Thyroid Diseases

Hurthle Cell carcinoma


 

Overview
 
Hurthle (HEERT-luh) cell cancer is a rare cancer that affects the thyroid gland.

The thyroid is a butterfly-shaped gland in the base of your neck. It secretes hormones that are essential for regulating your body's metabolism.

Hurthle cell cancer is also called Hurthle cell carcinoma or oxyphilic cell carcinoma. Hurthle cell cancer is one of several types of cancers that affect the thyroid.


Hurthle cell cancer can be more aggressive than other types of thyroid cancer. Surgery to remove the thyroid gland is the most common treatment.

Symptoms

Hurthle cell cancer doesn't always cause symptoms, and it's sometimes detected during a physical examination or an imaging test done for some other reason.

Signs and symptoms of Hurthle cell cancer may include:

  • A lump in your neck, just below your Adam's apple
  • Pain in your neck or throat
  • Hoarseness or other changes in your voice
  • Shortness of breath
  • Swallowing difficulty
    These signs and symptoms don't necessarily mean you have Hurthle cell cancer. They may be indications of other medical conditions — such as inflammation of the thyroid gland or a noncancerous enlargement of the thyroid (goiter).

    When to see a doctor

    Make an appointment with your doctor if you have any signs or symptoms that worry you.

    Causes

    It's not clear what causes Hurthle cell cancer.

    Doctors know that cancer begins when a cell develops errors in its DNA — the genetic material that contains instructions for biochemical processes in your body. When DNA is altered or damaged, these genes may not function properly, causing cells to grow out of control and eventually form a mass (tumor) of cancerous (malignant) cells.

    Risk factors

    Factors that increase the risk of developing thyroid cancer include:

  • Being female
  • Being older
  • Having a history of radiation treatments to the head and neck

    Complications


    Possible complications of Hurthle cell cancer include:

  • Problems with swallowing and breathing. They can occur if the tumor grows and presses on the food tube (esophagus) and windpipe (trachea).
  • Spread of the cancer. Hurthle cell cancer can spread (metastasize) to other tissues and organs, making treatment and recovery more difficult.

    Diagnosis

    Tests and procedures used to diagnose Hurthle cell cancer include:

    Physical exam. Your doctor will examine your neck, checking the size of your thyroid and seeing whether your lymph nodes are swollen.
    Blood tests. Blood tests may reveal abnormalities in your thyroid function that give your doctor more information about your condition.
    Imaging tests. Imaging tests, including ultrasound and CT, can help your doctor determine whether an abnormal growth is present in the thyroid.
    Removing a sample of thyroid tissue for testing (biopsy). During a thyroid biopsy, a fine needle is passed through the skin of your neck guided by ultrasound images. The needle is attached to a syringe, which withdraws a sample of thyroid tissue. The sample is analyzed in a laboratory for signs of cancer.

    Treatment

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

    Surgery

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

    During thyroidectomy, the surgeon removes all or nearly all of the thyroid gland and leaves tiny edges of thyroid tissue near small adjacent glands (parathyroid glands) to lessen the chance of injuring them. The parathyroid glands regulate your body's calcium level.

    Surrounding lymph nodes may be removed if there's suspicion that the cancer has spread to them.

    Risks associated with thyroidectomy include:

    Injury to the nerve that controls the voice box (recurrent laryngeal nerve), which could cause temporary or permanent hoarseness or a loss of your voice
    Damage to the parathyroid glands
    Excessive bleeding
    After surgery, your doctor will prescribe the hormone levothyroxine (Synthroid, Unithroid, others) to replace the hormone produced by your thyroid. You'll need to take this hormone for the rest of your life.

    Radioactive iodine therapy

    Radioactive iodine therapy involves swallowing a capsule that contains a radioactive liquid.

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

    Temporary side effects of radioiodine therapy can include:

  • Dry mouth
  • Decrease in taste sensations
  • Neck tenderness
  • Nausea

    Radiation therapy

    Radiation therapy uses high-powered energy beams, such as X-rays or protons, to kill cancer cells. During radiation therapy, you're positioned on a table and a machine moves around you, delivering the radiation to specific points on your body.

    Radiation therapy may be an option if cancer cells remain after surgery and radioactive iodine treatment or if Hurthle cell cancer spreads.

    Side effects may include:

  • Sore throat
  • Sunburn-like skin rash
  • Fatigue

    Targeted drug therapy

    Targeted drug treatments use medications that attack specific abnormalities within cancer cells. Targeted therapy may be an option if your Hurthle cell cancer returns after other treatments or if it spreads to distant parts of your body.

    Side effects depend on the particular drug, but may include:

  • Diarrhea
  • Fatigue
  • High blood pressure
  • Liver problems
    Targeted drug therapy is an active area of cancer research. Doctors are studying many new targeted therapy drugs for use in people with thyroid cancer.
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  • Resource : Mayo Clinic