Thyroid oncocytic neoplasms

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Raoudha Doghri
Nadia Znaidi
Ahlem Blel
Raoudha Aloui
Rym Lahyeni
Memia Ben Salah
Soumaya Rammeh

Abstract

Background: Oncocytic tumors (OT) are rare, representing 3 to 10% of epithelial tumors of the thyroid. It is important to individualize these TO given the relatively high frequency of carcinomas in this group: 30% against 15% for micro-vesicular lesions of classical cytology and the aggressiveness of malignant OT due to their low iodine uptake.
Aim: The aim of our study was to describe the anatomo-clinical aspects of oncocytic tumors of the thyroid.
Methods: Our study was retrospective, realized on 99 cases of oncocyte thyroid tumors collected at the Anatomy and Pathology Cytology laboratory of Tunis Charles Nicolle Hospital during a 10-year period (2004-2014).
Results: Our series included: 76 oncocyte adenomas, 13 oncocytic papillary carcinomas, 7 oncocytic carcinomas and 3 tumors of uncertain malignant potential (3%). The correlation of the anatomo-clinical data with the diagnostic categories showed a statistically significant difference concerning the macrovesicular architecture.
We found no difference between benign and malignant TO, in relation to age, echogenicity, tumor size, macroscopic appearance, capsule thickness, percentage of oncocyte cells, and the presence of associated lymphocyte thyroiditis.
Conclusions: In view of the literature data and the findings of our study, it seems that there are no predictive factors for the malignancy of oncocytic tumors at the pre- and peroperative stage, with the exception of papillary-type nuclear atypia for Oncocytic papillary carcinoma.

Keywords:

thyroid tumor, oncocytes, Hurthle cell

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References

  1. Lloyd RV, Osamura RY, Klöppel G, Rosai J. Pathology and Genetics of Tumours of Endocrine Organs. Fourth edition - WHO - 2017. WHO Classification of Tumours, Volume 10
  2. Paunovic I, Krgovic K, Tatic S, Diklic A, Zivaljevic V, Kalezic N, et al. Surgery for thyroid Hürthle cell tumours--a single institution experience. Eur J Surg Oncol. 2006;32(4):458‑61.
  3. Zhang YW, Greenblatt DY, Repplinger D, Bargren A, Adler JT, Sippel RS, et al. Older age and larger tumor size predict malignancy in hürthle cell neoplasms of the thyroid. Ann Surg Oncol. 2008;15(10):2842‑6.
  4. Hanief MR, Igali L, Grama D. Hürthle cell carcinoma: diagnostic and therapeutic implications. World J Surg Oncol. 2004;2:27.
  5. Alaedeen DI, Khiyami A, McHenry CR. Fine-needle aspiration biopsy specimen with a predominance of Hürthle cells: a dilemma in the management of nodular thyroid disease. Surgery. 2005;138(4):650‑6.
  6. Lopez-Penabad L, Chiu AC, Hoff AO, Schultz P, Gaztambide S, Ordoñez NG, et al. Prognostic factors in patients with Hürthle cell neoplasms of the thyroid. Cancer. 2003;97(5):1186‑94.
  7. Raparia K, Min SK, Mody DR, Anton R, Amrikachi M. Clinical outcomes for « suspicious » category in thyroid fine-needle aspiration biopsy: Patient's sex and nodule size are possible predictors of malignancy. Arch Pathol Lab Med.2009;133(5):787‑90.
  8. Kushchayeva Y, Duh Q-Y, Kebebew E, D'Avanzo A, Clark OH. Comparison of clinical characteristics at diagnosis and during follow-up in 118 patients with Hurthle cell or follicular thyroid cancer. Am J Surg. 2008;195(4):457‑62.
  9. Melck A, Bugis S, Baliski C, Irvine R, Anderson DW, Wilkins G, et al. Hemithyroidectomy: the preferred initial surgical approach for management of Hurthle cell neoplasm. Am J Surg. 2006;191(5):593‑7.
  10. Mills SC, Haq M, Smellie WJB, Harmer C. Hürthle cell carcinoma of the thyroid: Retrospective review of 62 patients treated at the Royal Marsden Hospital between 1946 and 2003. Eur J Surg Oncol. 2009;35(3):230‑4.
  11. Shawky M, Sakr M. Hurthle Cell Lesion: Controversies, Challenges, and Debates. Indian J Surg. 2016;78(1):41‑8.
  12. Tuzun D, Ersoy R, Kilicyazgan A, Kiyak Gu, Yalcin S, Cakir B. Elastosonography scoring and strain index of thyroid nodules with Hurthle cells. Minerva Endocrinol. 2016;41(2):157‑65.
  13. Vattimo A, Bertelli P, Cintorino M, Burroni L, Volterrani D, Vella A, et al. Hürthle cell tumor dwelling in hot thyroid nodules: preoperative detection with technetium-99m-MIBI dual-phase scintigraphy. J Nucl Med. 1998;39(5):822‑5.
  14. Pryma DA, Schöder H, Gönen M, Robbins RJ, Larson SM, Yeung HWD. Diagnostic accuracy and prognostic value of 18F-FDG PET in Hürthle cell thyroid cancer patients. J Nucl Med. 2006;47(8):1260‑6.
  15. Chao T-C, Lin J-D, Chen M-F. Surgical treatment of Hurthle cell tumors of the thyroid. World J Surg. 2005;29(2):164‑8.
  16. Bronner MP, Hamilton R, LiVolsi VA. Utility of frozen section analysis on follicular lesions of the thyroid. Endocr Pathol. 1994;5(3):154‑61.
  17. Alexander EK, Kennedy GC, Baloch ZW, Cibas ES, Chudova D, Diggans J, et al. Preoperative diagnosis of benign thyroid nodules with indeterminate cytology. N Engl J Med. 2012;367(8):705‑15.
  18. Bricaire-Dubreuil L. Anomalies moléculaires et cytoponction d'un nodule thyroïdien. Corresp En MHDN. 2012;16(7):182‑9.
  19. Giorgadze TA, Shiina N, Baloch ZW, Tomaszewski JE, Gupta PK. Improved detection of amyloid in fat pad aspiration: an evaluation of Congo red stain by fluorescent microscopy. Diagn Cytopathol. 2004;31(5):300‑6.
  20. Stojadinovic A, Hoos A, Ghossein RA, Urist MJ, Leung DHY, Spiro RH, et al. Hürthle cell carcinoma: a 60-year experience. Ann Surg Oncol. 2002;9(2):197‑203.
  21. Pisanu A, Sias L, Uccheddu A. Factors predicting malignancy of Hürthle cell tumors of the thyroid: influence on surgical treatment. World J Surg. 2004;28(8):761‑5.
  22. Dahl LD, Myssiorek D, Heller KS. Hurthle cell neoplasms of the thyroid. The Laryngoscope. 2002;112(12):2178‑80.
  23. Mete O, Asa SL. Oncocytes, oxyphils, Hürthle, and Askanazy cells: morphological and molecular features of oncocytic thyroid nodules. Endocr Pathol. 2010;21(1):16‑24.
  24. Asa SL. The role of immunohistochemical markers in the diagnosis of follicular-patterned lesions of the thyroid. Endocr Pathol. 2005;16(4):295‑309.
  25. Chen H, Udelsman. Hurthle cell adenoma and carcinoma. Textbook of Endocrine Surgery 2nd ed. Philadelphia. 2005. 123-128 p.