Follicular and Hurthle cell carcinoma of the thyroid

Hurthle cell carcinoma is an uncommon form of thyroid cancer that is usually classified as a variant of follicular carcinoma. Dinstinguishing between benign and malignant Hurthle cell lesions may be quite difficult, and it requires demonstration of vascular or full-thickness capsular invasion in a surgical specimen. Radioiodine and other noninvasive therapies are rarely of benefit, and surgery is the only effective treatment. Total thyroidectomy is recommended for patients with histologically malignant lesions. Patients with apparently benign Hurthle cell tumors may be treated with lobectomy. Hurthle cell carcinoma is a relatively aggressive thyroid tumor. Distant metastatic disease ultimately develops in about ofn third of patients and is associated with a 5-year mortality rate of about 80%. Major adverse prognostic factors in Hurthle cell carcinoma include extensive tumor load and inadequate initial surgery. DNA aneuploidy in histologically malignant Hurthle cell lesions also correlates with decreased survival.