Predictive factors of carcinoma in 279 patients with Hürthle cell neoplasm of the thyroid gland.

BACKGROUND AND OBJECTIVES: Estimation of the risk of malignancy in a Hürthle cell (HC) neoplasm is important for optimum extent of thyroid surgical treatment. The aim of this retrospective study was to find predictive factors of carcinoma in patients with HC neoplasm.

METHODS: A total of 279 patients (241 females, 38 males; median age 55 years, range 15-86 years) with HC neoplasm in whom carcinoma was only suspected and who were surgically treated at our Institute in the period 1990-2007, were included in this study. Risk factors for malignancy were identified by the chi-squared test and logistic regression.

RESULTS: The histopatological diagnoses were carcinoma, benign goiter and adenoma in 71 (25%), 68 (25%) and 140 (50%) patients, respectively. Predictive factors for carcinoma, shown by chi-square test, were: age of patients, tumor diameter, thyroid volume and T(g) concentration. The independent predictors of malignancy as shown by multivariate logistic regression were age of patients and pre-operative T(g) concentration. Carcinoma was more common in the patients older than 65 years of age and with T(g) concentration over 1,000 ng/ml.

CONCLUSIONS: The independent predictors of malignancy in HC neoplasm were age of patients and pre-operative T(g) concentration.