Materiały źródłowe

• #1 Hurthle Cell Cancer Diagnosis

  https://www.thyroidcancer.com/thyroid-cancer/hurthle/diagnosis

  The diagnosis of hurthle cell/oncocytic cancer (also called hurthle cell/oncocytic carcinoma) is usually found in individuals without any symptoms whatsoever. The diagnosis of oncocytic or hurthle cell cancer is almost always found only after the oncocytic/hurthle cell thyroid cancer has been removed in a thyroid surgery. Because most patients with hurthle cell cancer have no symptoms, the diagnosis of hurthle cell cancer is most commonly found by accident in the evaluation for other reasons. […] The diagnosis of hurthle cell cancer cannot be made by fine needle aspiration of a thyroid nodule. The diagnosis of hurthle cell cancer in a thyroid nodule can only be obtained by complete removal of the thyroid mass. […] Fine needle aspiration of a thyroid mass cannot diagnosis oncocytic carcinoma/ hurthle cell cancer because it can only provide analysis of the cells themselves. The diagnosis of hurthle cell cancer within a thyroid gland can be made by complete removal of the thyroid mass and then microscopic examination of the mass within the thyroid.

• #1 Hurthle cell cancer | Altru Health System

  https://www.altru.org/health-library/conditions/hurthle-cell-cancer

• #2 Genetics, Diagnosis, and Management of Hürthle Cell Thyroid Neoplasms

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8223676/

  Hrthle cell lesions have been a diagnostic conundrum in pathology since they were first recognized over a century ago. […] The diagnosis of Hrthle cell adenoma (HCA) or Hrthle cell carcinoma (HCC) has typically relied on a judgement call by pathologists as to the presence or absence of capsular and/or vascular invasion of the adjacent thyroid parenchyma, easy to note in widely invasive disease and a somewhat subjective diagnosis for minimally invasive or borderline invasive disease. […] Diagnostic specificity, which has incorporated a sharp increase in molecular genetic studies of thyroid tumor subtypes and the integration of molecular testing into preoperative management protocols, continues to be challenged by Hrthle cell neoplasia. […] Preoperative fine needle aspiration (FNA) biopsy is frequently performed for patients with solitary or multiple large thyroid nodules.

• #2 Hürthle Cell Carcinoma: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/21055-hurthle-cell-carcinoma

  Hrthle cell carcinoma is a rare, aggressive form of thyroid cancer. […] Healthcare providers treat this cancer with surgery to remove all or part of your thyroid. […] They diagnose this condition by doing a physical examination and asking about your symptoms, your medical history and your family medical history. Healthcare providers may do tests, including: […] Healthcare providers use cancer staging systems to plan treatment. They stage Hrthle cell carcinoma with the TNM staging system. […] Surgery is the most common treatment for this condition. Depending on your situation, surgeons may remove all or part of your thyroid gland. […] If you have symptoms, healthcare providers may need to do thyroid surgery to confirm you have this condition. Surgery to diagnose the cancer often eliminates the issue.

• #3 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Workup: Laboratory Studies, Imaging Studies, Fine-Needle Aspiration

  https://emedicine.medscape.com/article/279462-workup

  A full set of thyroid function tests should be ordered, including the following: […] In addition, the following antibody studies should be ordered: […] Imaging study findings are as follows: […] Positron emission tomography with 18F-2-fluoro-2-deoxy-D-glucose (18F-FDG PET) has been shown to be helpful in diagnosing metastatic disease in Hrthle cell carcinomas, particularly with tumors that have low iodine avidity. […] Cytologic analysis of fine-needle aspiration (FNA) specimens can diagnose Hrthle cell neoplasm in most patients. […] However, FNA cannot differentiate Hrthle cell adenoma from Hrthle cell carcinoma, because it does not permit assessment of vascular and capsular invasion, which are the two main factors that differentiate carcinoma from adenoma. […] A test that measures the expression of 167 genes may help determine whether a cytologically indeterminate thyroid nodule is benign, and thus may be considered for more conservative treatment.

• #4 Follicular and Hurthle Cell Thyroid Cancer | Columbia Surgery

  https://columbiasurgery.org/conditions-and-treatments/follicular-and-hurthle-cell-thyroid-cancer

  Follicular and Hurthle cell thyroid cancer makes up about 15 to 20% of all cases of thyroid cancer. […] Most follicular and Hurthle cell thyroid cancers do not cause symptoms (i.e. they are asymptomatic). […] When a thyroid nodule is discovered, a complete history and physical examination should be performed. […] The next step in the work-up of a thyroid cancer is an ultrasound (USG) of the neck. […] The best test to determine if a thyroid nodule is benign or cancer is a fine-needle aspiration biopsy (FNAB). […] Unlike papillary thyroid cancer, it can be difficult to diagnose follicular and Hurthle cell thyroid cancer without performing surgery, because there are no characteristic changes in the way the thyroid cells look on FNAB. […] Ultimately, if a patient has a follicular or Hurthle cell cancer, they will need to have their entire thyroid removed. […] After surgery for follicular or Hurthle cell thyroid cancer, it is important to be examined regularly for signs that the cancer may have recurred.

• #5 Hurthle Cell Thyroid Cancer: Symptoms and Treatment

  https://www.healthline.com/health/cancer/hurthle-cell-thyroid-cancer

  Hrthle cell thyroid cancer is a rare and aggressive type of thyroid cancer. However, the outlook for people with this cancer can be good when its diagnosed and treated in its early stages. […] The diagnosis of HCC begins with your doctor taking your medical history and doing a physical exam. During the physical exam, they will feel your thyroid and the lymph nodes in your neck to see whether theyre larger than usual. […] Healthcare professionals may use an ultrasound to check for and evaluate thyroid nodules. A radioiodine scan can also be used to assess nodules. Nodules that take up a lot of radioactive iodine, called hot nodules, are rarely cancerous. […] For nodules that may be cancerous, healthcare professionals will perform a biopsy using fine needle aspiration (FNA). Molecular tests on the biopsy sample can help identify cellular changes that are associated with cancer.

• #6 Diagnostic Accuracy and Prognostic Value of 18F-FDG PET in Hürthle Cell Thyroid Cancer Patients | Journal of Nuclear Medicine

  https://jnm.snmjournals.org/content/47/8/1260

  Hrthle cell carcinoma is an uncommon and occasionally aggressive differentiated thyroid cancer associated with increased mortality compared with other differentiated thyroid malignancies. […] However, there is limited information with regard to the true diagnostic accuracy and prognostic value of 18F-FDG PET in this disease. […] 18F-FDG PET has excellent diagnostic accuracy in Hrthle cell thyroid cancer patients, improving on CT and RIS. […] Intense 18F-FDG uptake in lesions is an indicator of a poor prognosis. […] Our data suggest that all patients with Hrthle cell thyroid cancer should undergo 18F-FDG PET as part of their initial postoperative staging and periodically to screen for occult recurrence, particularly in patients with elevated serum thyroglobulin. […] 18F-FDG PET had excellent sensitivity for disease detection and localization in our cohort of patients with Hrthle cell thyroid cancer.

• #7 Hurthle Cell Thyroid Cancer: Symptoms and Treatment

  https://www.healthline.com/health/cancer/hurthle-cell-thyroid-cancer

  Hrthle cell thyroid cancer is a rare and aggressive type of thyroid cancer. However, the outlook for people with this cancer can be good when its diagnosed and treated in its early stages. […] The diagnosis of HCC begins with your doctor taking your medical history and doing a physical exam. During the physical exam, they will feel your thyroid and the lymph nodes in your neck to see whether theyre larger than usual. […] Healthcare professionals may use an ultrasound to check for and evaluate thyroid nodules. A radioiodine scan can also be used to assess nodules. Nodules that take up a lot of radioactive iodine, called hot nodules, are rarely cancerous. […] For nodules that may be cancerous, healthcare professionals will perform a biopsy using fine needle aspiration (FNA). Molecular tests on the biopsy sample can help identify cellular changes that are associated with cancer.

• #8 Hurthle Cell Cancer Diagnosis

  https://www.thyroidcancer.com/thyroid-cancer/hurthle/diagnosis

  The diagnosis of hurthle cell/oncocytic cancer (also called hurthle cell/oncocytic carcinoma) is usually found in individuals without any symptoms whatsoever. The diagnosis of oncocytic or hurthle cell cancer is almost always found only after the oncocytic/hurthle cell thyroid cancer has been removed in a thyroid surgery. Because most patients with hurthle cell cancer have no symptoms, the diagnosis of hurthle cell cancer is most commonly found by accident in the evaluation for other reasons. […] The diagnosis of hurthle cell cancer cannot be made by fine needle aspiration of a thyroid nodule. The diagnosis of hurthle cell cancer in a thyroid nodule can only be obtained by complete removal of the thyroid mass. […] Fine needle aspiration of a thyroid mass cannot diagnosis oncocytic carcinoma/ hurthle cell cancer because it can only provide analysis of the cells themselves. The diagnosis of hurthle cell cancer within a thyroid gland can be made by complete removal of the thyroid mass and then microscopic examination of the mass within the thyroid.

• #9 Hurthle Cell Cancer Diagnosis

  https://www.thyroidcancer.com/thyroid-cancer/hurthle/diagnosis

  If you have a needle biopsy that suggests a hurthle cell neoplasm or hurthle cell tumor, then identifying an expert in thyroid cancer surgery is the most important next step! You must have surgery to diagnosis a hurthle cell cancer. A needle biopsy cannot tell the difference between a hurthle cell benign tumor and hurthle cell cancer. […] The diagnosis of hurthle cell cancer cannot be made with an ultrasound guided small sampling of cells within the thyroid gland. The diagnosis of hurthle cell cancer within the thyroid requires thyroid surgery. […] The first step leading to a diagnosis of hurthle cell cancer requires obtaining a small sampling of cells with a skinny needle. This is called fine needle aspiration (FNA) cytology. […] The diagnosis of hurthle cell cancer is highly suggested when distant spread of disease is suggested in lung, bone, or liver and a hurthle cell neoplasm of the thyroid is present.

• #10 Genetics, Diagnosis, and Management of Hürthle Cell Thyroid Neoplasms

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8223676/

  Hrthle cell lesions have been a diagnostic conundrum in pathology since they were first recognized over a century ago. […] The diagnosis of Hrthle cell adenoma (HCA) or Hrthle cell carcinoma (HCC) has typically relied on a judgement call by pathologists as to the presence or absence of capsular and/or vascular invasion of the adjacent thyroid parenchyma, easy to note in widely invasive disease and a somewhat subjective diagnosis for minimally invasive or borderline invasive disease. […] Diagnostic specificity, which has incorporated a sharp increase in molecular genetic studies of thyroid tumor subtypes and the integration of molecular testing into preoperative management protocols, continues to be challenged by Hrthle cell neoplasia. […] Preoperative fine needle aspiration (FNA) biopsy is frequently performed for patients with solitary or multiple large thyroid nodules.

• #11 Hurthle Cell Carcinoma (Oncocytic Carcinoma): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/279462-overview

  Hrthle cell carcinoma of the thyroid gland is an unusual and relatively rare type of differentiated thyroid cancer. Hrthle cell cancer accounts for only about 3-10% of all differentiated thyroid cancers; therefore, few institutions have extensive experience with Hrthle cell neoplasms. […] A benign neoplasm cannot be distinguished from a malignant neoplasm on the basis of cytologic analysis of a fine-needle aspiration (FNA) biopsy specimen. Features such as pleomorphism, anaplasia, hyperchromatism, and atypia are also observed in benign follicular adenomas; therefore, definitive differentiation of Hrthle cell carcinoma from Hrthle-cell adenoma is based on vascular invasion and/or capsular invasion, as well as on permanent histologic sections or extrathyroidal tumor spread and lymph node and systemic metastases.

• #12 Hurthle Cell Carcinoma. |

  http://www.shifrinmd.com/hurthle-cell-carcinoma.html

  Ultrasound-guided fine needle aspiration (FNA) biopsy is the first step in evaluation of any thyroid nodules and establishing the initial diagnosis of malignancy or suspicious for malignancy (follicular or Hurthle cell neoplasm). […] Preoperative diagnosis by FNA biopsy is very difficult and surgery may be needed for ultimate diagnosis. […] Fifteen to thirty percent of FNA biopsies that have findings of a „Hurthle cell neoplasm” will have final diagnosis of Hurthle Cell Carcinoma after the surgery.

• #13 Genetics, Diagnosis, and Management of Hürthle Cell Thyroid Neoplasms

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8223676/

  Preoperative genetic testing is of some limited utility, although Hrthle cell neoplasia may be ruled in, ruled out, or deemed suspicious/neoplastic, depending upon assay choice, by molecular testing with indications for surgical excision. […] HCCs are considered to exhibit a more aggressive clinical course compared to other forms of differentiated thyroid carcinoma (DTC), with higher incidence of distant metastases and more rapid progression of metastatic disease. […] However, it is important to note that aggressive clinical behavior is well-established primarily for patients presenting with widely invasive disease (extrathyroidal extension or extensive vascular invasion). […] Overall, it remains questionable whether RAI has therapeutic benefit, especially in patients presenting with recurrent or metastatic disease.

• #14 Oncocytic (Hürthle Cell) Thyroid Carcinoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568736/

  Molecular testing with commercially available genetic testing kits (eg, Afirma or ThyroSeq Genetic Classifier) may be helpful in further evaluating Bethesda 3 and 4 lesions. However, the data on their efficacy in oncocytic carcinoma are limited, and thus far, they have been associated with high false-positive rates (38% to 41%), which limits their utility. Ultimately, most patients with oncocytic lesions undergo a diagnostic thyroid lobectomy. On final pathology, the diagnosis of oncocytic thyroid carcinoma can be made.

• #15 Identification of Hürthle cell cancers: solving a clinical challenge with genomic sequencing and a trio of machine learning algorithms | BMC Systems Biology | Full Text

  https://bmcsystbiol.biomedcentral.com/articles/10.1186/s12918-019-0693-z

  We sought to overcome this low-specificity limitation by expanding the feature set for ML using next-generation whole transcriptome RNA sequencing and called the improved algorithm the Genomic Sequencing Classifier (GSC). The Hrthle identification leverages mitochondrial expression and we developed novel feature extraction mechanisms to measure chromosomal and genomic level loss-of-heterozygosity (LOH) for the algorithm. Additionally, we developed a multi-layered system of cascading classifiers to sequentially triage Hrthle cell-containing FNAB, including: 1. presence of Hrthle cells, 2. presence of neoplastic Hrthle cells, and 3. presence of benign Hrthle cells. The final Hrthle cell Index utilizes 1048 nuclear and mitochondrial genes; and Hrthle cell Neoplasm Index leverages LOH features as well as 2041 genes. Both indices are Support Vector Machine (SVM) based. The third classifier, the GSC Benign/Suspicious classifier, utilizes 1115 core genes and is an ensemble classifier incorporating 12 individual models.

• #16 Diagnostic Utility | Thyroseq®

  https://www.thyroseq.com/physicians/test-description/diagnostic-utility/

  The primary application of ThyroSeq is to provide accurate cancer diagnosis in thyroid nodules with indeterminate FNA cytology. […] ThyroSeq uniquely detects chromosomal copy number alterations, which are a hallmark of Hrthle cell cancer. […] Data from the multicenter clinical validation study and an independent real-world study show reliable stratification of Hrthle cell nodules with as high as 100% sensitivity, 67% specificity, 100% NPV and 64% PPV. […] The majority of patients with Hrthle cell nodules can safely avoid surgery with ThyroSeq.

• #17 Oncocytic (Hürthle Cell) Thyroid Carcinoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568736/

  Molecular testing with commercially available genetic testing kits (eg, Afirma or ThyroSeq Genetic Classifier) may be helpful in further evaluating Bethesda 3 and 4 lesions. However, the data on their efficacy in oncocytic carcinoma are limited, and thus far, they have been associated with high false-positive rates (38% to 41%), which limits their utility. Ultimately, most patients with oncocytic lesions undergo a diagnostic thyroid lobectomy. On final pathology, the diagnosis of oncocytic thyroid carcinoma can be made.

• #18 Thyroid Hürthle Cell Carcinoma: Clinical, Pathological, and Molecular Features

  https://www.mdpi.com/2072-6694/13/1/26

  Hürthle cell carcinoma (HCC) represents 3–4% of thyroid carcinoma cases. Hürthle cells can be identified only after fine needle aspiration cytology biopsy or by histological diagnosis after the surgical operation. […] Preoperative diagnosis is challenging, but indicators of malignancy are male, older age, tumor size > 4 cm, a solid nodule with an irregular border, or the presence of psammoma calcifications according to ultrasound. […] Clinical follow-up by thyroglobulin levels should be decided depending on the case. […] Preoperative diagnosis by ultrasound is challenging. In ultrasounds, HCC shows a range of sonographic appearances from predominantly hypoechoic to hyperechoic lesions, and no preoperative features can differentiate HCC from adenoma. […] Indicators of malignancy among Hürthle cell tumors include male, tumor size >4 cm, US class ≥ 3, older age (HCC 51.8 years old vs. Hürthle cell adenoma 43.1).

• #19 Hurthle Cell Carcinoma (Oncocytic Carcinoma): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/279462-overview

  In a study of patients with Hrthle cell thyroid neoplasm who underwent surgery for suspected carcinoma, the histopathologic diagnosis was carcinoma in 71 of 279 patients. Predictive factors for carcinoma were age older than 65 years and thyroglobulin concentration over 1000 ng/mL. […] Hrthle cell cancer reportedly behaves in a more aggressive fashion than other well-differentiated thyroid cancers, with a tendency to higher frequency of metastasis and a lower survival rate. […] Hrthle cell cancer has the highest incidence of metastasis among the differentiated thyroid cancers. Metastatic disease is reported at the time of initial diagnosis in 10-20% of patients and in 34% of the patients overall. […] In a study of 108 patients with metastatic Hrthle cell thyroid carcinoma, Besic et al reported that sites of metastasis, in decreasing order of frequency, were lung, bone, mediastinum, kidney, and liver. Overall 10-year disease-specific survival was 60%.

• #20 Hurthle Cell Cancer Diagnosis

  https://www.thyroidcancer.com/thyroid-cancer/hurthle/diagnosis

  The diagnosis of hurthle cell/oncocytic cancer (also called hurthle cell/oncocytic carcinoma) is usually found in individuals without any symptoms whatsoever. The diagnosis of oncocytic or hurthle cell cancer is almost always found only after the oncocytic/hurthle cell thyroid cancer has been removed in a thyroid surgery. Because most patients with hurthle cell cancer have no symptoms, the diagnosis of hurthle cell cancer is most commonly found by accident in the evaluation for other reasons. […] The diagnosis of hurthle cell cancer cannot be made by fine needle aspiration of a thyroid nodule. The diagnosis of hurthle cell cancer in a thyroid nodule can only be obtained by complete removal of the thyroid mass. […] Fine needle aspiration of a thyroid mass cannot diagnosis oncocytic carcinoma/ hurthle cell cancer because it can only provide analysis of the cells themselves. The diagnosis of hurthle cell cancer within a thyroid gland can be made by complete removal of the thyroid mass and then microscopic examination of the mass within the thyroid.

• #21 Pathology Outlines – Oncocytic (Hürthle cell) tumors

  https://www.pathologyoutlines.com/topic/thyroidhurthle.html

  Follicular neoplasm with more than 75% oncocytic tumor cells […] Malignant if capsular and / or vascular invasion […] Hematogenous metastases, 30% to lymph node (in contrast, rare in follicular carcinoma) […] No known exogenous risk factors for developing oncocytic tumors […] Malignant tumors have more aggressive behavior than conventional follicular carcinoma […] Overall, oncocytic carcinoma is more aggressive than conventional follicular carcinoma, with higher frequency of extrathyroidal extension, local recurrence and metastasis to lymph nodes […] Cannot definitively diagnose malignancy based on cytologic material […] but malignant cases tend to have small or large cell dysplasia, nuclear crowding and discohesive cells […] Adenoma: lobectomy […] Carcinoma: total thyroidectomy or radiation ablation […] Radioactive iodine: resistant compared to conventional follicular carcinoma […] Aneuploidy is common in oncocytic tumors, including chromosome gains and losses […] PTEN and TP53 mutations […] There are no known exogenous risk factors for developing oncocytic tumors.

• #22 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Workup: Laboratory Studies, Imaging Studies, Fine-Needle Aspiration

  https://emedicine.medscape.com/article/279462-workup

  In this study, 10 malignant Hurthle cell nodules were present, and 9 were correctly identified as malignant (90%). […] Histopathologic differentiation of Hrthle cell carcinoma from Hrthle cell adenoma is based on vascular and capsular invasion. […] Capsular invasion, vascular invasion, or both diagnose Hrthle cell carcinoma. […] Different prognostic criteria and staging systems are used in differentiating thyroid cancer and Hrthle cell cancer. […] No uniformly accepted staging system and prognostic classification exists for Hrthle cell carcinoma.

• #23 Oncocytic (Hürthle Cell) Thyroid Carcinoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568736/

  Molecular testing with commercially available genetic testing kits (eg, Afirma or ThyroSeq Genetic Classifier) may be helpful in further evaluating Bethesda 3 and 4 lesions. However, the data on their efficacy in oncocytic carcinoma are limited, and thus far, they have been associated with high false-positive rates (38% to 41%), which limits their utility. Ultimately, most patients with oncocytic lesions undergo a diagnostic thyroid lobectomy. On final pathology, the diagnosis of oncocytic thyroid carcinoma can be made.

• #24 Hurthle Cell Thyroid Cancer: Symptoms and Treatment

  https://www.healthline.com/health/cancer/hurthle-cell-thyroid-cancer

  However, an FNA biopsy alone may not be able to confirm a diagnosis of HCC, and a larger tissue sample may be needed. This can involve a lobectomy the removal of half the thyroid. […] Once your doctor has diagnosed HCC, they may do additional tests to see whether the cancer has spread to other areas of your body. This typically involves imaging tests such as: CT scan, MRI scan, PET scan, chest X-ray.

• #25 Hürthle Cell Carcinoma: Staging and Treatment | OncoLink

  https://www.oncolink.org/cancers/thyroid/huerthle-cell-carcinoma-staging-and-treatment

  Hrthle cell carcinoma is staged as a thyroid cancer. Staging is based on: […] Your healthcare provider will use the results of the tests you had to determine your TNM result and combine these to get a stage from 0 to IV. […] Staging for thyroid cancer also looks at the size of your tumor, your age, and if you have major capsular invasion. Major capsular invasion means the tumor is close to the thyroid junction (gaps where cells pass through), and the tumor has grown into the fat and tissue around the thyroid. […] The main treatment used is surgery. Some tumors will grow faster than others and that will guide what type of surgery you have. […] Radioactive iodine is given into a vein (IV, intravenously) and the thyroid cells take in this iodine. The radioactive iodine delivers radiation to these cells killing them. It may be used after surgery to kill any normal thyroid tissue left behind after surgery. […] Radiation is the use of high-energy x-rays to kill cancer cells. In Hrthle cell carcinoma, radiation therapy is used to treat symptoms of metastases (like pain and nausea), to control recurrent tumors (tumors that have come back), and to prevent recurrence (stopping the tumor from coming back).

• #26 Hurthle Cell Cancer Diagnosis

  https://www.thyroidcancer.com/thyroid-cancer/hurthle/diagnosis

  The diagnosis of hurthle cell cancer is directly related to the size of the hurthle cell neoplasm within the gland itself. The diagnosis of hurthle cell cancer that is less than 1.5 cm in size have the best cure rates. […] The diagnosis of hurthle cell cancer is associated with spread to lymph nodes of the neck in at least 20% of cases. […] The diagnosis of hurthle cell cancer spread to distant sites of the body may occur in around 30% of patients. […] The diagnosis of hurthle cell cancer with distant spread in the body is an indication for radioactive iodine treatment. Total thyroidectomy should be performed for the diagnosis of hurthle cell cancer with distant spread. […] The diagnosis of hurthle cell cancer is best treated almost exclusively by a good surgery. A good surgery is performed by a highly experienced thyroid cancer surgeon. The best surgery provides a patient with a diagnosis of hurthle cell cancer the best opportunity for long term control and cure of their cancer.

• #27 Hurthle Cell Carcinoma (Oncocytic Carcinoma): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/279462-overview

  In a study of patients with Hrthle cell thyroid neoplasm who underwent surgery for suspected carcinoma, the histopathologic diagnosis was carcinoma in 71 of 279 patients. Predictive factors for carcinoma were age older than 65 years and thyroglobulin concentration over 1000 ng/mL. […] Hrthle cell cancer reportedly behaves in a more aggressive fashion than other well-differentiated thyroid cancers, with a tendency to higher frequency of metastasis and a lower survival rate. […] Hrthle cell cancer has the highest incidence of metastasis among the differentiated thyroid cancers. Metastatic disease is reported at the time of initial diagnosis in 10-20% of patients and in 34% of the patients overall. […] In a study of 108 patients with metastatic Hrthle cell thyroid carcinoma, Besic et al reported that sites of metastasis, in decreasing order of frequency, were lung, bone, mediastinum, kidney, and liver. Overall 10-year disease-specific survival was 60%.

• #28 Hurthle Cell Thyroid Cancer: Top 3 Things to Know

  https://www.thyroidcancer.com/blog/hurthle-cell-thyroid-cancer-top-3-things-to-know

  Hurthle cell thyroid cancers are rare. While thyroid cancer is relatively common, Hurthle cell thyroid cancer is very uncommon. In fact, like most thyroid nodules, the vast majority of Hurthle cell nodules are benign. Hurthle cell thyroid cancer only accounts for roughly 3% of all thyroid cancers. […] Many thyroid cancers are a challenge to diagnose because they rarely cause symptoms and are not detected with blood tests. Hurthle cell thyroid cancers, however, present even more of a challenge for definitive diagnosis primarily because they cannot be diagnosed by needle biopsy of a thyroid mass (nodule). Additionally, the newer molecular/genetic tests that are done on cells from the needle biopsy are poor at diagnosing Hurthle cell thyroid cancer as well. Most patients that have Hurthle cell thyroid cancer will not know their diagnosis until after the surgical removal of their thyroid nodule, which was likely initially called a Hurthle cell tumor.

• #29 Hurthle cell in thyroid diseases

  https://www.oatext.com/hurthle-cell-in-thyroid-diseases.php

  The differential diagnosis of Hurthle cell lesions is quite broad. […] This review provides an overview of studies to distinguish benign from malignant Hurthle cell lesions. […] The histologic distinction between adenoma and carcinoma can generally only be definitively made on histologic examination of a resection specimen; like other follicular lesions, it is determined by the presence or absence of capsular and/or vascular invasion, or metastasis to lymph nodes or distant organs and also hypoechogenicity, microcalcifications, internal vascularity, and nodules that are taller than wide, which are the hallmarks of Hurthle cell carcinoma (HCC). […] The ability to distinguish benign from malignant HC lesions of the thyroid preoperatively is very important for the management of the nodules.

• #30 What is Hurthle cell carcinoma? | MD Anderson Cancer Center

  https://www.mdanderson.org/cancerwise/4-facts-about-hurthle-cell-carcinoma.h00-159617067.html

  There are four main types of thyroid cells: follicular, papillary, medullary and Hurthle. […] Although Hurthle cell carcinoma is rare, it can be aggressive. […] But Hurthle cells alone arent always a cause for concern. […] The presence of Hurthle cells or any other potentially cancerous cells within a thyroid just means we need to do more investigating to see whats going on inside that nodule that has a majority of those cells. […] When you have a thyroid issue thats worrisome for cancer and causing trouble breathing or swallowing, or making your voice hoarse, the first step is usually to remove part or all of the thyroid through surgery. […] So, even if a nodule has a high number of Hurthle cells, patients arent officially diagnosed with Hurthle cell carcinoma until after surgical removal. […] The risk of Hurthle cell nodules being cancerous is about 15%, compared to papillary types of cells, which make up about 80% of thyroid cancer diagnoses. […] Its important to seek care from a cancer center with experience diagnosing and treating thyroid cancer.

• #31 Hurthle Cell Thyroid Cancer: Top 3 Things to Know

  https://www.thyroidcancer.com/blog/hurthle-cell-thyroid-cancer-top-3-things-to-know

  Hurthle cell thyroid cancer surgery should only be done by expert surgeons. By choosing the correct surgeon and surgery, you are cured. The wrong choice may lead to repeated surgeries, complications, and even an inability to control and cure the Hurthle cell cancer! Be aware, the wrong first surgery with a Hurthle cell cancer can be a dire misstep!

• #32 Identification of Hürthle cell cancers: solving a clinical challenge with genomic sequencing and a trio of machine learning algorithms | BMC Systems Biology | Full Text

  https://bmcsystbiol.biomedcentral.com/articles/10.1186/s12918-019-0693-z

  The accurate algorithmic depiction of this complex biological system among Hrthle subtypes results in a dramatic improvement of classification performance; specificity among Hrthle cell neoplasms increases from 11.8% with the GEC to 58.8% with the GSC, while maintaining the same sensitivity of 89%. […] Insights into Hrthle cell carcinomas are growing, with recent investigations reporting alterations in nuclear and mitochondrial genomes and enriched genomic instability, which differ from the genomic profiles of non-Hrthle neoplasms. Still, mitochondrial and classic DNA mutations, and other cytological, radiological, and laboratory approaches have shown low sensitivity in detecting carcinomas among Hrthle cell FNAB, and imperfect specificity in differentiating benign from malignant nodules.

• #33 Cytological and molecular diagnosis of Hürthle cell thyroid tumors: Analysis of three cases

  https://www.spandidos-publications.com/10.3892/mco.2021.2311

  The cytological diagnosis of Hrthle cell (oncocytic) thyroid tumors by means of fineneedle aspiration biopsy represents a challenge, as Hrthle cell polymorphism and atypia alone are not indications of malignancy. […] In our recent work, an original diagnostic algorithm was proposed, which identified and typed malignant thyroid tumors by analyzing the molecular markers of cytological preparations. […] The aim of the present study was to assess the effectiveness of this algorithm at detecting Hrthle cell thyroid tumors in clinical samples used for cytological examination. […] The results revealed that the molecular test determined the malignancy of three cases of Hrthle cell tumor. This method may therefore be used to complement the cytological diagnosis of fineneedle aspiration biopsy.

• #34 Cytological and molecular diagnosis of Hürthle cell thyroid tumors: Analysis of three cases

  https://www.spandidos-publications.com/10.3892/mco.2021.2311

  The present study demonstrated that molecular testing together with cytological analysis can reduce the risk of error in the preoperative cytological diagnosis of unclear or ambivalent cases. […] Therefore, elevated mtDNA content of a tissue sample is indicative of Hrthle cells but not of malignancy. The hallmark of HCC is overexpression of miR-221. […] This diagnostic algorithm can be applied to any cytological slides but primarily to Bethesda categories III and IV. […] The main limitation of this study is the small number of samples involved (three). This is due to the relative rarity of Hrthle cell tumors, but this number is planned to increase over time. […] As far as the analyzed cases are concerned, the use of molecular markers in the analysis of cytological material helped to make a correct diagnosis preoperatively, demonstrating potential usefulness of this approach for addressing and solving cytologically unclear or ambivalent cases.

• #35 Diagnostic Accuracy and Prognostic Value of 18F-FDG PET in Hürthle Cell Thyroid Cancer Patients | Journal of Nuclear Medicine

  https://jnm.snmjournals.org/content/47/8/1260

  the intensity of 18F-FDG uptake in metastatic lesions provides important prognostic information about overall survival. […] 18F-FDG PET has an excellent diagnostic accuracy in the detection of residual Hrthle cell thyroid cancer. […] 18F-FDG PET has better sensitivity and specificity than CT on a per patient basis. […] 18F-FDG PET may detect disease sooner than other imaging modalities. […] 18F-FDG PET conveys important prognostic information that may potentially alter patient management.

• #36 Hürthle Cell Thyroid Cancer: A Rare but Intriguing Subtype – Qualisure Diagnostics

  https://qualisuredx.com/hurthle-cell-thyroid-cancer/

  Hrthle cell thyroid cancer accounts for about 3-5% of all thyroid cancers. Its more commonly seen in older individuals, and women tend to be affected more than men. Diagnosing Hrthle cell carcinoma can be tricky because it looks similar to non-cancerous Hrthle cell adenomas. Doctors often use a procedure called fine-needle aspiration biopsy, along with molecular testing and imaging techniques like ultrasound and PET scan, to tell the difference between benign and malignant Hrthle cell growths. […] Hrthle cell thyroid cancer presents unique challenges within the realm of thyroid malignancies. Its distinct features, diagnostic complexities, and treatment considerations call for a personalized approach. […] If you or someone you know is diagnosed with Hrthle cell thyroid cancer, it is crucial to consult with a qualified healthcare professional specializing in thyroid cancer management. They can provide personalized guidance, explore appropriate treatment options, and offer support throughout the recovery process.

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