gland is a rare disease. The reported cases in Korea
are not so many; thus, there has been a lack of common therapeutic and prognostic guidance. METHODS:
The cases of 15 patients with a H rthle cell neoplasm of the thyroid gland, hospitalized at Seoul National
University Hospital from Nov. 1981 to Feb. 1998, were retrospectively reviewed. RESULTS: There were
4 males and 11 females. The ages varied from 23 to 69 years old (mean: 46.3 years old). Among them,
13 had neck masses with a mean size of 3.3 cm (1.2-6.0 cm), and the mean duration of the symptom
was 4 years (5 months-8 years). Of the other two, one had laryngeal discomfort for 2 months, and
the other one was diagnosed through a fine needle aspiration follow-up. One of the 15 patients had
hyperthyroidism whereas the others had euthyroidism. The thyroid scans for 10 of them showed cold
nodules. The operations consisted of a unilateral lobectomy in 2 cases, a unilateral lobectomy and isth
mectomy in 11 cases, a unilateral lobectomy, isthmectomy and contralateral partial lobectomy in 1 case,
and a total thyroidectomy and neck lymph node dissection in the 1 case that was combined with a
papillary carcinoma. Thirteen patients (86.7%) had a H rthle cell adenoma, and two of them (13.3%)
had a H rthle cell carcinoma. The mean duration of follow-up was 33 months (range 1 month-12 years),
and no recurrence or death occurred during the follow-up period. CONCLUSIONS: The incidence of H rthle
cell neoplasms is higher in women and the sex ratio is 1:2.8. The incidence of H rthle cell carcinomas
among H rthle cell neoplasms is 13.3% (2/15). We found no specific clinical features for differentiating
a H rthle cell adenoma from a H rthle cell carcinoma and no factors for adequate operative methods
and prognosis due to the rarity of the condition and the short duration of the follow-up. Because of
the low incidence of H rthle cell neoplasms and our limited experience, not only co-research of centers
but also pathologic research is needed.