Hurthle Cell Carcinoma

Hürthle cell carcinoma is a rare, aggressive form of thyroid cancer. Cancer specialists may use the term oncocytic thyroid carcinoma. Your thyroid is a tiny gland in the front of your neck that controls your metabolism. Hürthle (pronounced “HEERT-luh” or “HER-THUL) cell carcinoma causes tumors that can spread from your thyroid to other areas of your body.

Symptoms of Hürthle cell carcinoma

This disease may not cause symptoms. Often, healthcare providers discover it during routine checkups because they feel a lump on your thyroid. When you have symptoms, they may include:

• Difficulty breathing or swallowing
• Feeling as if you’re choking
• A painful lump in the front of your throat, below your Adam’s apple
• Swollen lymph nodes
• Fatigue
• Losing weight without trying

Hürthle cell carcinoma causes

Medical researchers don’t know the exact cause. But certain risk factors increase the chance you’ll have this disease. Those risk factors include:

• Age: It’s more common in people age 55 and older.
• Sex: It affects females more than males.
• Family health history: Your risk increases if your biological parents or siblings have thyroid cancer.
• Iodine deficiency: Low iodine in your thyroid may lead to genetic changes that cause cancer.
• Radiation exposure: This is exposure to radiation from X-rays or receiving radiation therapy.

How doctors diagnose the disease

A healthcare provider will do a physical exam. They’ll ask about your symptoms, your health history and whether any close family members have thyroid cancer. They’ll do tests like:

• Ultrasound: This test is the first step in checking on a thyroid nodule or mass.
• Fine needle aspiration (FNA): Your provider may do this test after your initial ultrasound. They use a thin needle to get a sample of your thyroid tissue. A medical pathologist will check the sample for cancer.

Your provider may do other imaging tests like a CT scan, an MRI or PET scan. The tests may show if this cancer is spreading outside of your thyroid.

Hürthle cell carcinoma stages

Oncologists use cancer staging systems to plan treatment. Hürthle cell carcinoma stages range from Stage I to Stage IV:

• Stage I: The tumor measures between 2 and 4 centimeters (about half an inch to 1.5 inches). It hasn’t spread outside your thyroid.
• Stage II: The tumor still measures between 2 and 4 centimeters, but it’s now in nearby lymph nodes.
• Stage III: The tumor is in nearby neck tissues, like your voice box (larynx), windpipe (trachea) or food pipe (esophagus).
• Stage IV: The tumor is spreading to more areas of your body. It may be moving toward your spine and nearby large blood vessels, your bones, brain or lungs.

How do doctors treat this disease?

Surgery to remove part or all of your thyroid may cure Hürthle cell carcinoma. You may take medication after surgery that stops your thyroid from making hormones. This reduces the risk that cancer will come back. Other possible treatments are:

• Hormone therapy: Replacing thyroid hormones with medication after surgery can keep cancer cells from coming back.
• Radioactive iodine therapy: This treatment kills thyroid cancer cells.

When should I see my healthcare provider?

Hürthle cell cancer can come back. Your provider will schedule regular checkups to look for disease signs or symptoms. They’ll check your neck for new lumps. They’ll likely do a neck ultrasound and blood tests at least once a year.

What’s the survival rate for Hürthle cell carcinoma?

This disease is rare, which can make it challenging to pin down specific survival rates. For example, the National Cancer Institute (U.S.) groups this cancer as a subtype of follicular thyroid cancer. NCI states that, overall, 98% of people with follicular thyroid cancer were alive five years after diagnosis.

NCI classifies cancer as being localized, regional or distant. In this case, localized cancer means the tumor only affects your thyroid. Regional cancer affects nearby tissues or organs, and distant cancer is in another area of your body.

According to NCI data, 9 out of 10 people with localized or regional follicular thyroid cancer were alive five years after their diagnosis. That survival rate drops to 6 out of 10 people when cancer spreads to more distant areas of your body.

Why is there a new name for Hürthle cell carcinoma?

The disease was named after medical researcher Karl Hürthle, who concluded that one type of cancerous cell led to a specific thyroid cancer. Later research concluded a different cell type — oncocytes — forms the tumors.