Introduction:
The thyroid gland is a butterfly-shaped gland present in the lower neck. The thyroid gland secretes hormones that regulate the body's metabolism. Hurthle cell carcinoma is a type of follicular type of thyroid cancer. Hurthle cell thyroid is predominant in females as compared to men. Hurthle cell thyroid is an aggressive type of thyroid cancer as compared to other thyroid cancers.
What Is a Hurthle Cell?
A Hurthle cell is a thyroid cell that looks distinct when viewed under a microscope. A hurtle cell is larger than a follicular cell. The Hurthle cell is a pink-staining cell. These cells are termed enlarged pink-staining oncocytic cells.
What Is Hurthle Cell Thyroid Carcinoma?
Hurthle cell carcinoma is a type of follicular type of thyroid cancer. The thyroid is a butterfly-shaped gland present in the neck region. The thyroid produces hormones that help to regulate body metabolism. Papillary thyroid cancer can arise along with the features of hurthle cell carcinoma. Hurthle cell cancer is a rare type of cancer affecting the thyroid gland. Hurthle cell cancer is also referred to as hurthle cell carcinoma or oxyphilic cell carcinoma. Hurthle cell cancer metastasizes through arteries and veins to distinct parts of the body and also through lymphatic circulation. Hurthle cell cancer has a poor prognosis as compared to other types of cancer.
Who Can Develop Hurthle Cell Carcinoma?
Hurthle cell cancer can develop in any group of individuals. However, it is commonly seen in the elderly and individuals with a history of head and neck radiation therapy. Three percent of all thyroid cancer consists of hurthle cell cancer. Individuals with a family history of thyroid cancer are at risk of developing hurthle cell cancer.
What Is the Pathophysiology of Hurthle Cell Cancer?
Hurthle cell cancer can be a benign form of adenomas. The tumors are characterized by the invasion of blood vessels and the thyroid gland capsule. The tumor tends to invade the surrounding areas and lymph nodes. Mutations in the ATPase 6 gene, which disturbs DNA and mitochondrial function and causes hurthle cell cancer,
What Causes Hurthle Cell Cancer?
No distinct causes of hurthle cell cancer are known. However, cancer develops when thyroid cells change DNA structure. Cellular DNA determines the behavior of that cell. The DNA changes are termed mutations, which result in the growth and multiplication of thyroid cells rapidly. The cells continue living when the surrounding cells die naturally. The cells collect to form a mass called a tumor. This tumor mass can invade and destroy surrounding healthy tissue. This tumor spreads to other body parts due to:
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Exposure to X-ray radiation or radiation therapy as a treatment for cancer.
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Family history of thyroid cancer.
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Prolonged iodine deficiency.
What Are the Symptoms of Hurthle Cell Carcinoma?
Generally, hurthle cell cancer presents without any symptoms. However, symptoms appear when large thyroid nodules appear, which further develop into cancer. These nodules affect the surrounding tissues. Hurthle cell cancer shows the following symptoms:
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Muscle loss.
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Unexplained weight loss.
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Changes in voice, hoarseness.
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Choking or inability to breathe.
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Difficulty breathing and swallowing.
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Painful nodule in the neck or throat.
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Swollen lymph nodes.
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These signs and symptoms are not clear indicators of hurthle cell cancer. They may indicate conditions like inflammation or enlargement of the thyroid gland.
What Is Post-surgery Follow-up?
Regular follow-up after surgery is important. To evaluate thyroid hormone replacement is optimally dosed and thyroid levels are under control. To confirm that there is no recurrence of cancer. Patients are monitored at six monthly or yearly intervals. Follow-up visits should include a physical examination, an ultrasound of the neck region, and blood tests to evaluate thyroid hormone levels. This follow-up also depends on the age of the patient, location, size, and extent of the tumor.
How to Diagnose Hurthle Cell Cancer?
To diagnose hurthle cell cancer, a thorough physical examination is performed by the doctor. The doctor may run tests like the following:
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Fine Needle Aspiration: A small, thin needle is used to collect thyroid tissue samples. This sample is examined under a microscope to detect cancer.
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Ultrasound: Ultrasound or fiber optic laryngoscopy to evaluate vocal cord mobility.
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Imaging Tests: Imaging tests like computed tomography scans, magnetic resonance imaging scans, and positron emission tomography scans with the use of magnetic fields, radio waves, and radiations to look for the spread of cancer.
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Thyroid Uptake Scan: It involves an injection of radioactive iodine into the bloodstream. Radioactive iodine is taken up by the cancer cells in the thyroid gland. This injection is followed by a PET scan to evaluate the spread of cancer.
How Is Hurthle Cell Cancer Treated?
The important treatment for hurthle cell cancer is surgery. Surgical removal of part or all of the thyroid gland, followed by lymph node dissections of the neck tissues involved.
Medication therapy to reduce thyroid hormones post-surgery. These medications reduce the risk of recurrence of cancer.
What Are the Complications Associated With Hurthle Cell Cancer?
Hurthle cell cancer is more aggressive than other forms of thyroid cancer. It spreads to the surrounding lymph nodes. The more spreads, the more difficult for the cancer to cure.
How Can Hurthle Cell Cancer Be Prevented?
There is no direct way to prevent the occurrence of hurthle cell cancer. Risk can be reduced by avoiding head and neck radiation.
Factors that increase the risk of developing thyroid cancer include:
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Low iodine levels.
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Female population.
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Elderly individuals.
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History of radiation to head and neck.
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Family history of thyroid cancer.
What Are the Complications of Hurthle Cell Cancer?
Possible complications of hurthle cell cancer include problems with swallowing and breathing if cancer pressurizes the food pipe and windpipe. Hurthle cell cancer can spread to surrounding tissues and organs. This complicates further treatment and delays recovery.
Conclusion:
It is important to treat hurthle cell cancer as early as possible. Many people recover from hurthle cell cancer post resection of the thyroid gland. Post-resection medications are necessary to balance the thyroid hormones. Hurthle cell cancer is challenging in terms of diagnosis as well as treatment.
