Hurthle Cell Cancer

Definition:Hurthle (HEERT-luh) cell cancer is a rare cancer that affects the thyroid gland. The thyroid is a butterfly-shaped gland in the base of your neck. It secretes hormones that are essential for regulating your body's metabolism.

Symptoms:Most patients with thyroid cancer do not have any symptoms. Typically, patients present with a thyroid nodule that on further evaluation is found to be cancer. As with all thyroid disease, a thorough history is important, such as a family history of thyroid cancer, personal history of radiation exposure, or enlarged lymph nodes. Your physician will review with you any symptoms such as pain, swelling in the neck, difficulty with swallowing, shortness of breath, difficulty with breathing or changes in your voice. If the nodule is large, it may cause symptoms such as difficulty swallowing, choking sensations, or a large mass in the neck. Rarely, the cancer can grow into the nerves (i.e. the recurrent laryngeal nerves) that control the voice box and cause hoarseness.

Treatment:The best treatment for follicular and Hurthle cell cancers is total thyroidectomy (i.e. removal of the whole thyroid). However, most of these patients will present with a follicular or Hurthle cell neoplasm. Therefore, most patients are initially treated with a thyroid lobectomy to remove the nodule and make a diagnosis. (See Thyroid Surgery) If there is no evidence of invasion outside of the nodule, then it is a benign adenoma. However, if the cells grow outside of the surrounding capsule (capsular invasion), into blood vessels (vascular invasion), or into the lymphatics (lymphatic invasion), then the patient has cancer and usually needs to have the rest of the thyroid removed in an operation called a completion thyroidectomy. This can be done at any point after the first operation, but most surgeons prefer to either do it within a week or after 6 weeks.

Statistics:Overall, there were 26 (23%) patients with constipation, and 9/23 (39%) had delayed passage of meconium after 48 hours. Despite frequent bowel disorders only 4 (3.5%) patients had undergone histologic examination of the Throat.