Hurthle Cell Thyroid Cancer
Hurthle cell thyroid cancer is usually classified with follicular thyroid cancer, although it is a distinct and uncommon type of thyroid tumour. Like follicular tumours, there are benign Hurthle cell tumours and malignant Hurthle cell tumours, and the pathologist tells the difference between them based on invasion of the capsule and the blood vessels. Benign Hurthle cell tumours are not a threat at all and should not come back once they are removed.
The average age for patients with Hurthle cell cancer is 55, about 10 years older than for patients with follicular cancer and like follicular cancer, Hurthle cell thyroid cancer infrequently spreads to lymph nodes (about 10%) but can recur locally in the neck or spread to the lungs or bones.
Treatment
- Surgery is the best treatment for Hurthle cell cancer
- During surgery all of the thyroid gland is removed – this procedure is called a total thyroidectomy
- Surgery may be followed with radioactive iodine but radioactive iodine does not work as well for Hurthle cell cancer as it does for follicular cancer
- The Hurthle cells are less likely to “take up” the radioactive iodine and then be destroyed by it – however, radioactive iodine is well-tolerated treatment and may be helpful for some patients
- Patients are then followed at regular intervals to check for recurrence, which can be dangerous in Hurthle cell cancer and needs to be watched for carefully.
Prognosis
- Because younger patients with thyroid cancer tend to have a better prognosis than older patients with a very similar tumour, and because Hurthle cell cancers occur in older patients, they have the reputation for having a worse prognosis
- However, if you control for age and other factors like tumour size and extent (whether it has spread locally in the neck or elsewhere in the body), Hurthle cell tumours behave very similarly to follicular tumours
- A small Hurthle cell cancer which does not have extensive invasion, especially in a younger patient (under 45), can have an excellent prognosis
If you have any questions about thyroid symptoms or thyroid surgery, you should speak to your local doctor, who will arrange to contact your thyroid surgeon.
