Report of a hürthle cell neoplasm in a peripubertal girl

Unusual Thyroid Mass in an Adolescent Patient

Hurthle cell tumors are rare follicular-derived thyroid neoplasms. Hurthle cell tumors may be benign or malignant. Workup includes imaging, fine needle aspiration, and treatment usually consists of observation versus thyroidectomy. We describe a case of Hurthle cell adenoma in an adolescent; to the best of our knowledge, this represents only the third case described in the English literature of adolescent Hurthle cell adenoma.

Hurthle cell carcinoma in childhood: A retrospective analysis of five cases and review of pediatric literature

BACKGROUND

the available studies on Hurthle cell carcinoma (HCC) in pediatric age are scarce and based on isolated case reports. Aims of the present study were to review the available pediatric literature on HCC (2000-2019), to describe the cohort of children with this cancer histotype, and to estimate its relative prevalence in pediatric age.

PROCEDURE

We retrospectively reconstructed an HCC course in five patients < 19 years who were identified in our departments during the period 2000-2019, and we reviewed the available pediatric studies on this differentiated thyroid cancer (DTC) variant.

RESULTS

HCC occurred with a relative prevalence of 5.8% at a median chronological age of 12.5 years. None of HCC patients exhibited, at diagnosis, thyroid dysfunction, extensive lateral neck disease, or distant metastases, and all showed a persistent remission over time. Three patients showed, at diagnosis, antecedents of other diseases (Hashimoto's thyroiditis, neurofibromatosis type 1, and osteosarcoma).

CONCLUSIONS

(1) In childhood, the relative prevalence of HCC among different thyroid cancer histotypes is 5.8%, that is close to the one previously reported both in the general population and in other less numerous children's cohorts; (2) HCC may develop even early, at the age of 7; (3) in childhood, HCC does not seem to have a more aggressive behavior when compared with other DTC histotypes; (4) antecedents of other diseases are not infrequent in the history of children with HCC.

Typical manifestations of Hürthle cell adenoma of the thyroid on contrast-enhanced CT: A case report

RATIONALE

Hürthle cell adenoma (HCA) of the thyroid is a rare thyroid tumor, and there are limited studies on the contrast-enhanced computed tomography (CT).

PATIENT CONCERNS

We report the case of a 63-year-old woman with gradual enlargement of the thyroid over 10 years.

DIAGNOSES

Preoperative contrast-enhanced CT revealed typical lesion characteristics of HCA, confirmed by postoperative pathology.

INTERVENTIONS

Left thyroidectomy and partial right thyroidectomy were performed on the patient after general anesthesia.

OUTCOMES

At follow-up of 12 months after surgery, the patient was in good health without recurrence.

LESSONS

The typical imaging features of HCA on contrast-enhanced CT are helpful for the early diagnosis of thyroid eosinophilic adenoma. This will provide an important basis for the preoperative diagnosis and treatment strategy of HCA of the thyroid in future.

Hurthle cell neoplasms of the thyroid: sonographic appearance and histologic characteristics

OBJECTIVE

The purpose of this study was to determine the sonographic features of Hürthle cell neoplasms (HCNs) of the thyroid.

METHODS

We retrospectively analyzed the sonographic appearance of 15 histologically proven HCNs in 15 patients aged 16 to 70 years (mean age, 44 years). Sonographic features that were reviewed included the size and echogenicity of the tumors, the presence of cystic areas or calcifications, and detectable blood flow on color Doppler imaging. Correlation of sonographic findings with pathologic results was performed.

RESULTS

The tumors ranged from 0.4 to 7 cm in diameter, but most were less than 3 cm in diameter. Four (27%) of the 15 tumors were homogeneously hypoechoic. Two tumors (13%) were predominantly hypoechoic with isoechoic areas to thyroid parenchyma. Two (13%) neoplasms were isoechoic to thyroid parenchyma. Four (27%) tumors were predominantly isoechoic, containing hypoechoic areas, and 3 (20%) tumors were hyperechoic. Three neoplasms contained cystic components. None of the tumors contained calcifications. One tumor was avascular on Doppler examination. One neoplasm showed only peripheral blood flow. Thirteen tumors showed internal vascularity, 7 of them with peripheral blood flow. Twelve HCNs were benign, and 3 were malignant on pathologic examination.

CONCLUSIONS

Hürthle cell neoplasms show a spectrum of sonographic appearances from predominantly hypoechoic to hyperechoic lesions and from peripheral blood flow with no internal flow to extensively vascularized lesions. Pathologic criteria differentiating benign and malignant HCNs (absence or presence of a capsular breach, vascular or extrathyroidal tissue invasion, nodal involvement, and distant metastasis) are beyond the resolution of sonography and fine-needle aspiration biopsy and require removal of the entire lesion. This precludes diagnosis and characterization of HCNs by sonography.