--- title: "Hurthle cell Carcinoma of Thyroid" description: "Comprehensive ENT notes on Hurthle cell Thyroid Carcinoma - Risk factors, Clinical Features, Histology, Investigations and Treatment - ideal for MBBS and ENT students." source: "The ENT Resident" canonical_url: "https://www.theentresident.com/ent-notes-lectures/hurthle-cell-thyroid-carcinoma" categories: ["Thyroid"] video: "https://www.youtube.com/watch?v=yZydslg2Dw8" image: "https://media.theentresident.com/og-images/hurthle-cell-thyroid-carcinoma.png" --- # Hurthle cell Carcinoma of Thyroid Comprehensive ENT notes on Hurthle cell Thyroid Carcinoma - Risk factors, Clinical Features, Histology, Investigations and Treatment - ideal for MBBS and ENT students. Watch the full video lecture on YouTube: https://www.youtube.com/watch?v=yZydslg2Dw8 ## 🧬 Hurthle Cell Carcinoma of Thyroid ### 📖 Definition of Hurthle Cell Carcinoma of Thyroid **Hurthle Cell Carcinoma** is a **malignant thyroid tumor** composed predominantly of **Hurthle cells**. It accounts for **3–10%** of all **differentiated thyroid cancers**. >What are Hurthle cells? >What are some other names of Hurthle cells? --- ### 🧠 Historical Background - **Previously classified as:** A variant of *follicular carcinoma*. - **Now (WHO classification):** Recognized as an **independent tumor type** due to: - Distinct **molecular alterations** - Different **biological behavior** - Unique **clinical course** >Where does Hurthle Cell Carcinoma of Thyroid originate from? --- ### 👩‍🦳 Epidemiology of Hurthle Cell Carcinoma of Thyroid - **Age:** More common in **elderly individuals** - **Sex:** Predominantly **females** - **Incidence:** 3–10% of differentiated thyroid malignancies --- ### 🔬 Cytological & Histological Features of Hurthle Cell Carcinoma of Thyroid 🔹 Hurthle Cells — The Characteristic Cell >What is the microscopic appearance of Hurthle cells? #### 🧫 Microscopy - The tumor is usually **encapsulated** with a **thick capsule**. - Sheets or nests of **Hurthle cells** with granular cytoplasm are seen. - **Capsular or vascular invasion** must be demonstrated to confirm **carcinoma** (similar to follicular carcinoma). > 📸 **Key Diagnostic Point:** > The presence of **capsular and/or vascular invasion** differentiates **Hürthle cell carcinoma** from **Hürthle cell adenoma**. --- ### 🩺 Clinical Features of Hurthle Cell Carcinoma of Thyroid Patients usually present with: - A **thyroid nodule**, which can be: - **Solitary** or **multifocal** - **Unilateral** or **bilateral** - The swelling is typically **firm and non-tender**. - **More aggressive** course than follicular carcinoma. - **Local invasion** and **recurrence** are common. **Metastatic Spread:** - **Hematogenous spread:** To **lungs, bone, liver** - **Lymphatic spread:** More common than in follicular carcinoma --- ### 🔍 Investigations of Hurthle Cell Carcinoma of Thyroid 1. **Fine Needle Aspiration Cytology (FNAC)** - Shows presence of Hurthle cells. - Cannot differentiate between **adenoma** and **carcinoma** — histological evidence of **capsular/vascular invasion** is essential. 2. **CT Scan / MRI Neck** - Evaluates **local extension** and **regional lymph nodes**. 3. **Bone Scan** - To detect **bony metastases**. > 🧠 **Note:** Hurthle cell carcinoma may show **reduced iodine uptake** on radioisotope scanning. --- ### 💊 Treatment of Hurthle Cell Carcinoma of Thyroid 1️⃣ **Surgery — Mainstay of Treatment** - **Total Thyroidectomy** is the treatment of choice. >Why is Total Thyroidectomy the treatment of choice in Hurthle Cell Carcinoma of Thyroid? 2️⃣ **Radioiodine Ablation** - **Not effective** in most cases >Why is radioiodine therapy of limited benefit in Hurthle Cell Carcinoma of Thyroid? 3️⃣ **Thyroid Hormone Suppression Therapy** - **Lifelong TSH suppression** with **Levothyroxine** is essential - Prevents stimulation of residual tumor cells. --- ### 📉 Prognosis of Hurthle Cell Carcinoma of Thyroid Hürthle Cell Carcinoma has a **worse prognosis** compared to follicular carcinoma. >Why does Hurthle Cell Carcinoma of Thyroid have the worst prognosis? --- ### 🧾 Summary Table | Feature | Hürthle Cell Carcinoma | | --- | --- | | **Cell of Origin** | Follicular epithelial cells | | **Cell Type** | Hurthle cells | | **Nature** | Malignant tumor | | **Capsular/Vascular invasion** | Required for diagnosis | | **Common in** | Elderly women | | **Spread** | Both hematogenous & lymphatic | | **Radioiodine uptake** | Poor | | **Treatment** | Total thyroidectomy + lifelong TSH suppression | | **Prognosis** | Poorer than follicular carcinoma | --- ## About This Note This note on Hurthle cell Carcinoma of Thyroid is one of the free ENT study notes published by The ENT Resident. 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Other contact options are on the contact page: https://www.theentresident.com/contact.md ## Related ENT Notes & Lectures #### Thyroid - [Anaplastic Thyroid Carcinoma](https://www.theentresident.com/ent-notes-lectures/anaplastic-thyroid-carcinoma.md) - [Anatomy of Thyroid Gland](https://www.theentresident.com/ent-notes-lectures/anatomy-of-thyroid.md) - [Follicular Thyroid Carcinoma](https://www.theentresident.com/ent-notes-lectures/follicular-thyroid-carcinoma.md) - [Medullary Thyroid Cancer](https://www.theentresident.com/ent-notes-lectures/medullary-thyroid-cancer.md) - [Papillary Thyroid Carcinoma](https://www.theentresident.com/ent-notes-lectures/papillary-thyroid-carcinoma.md) - [Thyroid Cancer](https://www.theentresident.com/ent-notes-lectures/thyroid-cancer-causes-symptoms-staging.md) - [Triangles in Thyroid Surgery](https://www.theentresident.com/ent-notes-lectures/triangles-in-thyroid-surgery.md) --- Complete index of all pages on this site, with descriptions and markdown links: https://www.theentresident.com/llms.txt