A Guide to Hürthle Cell Carcinoma

Medically Reviewed By Kelly Wood, MD
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Hürthle cell carcinoma is a rare type of cancer that begins in the thyroid gland, a small gland in the base of your neck. While the early stages of the disease may be asymptomatic, late-stage symptoms can include a lump in the neck, pain, and shortness of breath. Doctors commonly diagnose the condition with a physical examination and a blood test. They may also perform an imaging test. Treatments include surgery and radiation therapy.

This article covers the causes and symptoms of Hürthle cell carcinoma. It also explains the diagnostic process, treatments, and outlook for people with the condition.

Causes and risk factors

A woman feeling the front of her neck
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Exactly what causes Hürthle cell carcinoma is currently unclear. However, according to experts, exposure to radiation to the head, neck, and chest is a risk factor for developing the condition.

In addition, having a personal or family history of thyroid cancer may increase the risk of developing Hürthle cell carcinoma.

Learn more about thyroid carcinoma.

Symptoms

Early-stage Hürthle cell carcinomas may not cause any symptoms. 

Advanced cases, on the other hand, may cause the lymph nodes in the head and neck to become atypically enlarged.  

Other symptoms include:

Speak with your doctor if you have any of these symptoms.

Learn 8 things to know about thyroid cancer.

Diagnosis

To begin the diagnostic process for Hürthle cell carcinoma, your doctor will use a physical exam to determine if you have a thyroid nodule. The nodule may be hard and immobile, which could indicate cancer. They will also typically record your family and medical history.

Last, they will run a range of tests, including:

  • Blood tests: These tests can help doctors asses whether your thyroid glands function properly.
  • MRI or CT scan: This will help determine if the carcinoma invades other tissue.
  • Thyroid fine needle aspiration: This is a type of biopsy that uses a needle to collect a tumor sample. It can help identify Hürthle cells and detect cancer.
  • Laryngoscopy: This is a procedure to examine your larynx, which is your voice box. It can help spot lesions.

Staging

Experts use the tumor, nodes, and metastasis (TNM) staging system to assess the progression of Hürthle cell carcinoma in the body.

The TNM staging system uses the following principles:

  • T for tumor: This describes the size and location of the cancerous tumor.
  • N for lymph node involvement: This looks at the extent of the spread of cancer to the lymph nodes.  
  • M for metastasis: This measures the extent of the spread of the tumor to distant parts of the body.

In general, the bigger the tumor and the farther the spread, the higher the stage. There are 4 stages of Hürthle cell carcinoma, with stage 4 being the latest stage with the most spread.

The staging process helps doctors prepare an appropriate treatment plan.

Treatments

Surgery is the gold standard in the treatment of Hürthle cell carcinoma. Your doctor will use the following steps to perform the procedure:

  1. They will give you a general anesthetic to put you to sleep.
  2. Next, they will make an incision at the front part of your neck.
  3. They will locate the tumor and the affected lymph nodes.
  4. Finally, they will remove all or almost all of your thyroid gland. They may also remove any affected lymph nodes.

The technical term for this method is “thyroidectomy.” It is generally safe, but it can cause some side effects, including:

Learn more about what to expect with thyroidectomy.

Additional treatments for Hürthle cell carcinoma may include:

  • Thyroid hormone pills: These drugs replace the thyroid hormones for people who do not have a thyroid after undergoing thyroid removal surgery.
  • Radioiodine therapy: This therapy involves a drug that targets any remaining thyroid cancer cells.
  • Targeted therapy: If radioiodine therapy is ineffective for you, doctors may administer drugs that target specific parts of cancer cells.
  • Radiation therapy: This therapy uses high doses of radiation to target cancer cells. Your doctor may administer this treatment after surgery. In some cases, they may also administer it if radioiodine therapy is ineffective or if the cancer spreads or recurs.

Outlook

With treatment, the outlook for people with Hürthle cell carcinoma is encouraging.

A 2017 study involved 239 people with the condition and analyzed their 5-year, 10-year, and 20-year survival rates. The average age of the participants was 54.3 years, and they had a female-to-male ratio of 3.6:1.

The results of the study were as follows:

  • The overall 5-year survival rate was 89.4%.
  • The overall 10-year survival rate was 77.2%.
  • The overall 20-year survival rate was 61.9%.

The study also shared that cancer recurrences are rare after adequate surgical treatment.

Survival rate refers to the number of people who are still alive for a specific length of time after a particular diagnosis.

For example, a 5-year survival rate of 50% means that half of the people are still alive 5 years after their diagnosis. 

It is important to remember that these figures are estimates and are based on previous medical studies. Talk with your doctor about the outlook for your specific condition.

Complications

Without treatment, Hürthle cell carcinoma can involve various health complications. 

Hürthle cell carcinoma might invade the vocal cords, windpipe, and other parts of the neck. It may also compress the major nerves and vessels in the neck.

Additionally, metastasis or the spreading of cancer to distant organs may occur. This cancer can affect various parts of the body, including the bones, lungs, and brain. 

Early diagnosis and prompt treatment are typically the best ways to prevent complications from Hürthle cell carcinoma.

FAQ

Here are a few common questions about Hürthle cell carcinoma. Kelly Wood, MD, reviewed the answers.

Is Hürthle cell thyroid cancer aggressive?

Hürthle cell carcinoma is an aggressive form of cancer. However, with prompt treatment, the outlook for people with the condition can be good.

Is Hürthle cell carcinoma rare?

According to researchers, Hürthle cell carcinoma is rare, accounting for 3–5% of all thyroid cancers.

Summary

Hürthle cell carcinoma is a rare type of cancer that begins in the thyroid gland, a small gland in the base of your neck. Symptoms may include a lump in the neck, pain, and shortness of breath.

While the exact cause of the condition is unknown, exposure to radiation in the head, neck, and chest may be involved. Experts also believe a family history of thyroid cancer might play a role.

Diagnosis typically begins with a physical exam. A doctor will also typically perform a range of tests, including a biopsy. Treatments include surgery, radioiodine therapy, and radiation therapy.

Talk with your doctor about the best treatment plan for your individual situation.

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Medical Reviewer: Kelly Wood, MD
Last Review Date: 2022 Dec 7
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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  2. Fariduddin, M. M., et al. (2022). Hurthle cell thyroid carcinoma. https://www.ncbi.nlm.nih.gov/books/NBK568736/
  3. Kure, S., et al. (2020). Thyroid Hürthle cell carcinoma: Clinical, pathological, and molecular features. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793513/
  4. Oluic, B., et al. (2017). Survival and prognostic factors for survival, cancer specific survival and disease free interval in 239 patients with Hürthle cell carcinoma: A single center experience. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5445517/