Hurthle Cell Carcinoma: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Hurthle cell cancer is a very uncommon kind of thyroid gland cancer. Located near the base of the neck, the thyroid gland is shaped like a butterfly which secretes hormones and maintains the metabolism of our body. Oxyphilic and Hurthle cell carcinoma are other names for this type of cancer. 

This is just one type of thyroid cancer among many others. This type of thyroid cancer could be more aggressive than others. Surgery to remove the thyroid gland is the most popular type of treatment.

Causes Of Hurthle Cell Carcinoma

Hurthle cell carcinoma has an unclear aetiology. The primary cause of this cancer is changes in the DNA of thyroid cells. A cell's DNA contains instructions that tell it what to do. The thyroid cells are directed to multiply and mature quickly by the anomalies in the DNA.

 The cells have the ability to survive while other cells would usually die. Together, the proliferating cells create a mass known as a tumour, which can invade, destroy, and spread to nearby healthy tissue as well as other parts of the body.

Also Read: Salivary Gland Tumours: Causes, Symptoms, Types, Diagnosis and Treatment

Symptoms Of Hurthle Cell Carcinoma

Hurthle cell cancer is not always symptomatic; in rare cases, a physical examination or imaging test performed for a different reason may reveal the malignancy.

When they do manifest, the following signs and symptoms may be present:

There is a bulge in the neck below the Adam's apple.

• Discomfort in the throat or neck
• Any modifications to voice, like hoarseness
• Breathing problems
• Difficulty swallowing

If you have these signs and symptoms, Hurthle cell carcinoma may not be your only diagnosis. These may indicate additional conditions, such as goitre or thyroid gland irritation.

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Risk Factors Of Hurthle Cell Carcinoma

Thyroid cancer risk factors include the following:

• Being a female
• Becoming older 
• Already undergone radiation treatment to the head and neck
• Having a family history

Diagnosis Of Hurthle Cell Carcinoma

The diagnostic procedures and tests used to identify Hurthle cell carcinoma are as follows:

• Physical assessment: During the examination, your doctor will measure the size of your thyroid and check to see if there are any swollen lymph nodes in your neck.
• Blood tests: Blood tests that reveal abnormalities in your thyroid function might tell your doctor more about your condition.
• Imaging tests: If there is a growth on your thyroid, your doctor may use imaging tests like CT and ultrasound to determine it.
• Inspection of the voice cords (laryngoscopy): Your doctor will visually examine your voice chords during a laryngoscopy procedure by looking into the back of your throat with a tiny mirror and a light. Your physician may also use fibre-optic laryngoscopy. 
  • A small, flexible tube is introduced by your mouth or nose and into the back of your throat, containing a tiny camera and light. Your healthcare provider will then be able to see how your voice chords move when you speak. This procedure might be recommended if there is a possibility that the cancer cells have spread to the vocal cords, such as if you notice unsettling changes in your voice.
• Taking a sample of thyroid tissue out for analysis (biopsy): During a thyroid biopsy, a thin needle is injected into the skin of the neck with the use of ultrasound images. A sample of thyroid tissue is extracted using a syringe that has a needle attached. experts who have experience looking for signs of cancer in samples- in a lab analysing blood and body tissue.

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Treatment Of Hurthle Cell Carcinoma

The following problems are possible with hepatocellular carcinoma:

• Breathing and swallowing problems: These could occur if the cancer spreads and puts pressure on the oesophagus and trachea, the windpipe and feeding tube.
• Cancerous development: When Hurthle cell carcinoma spreads (metastasizes) to other tissues and organs, treatment and recovery may become more difficult.

Surgery to remove the thyroid is the usual course of treatment for Hurthle cell carcinoma. Different courses of action may be recommended, depending on your situation.

Surgery

Thyroidectomy, or removal of the thyroid all or almost all, is the most common treatment for Hurthle cell carcinoma. During a thyroidectomy, the surgeon removes all or almost all of the thyroid gland, leaving thin margins of thyroid tissue surrounding it to lessen the chance of damaging the small neighbouring glands (parathyroid glands). 

The parathyroid glands regulate the body's calcium levels. The neighbouring lymph nodes could be removed if it seems that the cancer has damaged them.

Risks associated with thyroidectomy include:

• Voice loss and/or temporary or persistent hoarseness can be caused by damage to the recurrent laryngeal nerve, which controls the voice box.
• Medication may be required for parathyroid gland injury to regulate blood calcium levels.
• Severe bleeding

To replace the hormone the thyroid produces following surgery, your doctor will prescribe levothyroxine (Synthroid, Unithroid, and other brands). You have to take this hormone for the rest of your life.

Radioactive iodine therapy

Radioactive iodine therapy is administered by swallowing a capsule containing a radioactive liquid.

After surgery, radioactive iodine therapy could be recommended to help remove any remaining thyroid tissue since it might include cancerous leftovers. If the Hurthle cell carcinoma has spread to other parts of the body, radioactive iodine treatment is an additional option.

The following are some short-term side effects of radioiodine therapy:

• Dry mouth
• Reduced taste perception, 
• Discomfort in the neck, 
• Emesis
• Exhausted

Radiation Therapy

Radiation therapy uses powerful energy beams, like protons or X-rays, to kill cancer cells. Radiation therapy involves lying down on a table with a machine revolving around you to apply radiation to certain body parts.

If radioactive cancer cells remain after surgery or if Hurthle cell cancer spreads radiation therapy can be a possibility. Among the potential negative effects are:

• Sore throat 
• Skin rash that looks like a sunburn
• Tired

Targeted therapy

Targeted medicine therapies employ medication to target specific weaknesses in cancer cells. Targeted therapy may be an option for you if your Hurthle cell carcinoma spreads to other areas of your body or returns after undergoing treatment.

Side effects vary by medicine and may include:

• Feeling tired 
• Diarrhoea 
• Raised blood pressure
• Liver problems

In the current state of cancer treatment, research is concentrated on targeted pharmaceutical therapy. Many new targeted treatment drugs are being investigated by doctors for individuals with thyroid cancer.

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Complications Of Hurthle Cell Carcinoma

The following problems are possible with hepatocellular carcinoma:

• Breathing and swallowing problems: These could occur if the cancer spreads and puts pressure on the oesophagus and trachea, the windpipe and feeding tube.
• Cancerous development: When Hurthle cell carcinoma spreads (metastasizes) to other tissues and organs, treatment and recovery may become more difficult.

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