Radiation Oncology/Thyroid/Hurthle cell
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Thyroid: Main Page | Workup | Staging | Papillary and follicular | Medullary | Hurthle cell | Anaplastic | |
Hürthle cell carcinoma
Variant of follicular carcinoma. Is relatively aggressive with prognosis worse than papillary carcinoma. Represent about 3% of thyroid cancer.
Prognostic factors
[edit | edit source]- M.D.Anderson, 2003 (1944 - 1995) - PMID 12599224 — "Prognostic factors in patients with Hurthle cell neoplasms of the thyroid." Lopez-Penabad L et al. Cancer. 2003 Mar 1;97(5):1186-94.
- 89 pts with Hurthle cell carcinoma, 38 with Hurthle cell adenoma.
Patterns of failure
[edit | edit source]Most recurrences are in the neck. Lung is most common site of distant mets. Recurrent disease in the neck can be treated surgically.
Cause-specific mortality approximately 30%.
Treatment
[edit | edit source]Treatment should include total thyroidectomy and unilateral central compartment neck dissection. There is no known role for adjuvant radiation therapy; however, the tumor is radiosensitive.
Only about 7% respond to I-131; however, one study (PMID 12599224; see M.D.Anderson study above) suggested a survival benefit for thyroid ablation with radioactive iodine.
Adjuvant Radiation Therapy
[edit | edit source]- Mayo Clinic, 2003 - PMID 12829143 — "Is there a role for radiation therapy in the management of Hurthle cell carcinoma?" Foote RL et al. Int J Radiat Oncol Biol Phys. 2003 Jul 15;56(4):1067-72.