Hürthle cell thyroid cancer is a rare and aggressive type of thyroid cancer. However, the outlook for people with this cancer can be good when it’s diagnosed and treated in its early stages. The main treatment is surgery.

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Thyroid cancer begins in your thyroid gland, which makes hormones that are important for regulating your metabolism. There are many types of thyroid cancer.

Hürthle cell cancer (HCC), or oxyphil cell carcinoma, is a rare type of thyroid cancer. According to the American Cancer Society, only 3% of thyroid cancers are HCC.

Hürthle cells are large cells that are found in both benign and cancerous thyroid lesions. They have specific characteristics under a microscope, such as a round nucleus and a grainy appearance.

A 2020 study notes that, for many, the first symptoms of HCC include thyroid nodules and swelling of the lymph nodes in the neck.

Most of the time, thyroid nodules are asymptomatic, meaning that they cause no symptoms. They’re often discovered incidentally when imaging scans are done to evaluate other health conditions.

Larger nodules are generally more likely to cause symptoms, such as a bump or lump in your neck that you can feel and pain or discomfort in the front of your neck.

When nodules become very large, they can cause symptoms such as:

Risk factors for Hürthle cell thyroid cancer

You may have a higher risk of thyroid cancer in general if any of your close relatives have had it. HCC is more common in females and typically occurs after age 40.

Previous radiation exposure to the head, neck, or chest is also a known risk factor for thyroid cancer. However, a 2021 review notes that no correlation between radiation exposure and development of HCC has yet been reported.

The diagnosis of HCC begins with your doctor taking your medical history and doing a physical exam. During the physical exam, they will feel your thyroid and the lymph nodes in your neck to see whether they’re larger than usual.

Healthcare professionals may use an ultrasound to check for and evaluate thyroid nodules.. A radioiodine scan can also be used to assess nodules. Nodules that take up a lot of radioactive iodine, called hot nodules, are rarely cancerous.

For nodules that may be cancerous, healthcare professionals will perform a biopsy using fine needle aspiration (FNA). Molecular tests on the biopsy sample can help identify cellular changes that are associated with cancer.

However, an FNA biopsy alone may not be able to confirm a diagnosis of HCC, and a larger tissue sample may be needed. This can involve a lobectomy — the removal of half the thyroid.

Once your doctor has diagnosed HCC, they may do additional tests to see whether the cancer has spread to other areas of your body. This typically involves imaging tests such as:

The main type of treatment used for HCC is surgery. This can involve a lobectomy or the removal of the entire thyroid (thyroidectomy). If cancer has spread to nearby lymph nodes, these may be removed as well.

After surgery, radioactive iodine (RAI) may be used for cancers that have a high risk of recurrence. However, only about 10% of HCCs take up RAI. When RAI isn’t an effective option, external beam radiation therapy may be used instead.

If the cancer has metastasized, healthcare professionals may treat it with RAI, external beam radiation therapy, or targeted therapy drugs. The targeted therapy drugs used for HCC are lenvatinib (Lenvima) and sorafenib (Nexavar).

If HCC remains localized to your thyroid, it’s possible for healthcare professionals to remove it entirely from your body with surgery alone. However, if your thyroid is removed, you will need to take thyroid hormone therapy for the rest of your life.

HCC is more aggressive than many other types of thyroid cancer. That means it can grow and spread more quickly. However, the outlook can be positive when it’s diagnosed in early stages, before it has spread beyond the thyroid.

A 2020 study of 2,101 people with HCC found that 82.82% had local disease, while 11.66% and 4.24% had regional and metastatic disease, respectively. The 10-year cancer-specific survival rate for this entire group was 92.6%.

The outlook for metastatic HCC is less favorable. A small 2016 study of 32 people with metastatic HCC found a 10-year cancer-specific survival rate of 60%. It’s estimated that 1 in 4 people with HCC will develop metastatic disease at some point.

HCC can also come back after treatment. This is called recurrence. Researchers have estimated that 12% to 33% of people with HCC will experience a recurrence.

HCC is a rare type of thyroid cancer that is often asymptomatic.

HCC is more aggressive than other types of thyroid cancer. However, the outlook for people with this cancer tends to be positive if it’s diagnosed early.

Contact your doctor if you notice a new lump or bump in your neck, swollen lymph nodes in your neck, or pain in the front of your neck. While these symptoms may not be caused by thyroid cancer, they may indicate other conditions that need attention.