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Hurthle cell adenomas of the thyroid are rare neoplasms with a controversial biologic behaviour. Some authors believe that are to be considered malignant lesions with a lower progress capacity in comparison with carcinomas, proposing an aggressive surgical approach. Others sustain that they have no malignant potential and prefer lesser resections advocating lower complication rates. The aim of this article is to evaluate the role of total thyroidectomy in the treatment of such neoplasms.