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Review
. 2016 Nov 7:9:6873-6884.
doi: 10.2147/OTT.S119980. eCollection 2016.

Hürthle cell carcinoma: current perspectives

Sara Ahmadi  1 , Michael Stang  2 , Xiaoyin Sara Jiang  3 , Julie Ann Sosa  4
Affiliations
Review

Hürthle cell carcinoma: current perspectives

Sara Ahmadi et al. Onco Targets Ther. .

Abstract

Hürthle cell carcinoma (HCC) can present either as a minimally invasive or as a widely invasive tumor. HCC generally has a more aggressive clinical behavior compared with the other differentiated thyroid cancers, and it is associated with a higher rate of distant metastases. Minimally invasive HCC demonstrates much less aggressive behavior; lesions <4 cm can be treated with thyroid lobectomy alone, and without radioactive iodine (RAI). HCC has been observed to be less iodine-avid compared with other differentiated thyroid cancers; however, recent data have demonstrated improved survival with RAI use in patients with HCC >2 cm and those with nodal and distant metastases. Patients with localized iodine-resistant disease who are not candidates for a wait-and-watch approach can be treated with localized therapies. Systemic therapy is reserved for patients with progressive, widely metastatic HCC.

Keywords: Hurthle cell lesion; follicular cell carcinoma; minimally invasive HCC; thyroid cancer; thyroid nodule.

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Conflict of interest statement

JAS is a member of the Data Monitoring Committee of the Medullary Thyroid Cancer Consortium Registry, sponsored by NovoNordisk, GlaxoSmithKline, Astra Zeneca, and Eli Lilly. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Oncocytes (Hürthle cells) showing characteristic abundant, granular eosinophilic cytoplasm and prominent nucleoli (hematoxylin and eosin, ×40).
Figure 2
Figure 2
Prominent oncocytic change in chronic lymphocytic thyroiditis. Abundant lymphocytes with germinal center formation are present (hematoxylin and eosin, ×10).
Figure 3
Figure 3
Vascular invasion in a Hürthle cell carcinoma (hematoxylin and eosin, ×2).
Figure 4
Figure 4
(A) Hürthle cell carcinoma. (B) Hürthle cell adenoma. Both nodules have similar ultrasound characteristics.
Figure 5
Figure 5
Oncocytic change in lymphocytic thyroiditis on fine-needle aspiration cytologic smear showing marked cytologic atypia, with abundant nuclear contour irregularities and grooves (arrow) (Papaniolau stain, ×40).
Figure 6
Figure 6
Overall survival according to RAI use in patients with Hürthle cell carcinoma in the National Cancer Data Base, 1998–2006. Copyright © 2016. Adapted from Jillard Christa L, Youngwirth Linda, Scheri Randall P, Roman Sanziana, and Sosa Julie A. Thyroid. 2016;26(7):959–964. Abbreviation: RAI, radioactive iodine.
See this image and copyright information in PMC

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