Hurthle cell cancer is a rare type of thyroid carcinoma and it is usually classified with follicular thyroid carcinoma. Hurthle cell cancer has about 3-10% reported cases in past years. There are both benign hurthle cell tumors and malignant hurthle cell tumors similar to that of follicular cancer. The pathological difference is based on invasion of the capsule and the blood vessels.
1 Hurtle cell carcinoma mostly occurs in older patients and they widely spread to the lymph nodes and they may reoccur back in the neck and it may also spread to the lungsCAUSES 3· Radiation· Iodide deficiency· Overexpression of the p-53 oncogene· Mutation of the thyrotropin receptor· Somatic gene mutations involved in the growth control· Activation, mutation or translocation in the ras-oncogeneCLINICAL PRESENTATIONS 2· Lump in the neck· Pain in the neck and throat· Hoarseness in the voice· Shortness of breath· Difficulty in swallowingDIAGNOSIS 3· Physical examination of the neck· Thyroid biopsy· Blood tests· Imaging testsTREATMENTØ Surgery-Total or partial removal of the thyroid (thyroidectomy) is the most preferred common treatment for Hurthle cell cancer. Ø Radioactive iodine-131 treatmentØ Levothyroxine treatmentØ Levothyroxine treatment is started with the dose of 131I. The effective dose of T4 in adults is 2.2-2.
8 mcg/kg. Ø External radiotherapyØ Chemotherapy- The drugs include Multi-kinase inhibitors, selective kinase inhibitors, and combination therapies such as Sorafenib, Gefitinib, Axitinib, Motesanib, Sunitinib, and Pazopanib.2,4
