Diagnostic performance of thyroid ultrasound in Hürthle cell carcinomas

Autor(es)

Santana, Nathalie Oliveira ^[1] ; Costa Freitas, Ricardo Miguel ^[2] ; Marcos, Vinicius Neves ^[2] ; Chammas, Maria Cristina ^[3] ; Asato Camargo, Rosalinda Yossie ^[1] ; Schmerling, Claudia Kliemann ^[4] ; Brasileiro Vanderlei, Felipe Augusto ^[5] ; Hoff, Ana Oliveira ^[6] ; Maruil, Suemi ^[1] ; Seguro Danilovic, Debora Lucia ^{[1, 6]}

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Hosp Clin Fac Med, Lab Endocrinol Celular & Mol LIM25, Av Dr Arnaldo 455, Sale 4305, BR-01246903 Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Fac Med, Inst Canc Estado Sao Paulo, Radiol, Sao Paulo, SP - Brazil

^[3] Univ Sao Paulo, Hosp Clin Fac Med, Inst Radiol InRad, Radiol, Sao Paulo, SP - Brazil

^[4] Univ Sao Paulo, Fac Med, Inst Canc Estado Sao Paulo, Dept Patol, Sao Paulo, SP - Brazil

^[5] Univ Sao Paulo, Hosp Clin Fac Med, Dept Cirurgia Cabeca & Pescoco, Sao Paulo, SP - Brazil

^[6] Univ Sao Paulo, Fac Med, Inst Canc Estado Sao Paulo, Dept Endocrinol, Sao Paulo, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: ARCHIVES OF ENDOCRINOLOGY METABOLISM; v. 63, n. 3, p. 300-305, MAY-JUN 2019.
• Citações Web of Science: 0

Resumo

ABSTRACT Objective Hürthle cell carcinomas (HCCs) of the thyroid have been recently reclassified as a separate entity due to their distinct clinical and molecular profiles. Few studies have assessed the ability of preoperative characteristics in differentiating HCCs from Hürthle cell adenomas (HCAs) due to the low prevalence of both lesions. This study aimed to compare the preoperative features of HCCs and HCAs and evaluate the diagnostic performance of ultrasound in distinguishing between both. Subjetcs and methods Retrospective study including 101 patients (52 HCCs and 49 HCAs) who underwent thyroid surgery from 2000 to 2016. Clinical, ultrasonographic, and histological data were reviewed. Diagnostic performance of suspicious sonographic features was analyzed in 51 cases (24 HCCs and 27 HCAs). Results Hürthle cell neoplasms were predominant in females. Subjects ≥ 55 years represented 58% of the cases of HCCs and 53% of those of HCAs. Carcinomas were significantly larger (p < 0.001), and a tumor size ≥ 4 cm significantly increased the risk of malignancy (odds ratio 3.67). Other clinical, cytologic, and sonographic data were similar between HCCs and HCAs. Among the HCCs, the lesions were purely solid in 54.2%, hypoechoic in 37.5%, and had coarse calcifications in 12.5%, microcalcifications in 8.3%, irregular contours in 4.2%, and a taller-than-wide shape in 16.7%. Predominantly/exclusive intranodular vascularization was observed in 52.6%. Overall, 58% of the HCCs were classified as TI-RADS 4 or 5 compared with 48% of the HCAs. TI-RADS 4 or 5 had a specificity of only 51.8% and a positive likelihood ratio of 1.21. Conclusions Apart from the lesion size, no other preoperative feature adequately distinguished HCCs from HCAs. Sonographic characteristics raising suspicion for malignancy, which are mostly present in papillary carcinomas, were infrequent in HCCs. New tools must be developed to improve preoperative diagnosis and deferral of surgery in cases of adenomas. (AU)

• Processo FAPESP: 15/14819-7 - Sequenciamento de nova geração para detecção de mutações em carcinomas de células de hurthle da tireoide
• Beneficiário: Debora Lucia Seguro Danilovic
• Modalidade de apoio: Auxílio à Pesquisa - Regular