Hurthle Cell Cancer

1 What is Hurthle Cell Cancer?

Hurthle cell cancer, also known as Hurthle cell carcinoma or oxyphilic cell carcinoma, is a rare form of cancer that affects your thyroid gland.

The thyroid is a butterfly-shaped endocrine gland situated at the base of your neck. It secretes hormones that regulate the body's metabolism, growth and development.

A more aggressive form of thyroid cancer, surgical removal of thyroid gland is the most common treatment for Hurthle cancer.

2 Symptoms

Signs and symptoms of Hurthle cell cancer include:

  • A fast-growing lump in your neck, just below Adam's apple¬†
  • Pain in the neck region or throat
  • Hoarseness or other changes in your voice
  • Shortness of breath
  • Difficulty in swallowing

Presence of these signs and symptoms don't confirm you have Hurthle cell cancer. The symptoms may be indicative of other conditions such as inflammation of the thyroid gland or a noncancerous enlargement of the thyroid (goiter).

When to see a Doctor
Talk to your doctor if you experience any of the signs and symptoms.

3 Causes

The exact cause behind Hurthle cell cancer has not yet been explained.

The cancer may be the result of genetic mutations. Mutated genes contain errors in the DNA which lead to uncontrolled and rapid growth of cells that form a mass (tumor) of cancerous (malignant) cells.

4 Making a Diagnosis

If Hurthle cell cancer is suspected, you may be referred to an endocrinologist or an oncologist to receive a diagnosis.

Following tests and procedures may be recommended for the diagnosis of Hurthle cell cancer:

  • Physical examination: Includes examination of the neck region, checking the size of your thyroid and assessing whether your lymph nodes are swollen.
  • Blood tests: To identify any abnormalities in thyroid function.
  • Imaging tests: Imaging tests like Ultrasound, CT scan, MRI and positron emission tomography (PET) may be employed to detect any abnormalities in the size or growth of thyroid gland.
  • Biopsy: A sample of thyroid tissue is collected by passing a fine needle through the skin in the neck under guidance of ultrasound images. The sample is then analyzed in a laboratory for signs of cancer.

5 Treatment

Usually, Hurthle cell cancer is treated by the surgical removal of the thyroid gland. Alternative treatment modalities include radiation therapy and chemotherapy. 

  • Surgery: Also called thyroidectomy, this is the most common treatment for Hurthle cell cancer. Entire or a portion of the thyroid gland is surgically removed while the tiny edges of thyroid tissue near small adjacent glands called parathyroid glands, are left behind. The parathyroid glands help in regulation of body's calcium level. The adjacent lymph nodes may be removed if the spread of cancer is suspected.Risks associated with thyroidectomy include:
    • Injury to the nerve named recurrent laryngeal nerve, which may cause temporary or permanent hoarseness or a loss of voice.
    • Damage to the parathyroid glands.
    • Excessive bleeding.
    • After surgery, lifetime intake of the hormone, levothyroxine is necessary.
  • Radioactive iodine therapy: A radioactive liquid containing capsule is taken. This therapy may be recommended after surgery to help destroy any thyroid tissues that have survived the surgery. It may also be used if Hurthle cell cancer has moved to other parts of the body.Temporary side effects of radioiodine therapy include: Sore throat, dry mouth, reduced sense of taste, neck tenderness and nausea.
  • Radiation therapy: Radiation therapy uses ionizing radiations such as X-rays to kill cancer cells.During radiation therapy, the radiations produced by the machine are focused on specific body part with cancer. Radiation therapy may be an alternative treatment modality 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.
  • Chemotherapy: This involves the use of chemical drugs to treat cancer. Sorafenib (Nexavar) is a drug used in metastatic or aggressive thyroid cancer that doesn't respond to radioactive iodine therapy.Side effects include: high blood pressure, diarrhea, fatigue, skin rash, weight loss.

6 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with Hurthle cell cancer..

Being diagnosed with Hurthle cell cancer can be a devastating and life changing event.

Followings tips may work to help you cope up, manage the stress and anxiety.

  • Stay close to family, friends or others who are closer.
  • Join a support group.
  • Set goals that are reasonable, realistic and achievable: Setting goals can make you more focused and in control.
  • Take time for yourself: Eating well, relaxing and getting enough rest can help combat the stress and fatigue associated with cancer.

7 Risks and Complications

There are several risks and complications associated with Hurthle cell cancer.

Risks

  • Sex: Females are at higher risk to get Hurthle cell cancer.
  • Age: Older people are at greater risk of getting Hurthle cell cancer.
  • History of radiation treatments to the head and neck.

Complications

  • Difficulty in swallowing and breathing if the tumor grows and presses on the food pipe (esophagus) and windpipe (trachea).
  • Spread of the cancer (metastasis) to other tissues and organs, makes treatment and recovery more difficult.
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