scholarly journals Overview of Hurthle cell carcinoma of thyroid

2017 ◽  
Vol 3 (4) ◽  
Author(s):  
Martin A Korzeniowski ◽  
Aamer Mahmud ◽  
Angus Kirby ◽  
Kurian Joseph ◽  
Evgeny Sadikov ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Frozen Section ◽  
Treatment Decision ◽  
Needle Aspiration ◽  
Ethanol Ablation ◽  
Hürthle Cell ◽  
Systemic Treatments ◽  
Hürthle Cell Carcinoma ◽  
Hurthle Cell Carcinoma ◽  
Radioactive Iodine Ablation

<p>The clinical behaviour of Hurthle cell carcinoma (HCC) of the thyroid is variable and there are many controversies in the literature. Here, we summarize an up-to-date review of the literature on genetics, diagnosis (ultrasound scan, fine needle aspiration, frozen section, <em>etc.</em>), and management. At presentation, treatment decision should be made by a multidisciplinary board. Recurrent HCCs are seldom curable despite salvage treatments, which include radioactive iodine ablation, radiofrequency ablation, ethanol ablation, external radiotherapy, and systemic therapy. Further research is needed to develop more efficacious systemic treatments. Currently, lenvatinib, sunitinib, and sorafenib are available. The completed and ongoing clinical trials for HCC are summarized.</p>

scholarly journals Appearance of Hürthle cell carcinoma soon after surgical extirpation of Hürthle cell adenoma and follicular adenoma of the thyroid gland

2015 ◽  
Vol 49 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Nevena Ristevska ◽  
Sinisa Stojanoski ◽  
Daniela Pop Gjorceva
Keyword(s):  
Thyroid Gland ◽  
Cell Carcinoma ◽  
Tumour Size ◽  
Follicular Adenoma ◽  
Needle Aspiration ◽  
Cell Adenoma ◽  
Rare Tumour ◽  
Hürthle Cell ◽  
Hürthle Cell Carcinoma ◽  
Hurthle Cell Carcinoma

Abstract Background. Hürthle cell neoplasms could be benign (Hürthle cell adenoma) or malignant (Hürthle cell carcinoma). Hürthle cell carcinoma is a rare tumour, representing 5% of all differentiated thyroid carcinomas. The cytological evaluation of Hürthle cell neoplasms by fine needle aspiration biopsy (FNAB) is complicated because of the presence of Hürthle cells in both Hürthle cell adenoma and Hürthle cell carcinoma. Thus, the preoperative distinction between these two entities is very difficult and possible only with pathohistological findings of the removed tumour. Case report. A 57-year old female patient was admitted at our Department, for investigation of nodular thyroid gland. She was euthyroid and FNAB of the nodules in both thyroid lobes were consistent of Hürthle cell adenoma with cellular atypias. After thyroidectomy the histopathology revealed Hürthle cell adenoma with high cellular content and discrete cellular atypias in the left lobe and follicular thyroid adenoma without cellular atypias in the right lobe. One year after substitution therapy, a palpable tumour on the left side of the remnant tissue was found, significantly growing with time, presented as hot nodule on 99mTc-sestamibi scan and conclusive with Hürthle cell adenoma with marked cellularity on FNAB. Tumorectomy was performed and well-differentiated Hürthle cell carcinoma detected. The patient received ablative dose of 100 mCi 131I. No signs of metastatic disease are present up to date. Conclusions. The differences between Hürthle cell adenomas and Hürthle cell carcinomas could be clearly made only by histopathological evaluation. Patients with cytological diagnosis of Hürthle cell neoplasms should proceed to total thyroidectomy, especially if tumour size is > 1cm, FNAB findings comprise cellular atypias and/or multiple bilateral nodules are detected in the thyroid gland.

scholarly journals Bilateral Hurthle cell adenoma of thyroid: a rare case report

2017 ◽  
Vol 3 (2) ◽  
pp. 462
Author(s):  
Rahul Kumar Singh ◽  
Amit Goyal ◽  
Poonam Elhence ◽  
Amit Kumar
Keyword(s):  
Cell Carcinoma ◽  
Needle Aspiration ◽  
Thyroid Lobe ◽  
Aspiration Cytology ◽  
Cell Adenoma ◽  
Fine Needle ◽  
Hürthle Cell ◽  
Hürthle Cell Carcinoma ◽  
Hurthle Cell Carcinoma ◽  
Needle Aspiration Cytology

<p class="abstract">Hurthle cell of adenoma of thyroid gland is rare neoplasms of the thyroid.  Size more than 4 cm is rare finding and moreover the occurrence of a multifocal Hurthle cell adenoma is not supported by antecedents in literature. Sonography fails to identify its potentials for malignancy while fine needle aspiration cytology couldn’t differentiate it from Hurthle cell carcinoma of thyroid. The management of Hurthle cell adenoma and Hurthle cell carcinoma is quite different and hence diagnostic dilemma should be sorted out early. A 26 year old female presented with bilateral thyroid swelling. Ultrasonography of thyroid gland showed complex solid cystic nodules in bilateral thyroid lobes with right thyroid lobe measuring 4.1×3.4×2.5 cm and left thyroid lobe measure 3.1×1.7×1.6 cm. Fine needle aspiration cytology (FNAC) was suggestive of papillary malignancy with extensive Hurthle cell changes (Class V, Bethesda classification). The patient underwent total thyroidectomy with bilateral parathyroid gland preservation. Histopathology revealed it as Hurthle cell adenoma (HCA) involving bilateral lobe and multifocal in nature. The treatment of choice for Hurthle cell carcinoma is total thyroidectomy with neck dissection depending on the nature of the lesions. However the treatment of Hurthle cell adenoma is only hemithyroidectomy or lobectomy as it is a benign condition. Differentiation of these two entirely different conditions warrants more studies<span lang="EN-IN">.</span></p>

scholarly journals Hürthle Cell Carcinoma in a Lingual Thyroid

2018 ◽  
Vol 27 (5) ◽  
pp. 489-492 ◽  
Author(s):  
Jagdeep S. Thakur ◽  
Naina Verma ◽  
Riya Singh
Keyword(s):  
Cell Carcinoma ◽  
Fine Needle Aspiration Biopsy ◽  
Resection Margin ◽  
Clinical Presentation ◽  
Needle Aspiration ◽  
Lingual Thyroid ◽  
Hürthle Cell ◽  
Hürthle Cell Carcinoma ◽  
Hurthle Cell Carcinoma ◽  
Recurrent Haemorrhage

Objective: To present a case of lingual thyroid Hürthle cell carcinoma (HCC). Clinical Presentation and Intervention: A 37-year-old female presented with dysphagia and recurrent haemorrhage. Histopathology was suggestive of HCC; the tumour was excised by the trans-glossal approach which provided adequate exposure and helped avert external scarring or mandibular osteotomy. Histopathology showed a tumour-positive right lateral resection margin. This prompted referral to nuclear medicine for radio-iodine ablation. Conclusion: Lingual thyroid cases should be followed up closely and fine-needle aspiration biopsy should be considered when in doubt.

scholarly journals Thyroseq V3 Molecular Profiling for Tailoring the Surgical Management of Hürthle Cell Neoplasms

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Sarah Pearlstein ◽  
Arash H. Lahouti ◽  
Elana Opher ◽  
Yuri E. Nikiforov ◽  
Daniel B. Kuriloff
Keyword(s):  
Cell Carcinoma ◽  
Treatment Plan ◽  
Needle Aspiration ◽  
Molecular Profiling ◽  
Copy Number Alterations ◽  
Convincing Argument ◽  
Hürthle Cell ◽  
Hürthle Cell Carcinoma ◽  
Risk Of Malignancy ◽  
Hurthle Cell Carcinoma

Hürthle cell predominant thyroid nodules often confound the diagnostic utility of fine needle aspiration biopsy (FNAB) with cytology often interpreted as a Hürthle cell lesion with an indeterminate risk of malignancy, Bethesda category (BC) III or IV. Molecular diagnostics for Hürthle cell predominant nodules has also been disappointing in further defining the risk of malignancy. We present a case of a slowly enlarging nodule within a goiter initially reported as benign on FNAB, BC II but on subsequent FNAB suspicious for a Hürthle cell neoplasm, BC IV. The patient had initially requested a diagnostic lobectomy for a definitive diagnosis despite a higher risk of malignancy based on the size of the nodule > 4 cm alone. To better tailor this patient’s treatment plan, a newer expanded gene mutation panel, ThyroSeq® v3 that includes copy number alterations (CNAs) and was recently found to have greater positive predictive value (PPV) for identifying Hürthle cell carcinoma (HCC), was performed on the FNAB material. Molecular profiling with ThyroSeq® v3 was able to predict a greater risk of carcinoma, making a more convincing argument in favor of total thyroidectomy. Surgical pathology confirmed a Hürthle cell carcinoma with 5 foci of angioinvasion and foci of capsular invasion.

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