About Hurthle Cell Thyroid Cancer | Endocrinology

What is Hurthle cell thyroid cancer?

Hurthle cell thyroid cancer is a variant of follicular thyroid cancer (FTC). The thyroid is a butterfly-shaped gland in the neck. It produces many hormones (functions of your body) that regulate metabolism. It is also possible to develop papillary thyroid carcinoma with Hurthle cell variants / features. FTCs metastasize (spread) through veins and arteries to other organs in the body and through the lymphatic system.

Hurthle cell thyroid cancer is more aggressive than other types of thyroid cancer. HTC may have a worse prognosis than FTC. This is a rare cancer that affects the thyroid gland. The thyroid is a butterfly-shaped gland located at the base of your neck. It secretes hormones that your body needs to regulate metabolism.

Hurthle cell thyroid cancer is also known as Hurthle cell carcinoma or oxyphilic cell carcinoma. Hurthle cell thyroid cancer is one of many cancers that affect the thyroid.Hurthle Cell Thyroid Cancer is more aggressive than other types of thyroid cancer. Surgery to remove the thyroid gland is the most common treatment. 

Basics of Hurthle cell thyroid cancer

Most Hurthle cell cancer patients don’t know it exists until they have had thyroid surgery. However, for people diagnosed with the disease, there are some facts about Hurthle cell thyroid cancer that can help you get the right care:

  • Hurthle cell thyroid cancer is very rare
  • This type of cancer has a lower prevention rate than other types of thyroid, follicular, and papillary cancer, but it has a better cure rate than anaplastic thyroid cancer.
  • The 10-year survival rate for Hurthle cell cancer, which is limited to the thyroid gland, is 75%, which is close to 50% if it spreads to the cervical lymph nodes, and is even lower if it spreads to sites distant.
  • Hurthle cell thyroid cancer is not associated with radiation exposure
  • If you have a fine needle aspiration biopsy of a lump in your thyroid gland or neck, and your doctor tells you it is a Hurtley cell tumor or shows changes in Hurtley cells, make sure a surgeon with these specialists confirms it. This is important because most thyroid surgeons rarely see this type of cancer and do not have the specialized skills to ensure the best surgical outcome.

Symptoms of Hurthle cell thyroid cancer

For most people, HCC does not cause any symptoms. Symptoms are more likely if large nodules of thyroid cancer develop. These lumps can alter the surrounding tissues. Symptoms can include:

  • Changes in your throat
  • Oking exhausting sensations
  • Difficulty breathing or swallowing
  • Painful lump on your neck

Swollen lymph nodes. Lymph nodes are small bundles of tissue throughout your body. These filter the lymphatic fluid and produce some cells of the immune system.

Other total body characteristics may include:

  • Fatigue
  • Muscle loss
  • Unexplained or unexpected weight loss

These signs and symptoms do not mean that you have Hurhtle cell cancer. They can be indications of other medical conditions, such as an inflammation of the thyroid gland or an enlarged thyroid without cancer (goiter). 

Causes of Hurthle cell thyroid cancer

The exact cause of Hurthle cell cancer is unknown. Doctors know that cancer begins when a cell develops defects in its DNA, a genetic material that contains indications of biochemical processes in your body. When DNA is altered or damaged, these genes may not work properly, causing cells to grow out of control and eventually form a (cancer) cell mass (tumor). Doctors associate this disease with several risk factors, including:

  • Get rid of medical treatments such as X-ray radiation or radiation therapy for cancer. X-rays use low doses of radiation to create images of the internal anatomy.
  • Family history of thyroid cancer
  • Chronic iodine deficiency

Diagnosis of Hurthle cell thyroid cancer

Tests and procedures used to diagnose Hurthle cell cancer:

Physical exam. Your doctor will examine your neck, check the size of your thyroid, and see if your lymph nodes are swollen.

Blood test. Blood tests can reveal abnormalities in thyroid function, which can give your doctor more information about your condition.

Imaging tests. Imaging tests, including ultrasound and CT scans, can help your doctor determine if there is an abnormal growth on the thyroid.

Removal of a sample of thyroid tissue for examination (biopsy). During a thyroid biopsy, a fine needle guided by ultrasound images passes through the skin on your neck. The needle is attached to a syringe, which removes a sample of thyroid tissue. The sample is tested in the laboratory for signs of cancer.

Treatment options for Hurthle cell thyroid cancer

Treatment for Hurthle cell cancer usually requires surgery to remove the thyroid. Radiation therapy and chemotherapy may be options.

Surgery

Close or total removal of the thyroid (thyroidectomy) is the most common treatment for Hurthle cell thyroid cancer.

During thyroidectomy, the surgeon removes all or most of the thyroid gland, leaving small margins of thyroid tissue near adjacent small glands (parathyroid glands) to reduce the chance of injury. The parathyroid glands regulate the level of calcium in your body.

The surrounding lymph nodes are removed if cancer is suspected to have spread to them.

Risks associated with thyroidectomy:

  • Injury to the nerve that controls the larynx (recurrent laryngeal nerve), which can cause temporary or permanent sore throat or loss of voice
  • Damage to the parathyroid glands.
  • Excessive bleeding

After surgery, your doctor may prescribe a hormone called levothyroxine (synthroid, unithroid, others) to replace the hormone your thyroid makes. You should take this hormone for the rest of your life.

Radioactive iodine treatment

Radioactive iodine treatment involves swallowing a capsule containing radioactive fluid.

Radioactive iodine treatment may be recommended after surgery because it helps destroy the remaining thyroid tissue, which may have traces of cancer. Radioactive iodine therapy may also be used if Hurthle cell thyroid cancer has spread to other parts of the body.

Temporary side effects of radiation therapy include:

  • Dry mouth
  • Taste sensations are reduced
  • Neck tenderness
  • Nausea

Radiotherapy

Radiation therapy uses high-energy rays of energy, such as X-rays or protons, to kill cancer cells. During radiation therapy, you are placed on a table and a machine moves around you, distributing the radiation to specific points on your body.

Radiation therapy is an option if cancer cells remain after surgery and radioactive iodine treatment, or if Hurthle cell thyroid cancer has spread.

Side effects can include:

  • Sore throat
  • Skin rash like a sunburn
  • Fatigue
  • Targeted drug treatment

Targeted treatments use drugs that target specific abnormalities in cancer cells. Targeted therapy is an option if your heart cell cancer comes back after other treatments or if it spreads to distant parts of your body.

Side effects depend on the specific drug, but can include:

  • Diarrhea
  • Fatigue
  • Hypertension
  • Liver problems
  • Targeted drug therapy is an active area of cancer research. Doctors are studying several new targeted therapy drugs for use in people with thyroid cancer.
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