What is Hurthle cell carcinoma (HCC)?
Hurthle cell carcinoma is a variant of follicular thyroid cancer (FTC). The thyroid is a butterfly-shaped gland in the neck. It produces several hormones involved in regulating metabolism (your body’s functions). It is also possible to develop papillary thyroid carcinoma with Hurthle cell variant/features.
FTCs tend to metastasize (spread) through veins and arteries to other organs in the body and via the lymphatic system. Hurthle cell cancer can be more aggressive than other types of thyroid cancer. HCC may have a worse prognosis than FTC.
Who is likely to have Hurthle cell carcinoma (HCC)?
Anyone can develop HCC. It is more common among older people and people who have radiation therapy to the head or neck. HCC represents about 3 percent of all cases of thyroid cancer.
Women are more likely than men to develop thyroid cancer. Having a history of thyroid cancer in a close relative (parent, sibling, or child) is a risk factor for developing thyroid cancer.
Symptoms and Causes
What causes Hurthle cell carcinoma (HCC)?
The exact cause of HCC is unknown. Doctors associate several risk factors with the disease, including:
- Exposure to radiation from X-rays or medical treatments like radiation therapy for cancer. X-rays use low doses of radiation to create pictures of internal body structures.
- Family history of thyroid cancer
- Long-term iodine deficiency
What are the symptoms of Hurthle cell carcinoma (HCC)?
For most people, HCC causes no symptoms. Symptoms are likely to appear if large thyroid cancer nodules develop. These lumps may interfere with surrounding tissues. Symptoms may include:
- Changes in your voice
- Choking sensations
- Difficulty breathing or swallowing
- Painful lump in your neck
- Swollen lymph nodes. Lymph nodes are small bundles of tissue throughout your body. They filter lymph fluid and make certain immune system cells.
Other, whole-body symptoms may include:
- Muscle wasting
- Unintentional or unexplained weight loss
Diagnosis and Tests
How is Hurthle cell carcinoma (HCC) diagnosed?
To diagnose HCC, your doctor performs a thorough physical exam. You’ll also discuss your symptoms and medical history.
Your doctor may also use several tests, including:
- Blood tests
- Fine needle aspiration (FNA): Your doctor uses a small, thin needle to take a sample of thyroid tissue. Doctors examine the tissue under a microscope for evidence of cancer.
- Evaluation of vocal cord mobility: by ultrasound or in-office indirect/mirror or fiberoptic laryngoscopy
- Imaging tests: Doctors order computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, and positron emission tomography (PET) scans to check for signs that cancer has spread. These tests use magnetic fields, radio waves, or radioactive drugs to visualize structures inside the body.
- Thyroid uptake scan: Your doctor injects a small amount of radioactive iodine into your bloodstream. Radioactive iodine builds up in cancer tissues in the thyroid gland. After the injection, your doctor uses a PET scan to look for any cancer cells in your thyroid.
- Ultrasound: Using sound waves, an ultrasound makes a picture of internal organs or glands.
Management and Treatment
How is Hurthle cell carcinoma (HCC) treated?
The main treatment for HCC is surgery. Surgeons remove part or all of the thyroid gland. Therapeutic lymph node dissections of the affected neck compartment may be needed for advanced disease.
Some people receive medications to suppress thyroid hormones after surgery. These medications stop the thyroid gland from making hormones that could make it more likely that cancer will come back.
Most people do not need traditional cancer treatments like radiation therapy. But your doctor or clinic may recommend something else if cancer has spread outside the thyroid gland.
What complications are associated with Hurthle cell carcinoma (HCC)?
HCC is typically more aggressive than other forms of thyroid cancer. It is more likely to spread to lymph nodes nearby. When cancer spreads, it becomes harder to treat.
Can Hurthle cell carcinoma (HCC) be prevented?
There is no way to prevent HCC. You can lower your risk of developing this disease by avoiding radiation to the head or neck.
One risk for HCC is having very low iodine levels. Most people in developed countries receive enough iodine in their regular diet from iodine-rich foods such as dairy products, shellfish, and iodized table salt.
Outlook / Prognosis
What is the prognosis (outlook) for people with Hurthle cell carcinoma (HCC)?
Many people recover from HCC after doctors remove the thyroid gland. If doctors remove your thyroid, you’ll take medications to replace thyroid hormones.
When should I call my doctor if I suspect Hurthle cell carcinoma (HCC) or any thyroid cancer?
Contact your doctor if you have any symptoms of HCC or other thyroid cancer, especially:
- A painful lump in your throat
- Difficulty breathing, speaking, or swallowing
- Persistent fatigue
- Unexplained or unintentional weight loss
If you have been treated for HCC, make sure you follow any schedule of testing or appointments your healthcare provider recommends. You should also contact them if you have any difficulties or symptoms that worry you.