Radiation Oncology/Thyroid/Hurthle cell

Hürthle cell carcinoma

Variant of follicular carcinoma. Is relatively aggressive with prognosis worse than papillary carcinoma. Represent about 3% of thyroid cancer.

Prognostic factors

• 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

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

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

• 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.