Materiały źródłowe

• #1 Hurthle Cell Cancer Treatment

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

  Hurthle cell cancer treatment depends upon the stage of the cancer (How big it is, where the cancer is located within the body, and what it looks like under the microscope), the patients overall health, and the patients desires. This section discusses the typical treatment options for your hurthle cell cancer. Treatment decision making is based upon three important factors: […] Hurthle cell cancer surgery is introduced here. The correct operation depends upon the hurthle cell cancer, patient evaluation, and surgeons expertise. What is most important, is that all of the hurthle cell cancer is removed from the neck in the initial surgery! […] For hurthle cell cancer, surgery, by far, is the most common first treatment. In fact, hurthle cell cancer surgery is not only the first treatment but is commonly the only treatment that may be indicated. It is critical that a highly experienced surgeon and the correct surgery is obtained the first time. Hurthle cell cancer surgery should only be done by expert surgeons.

• #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. […] Surgery is the most common treatment for this condition. Depending on your situation, surgeons may remove all or part of your thyroid gland. They may also remove affected lymph nodes. Thyroid surgery may eliminate the cancer. […] After surgery, you may receive medication that stops your thyroid from making hormones that increase the chance cancer will come back. Other treatments include: Hormone therapy: Hormone therapy removes cancer cells or stops them from growing. Radioactive iodine therapy: This treatment kills thyroid cancer cells. […] Yes, it is. Surgery to remove all or part of your thyroid eliminates the cancer. If you have this surgery, you’ll take medication to replace your thyroid hormones.

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

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

  Hrthle cell thyroid cancer has certain features that set it apart from other types of thyroid cancer. Its more aggressive and has a higher chance of coming back compared to papillary or follicular thyroid cancer. Additionally, it does not absorb radioactive iodine as well, which makes traditional radioactive iodine therapy less effective for this type of cancer. […] Managing Hrthle cell thyroid cancer usually involves multiple approaches, starting with surgery as the main treatment. Doctors typically recommend removing the entire thyroid gland through a procedure called total thyroidectomy. The extent of surgery may vary depending on factors like tumor size, location, and whether the cancer has spread to lymph nodes. After surgery, additional treatments like radioactive iodine therapy, external beam radiation therapy, or targeted therapies may be considered based on the individuals risk.

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

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

  Treatment for Hrthle cell carcinoma is based on your cancer stage, age, overall health, and testing results. Your treatment may include some or all of the following: […] The main treatment used is surgery. Some tumors will grow faster than others and that will guide what type of surgery you have. The size of the cancer, your age, and your health will also help decide which surgery you will have. In some cases, the whole thyroid gland is removed (total thyroidectomy) along with any enlarged lymph nodes. If cancer is found in any lymph nodes you may need a lymph node dissection. In other cases, only part of the thyroid will be removed. […] 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. It is often used to treat thyroid cancer and some cases of Hrthle cell cancer.

• #5 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  Management of thyroid cancer is a team effort, and the following consultations should be obtained: Endocrinologist, Surgeon, Nuclear medicine specialist, Pathologist, Radiation oncologist. […] No particular diet is recommended, but an iodide-free diet is recommended at least 1 week prior to scanning to minimize the interference. Activity may be performed as tolerated. […] Surgical complications include laryngeal nerve injury and transient or permanent hypoparathyroidism. Other surgical complications are infection and hematoma. Surgical scars in the neck can be cosmetically disturbing in certain individuals. […] Hypothyroidism can occur if replacement therapy is inadequate. Hyperthyroidism can occur if the patient is overtreated with levothyroxine. […] The risk of secondary carcinoma or leukemia is increased only in patients who have received a high cumulative dose of 131I (500 mCi) and in those who also receive external radiation therapy.

• #6 Hurthle Cell Cancer Treatment

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

  Hurthle cell cancer treatment depends upon the stage of the cancer (How big it is, where the cancer is located within the body, and what it looks like under the microscope), the patients overall health, and the patients desires. This section discusses the typical treatment options for your hurthle cell cancer. Treatment decision making is based upon three important factors: […] Hurthle cell cancer surgery is introduced here. The correct operation depends upon the hurthle cell cancer, patient evaluation, and surgeons expertise. What is most important, is that all of the hurthle cell cancer is removed from the neck in the initial surgery! […] For hurthle cell cancer, surgery, by far, is the most common first treatment. In fact, hurthle cell cancer surgery is not only the first treatment but is commonly the only treatment that may be indicated. It is critical that a highly experienced surgeon and the correct surgery is obtained the first time. Hurthle cell cancer surgery should only be done by expert surgeons.

• #7 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  Chemotherapy for metastatic differentiated thyroid cancer is usually ineffective. However, some experimental trials have yielded promising results. […] A treatment algorithm can be viewed at the National Comprehensive Cancer Networks Thyroid Carcinoma clinical practice guideline. See Thyroid Cancer Treatment Protocols for summarized information. […] Surgery is the main treatment for patients with Hrthle cell carcinoma. Surgical treatment is aimed at removal of the entire cancer, which accomplishes the following: Minimizing the risk of locally persistent or recurrent disease, Providing adequate staging information, Minimizing risk without compromise to optimal cancer management, Improving efforts for postoperative adjunctive treatment (eg, radioactive iodide), Facilitating follow-up care.

• #8 Hurthle Cell Cancer Treatment

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

  Hurthle cell cancer surgery must be considered in several different lights when you think about the neck. Surgery of the thyroid gland itself and surgery for the surrounding soft tissues and lymph nodes around the thyroid gland. […] Hurthle cell cancer can be approached by three basics types of thyroid gland surgery: […] In this surgery, the entire thyroid gland is removed. […] Why should you consider removing the entire thyroid gland (total thyroidectomy)? […] Hurthle cell cancer can sometimes be more aggressive locally when it presents. […] The removal of the lymph nodes of the central neck should be performed initially when the thyroid gland is removed in the treatment of hurthle cell cancer on the side of the cancer or hurthle cell neoplasm. […] In hurthle cell cancer when it is recurrent or persistent, these surgeries are complex, difficult, and complicated with the risk of further recurrence. These surgeries should only be undertaken by the most skilled of thyroid cancer surgeons.

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

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

  Oncocytic carcinoma typically presents as a thyroid nodule, often occurring in middle-aged women. […] Treatment typically involves total thyroidectomy, particularly for more extensive or invasive tumors, as radioactive iodine therapy is less effective for this cancer. […] The primary treatment for oncocytic thyroid cancer is thyroidectomy, with the specific approach contingent upon the tumor’s size, location, and potential metastasis. Total thyroidectomy, involving the complete removal of the thyroid gland, is the most frequently performed procedure. This procedure is recommended for patients with tumors exceeding 4 cm, those displaying invasive characteristics, or in cases where lymph node metastasis is suspected. […] After total thyroidectomy, patients require thyroid hormone replacement, usually with levothyroxine.

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

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

  Fortunately, patients with follicular and Hurthle cell cancer rarely need chemotherapy or traditional external beam radiation therapy. There are three main parts to the treatment of follicular and Hurthle cell cancer: […] The best treatment for thyroid cancer is almost always total thyroidectomy (i.e. removal of the entire thyroid). […] Ultimately, if a patient has a follicular or Hurthle cell cancer, they will need to have their entire thyroid removed. […] After removal of the entire thyroid, patients will need to take thyroid hormone replacement pills (usually one pill a day for the rest of their lives) in order to replace the hormone that the thyroid would normally make. […] Depending on the final pathology, the patient may need RAI ablation or what some doctors call remnant ablation. […] Fortunately, patients with follicular and Hurthle cell thyroid cancer rarely need chemotherapy or traditional external beam radiation therapy. […] After surgery for follicular or Hurthle cell thyroid cancer, it is important to be examined regularly for signs that the cancer may have recurred.

• #11 Mayo Clinic Q and A: Treatment for Hurthle cell thyroid cancer – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-treatment-for-hurthle-cell-thyroid-cancer/

  A partial thyroidectomy can be an appropriate treatment for Hurthle cell thyroid cancer in some cases. […] Because there is potential to cure Hurthle cell thyroid cancer with surgery alone in many cases, removing part or all of the thyroid gland is the most common treatment. […] A partial thyroidectomy involves removing only a portion of the gland — usually one lobe or one side of the thyroid. […] The potential benefit of a partial thyroidectomy over a total thyroidectomy is that the thyroid gland may be able to continue functioning normally after the procedure without taking thyroid hormone therapy to replace the hormones your thyroid usually produces. […] For a total thyroidectomy, the surgeon removes all, or nearly all, of the thyroid gland tissue. […] Thyroid hormone replacement is critical in the event of complete removal of the thyroid gland.

• #12 Hurthle cell thyroid cancer: Symptoms, causes, and more

  https://www.medicalnewstoday.com/articles/hurthle-cell-thyroid-cancer

  Hurthle cell thyroid cancer (HCT) is a rare and aggressive form of thyroid cancer that has a tendency to spread to other parts of the body. […] This article reviews what the medical community knows about HCT cancer, including its causes, symptoms, diagnosis, treatment, and potential complications. […] Below are some potential treatment options for HCT cancer. […] The standard treatment for HCT cancer is surgery. This will involve one of two procedures: […] According to a 2020 study, thyroid lobectomy is preferable to total thyroidectomy because lobectomy carries less risk of injury during the procedure and offers similar clinical outcomes. […] In some cases, doctors may recommend radioactive iodine (RAI) as an additional, or adjuvant, therapy. This is a type of internal radiotherapy treatment for thyroid cancer.

• #13 Hurthle Cell Cancer Treatment

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

  Hurthle cell cancer surgery must be considered in several different lights when you think about the neck. Surgery of the thyroid gland itself and surgery for the surrounding soft tissues and lymph nodes around the thyroid gland. […] Hurthle cell cancer can be approached by three basics types of thyroid gland surgery: […] In this surgery, the entire thyroid gland is removed. […] Why should you consider removing the entire thyroid gland (total thyroidectomy)? […] Hurthle cell cancer can sometimes be more aggressive locally when it presents. […] The removal of the lymph nodes of the central neck should be performed initially when the thyroid gland is removed in the treatment of hurthle cell cancer on the side of the cancer or hurthle cell neoplasm. […] In hurthle cell cancer when it is recurrent or persistent, these surgeries are complex, difficult, and complicated with the risk of further recurrence. These surgeries should only be undertaken by the most skilled of thyroid cancer surgeons.

• #14 Mayo Clinic Health Library – Hurthle cell cancer | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20373556

  Treatment for Hurthle cell cancer usually involves surgery to remove the thyroid. Other treatments may be recommended, depending on your situation. […] Total or near-total removal of the thyroid (thyroidectomy) is the most common treatment for Hurthle cell cancer. […] During thyroidectomy, the surgeon removes all or nearly all of the thyroid gland and leaves tiny edges of thyroid tissue near small adjacent glands (parathyroid glands) to lessen the chance of injuring them. […] After surgery, your health care provider will prescribe the hormone levothyroxine (Synthroid, Unithroid, others) to replace the hormone produced by the thyroid. You’ll need to take this hormone for the rest of your life. […] Radioactive iodine therapy may be recommended after surgery because it can help destroy any remaining thyroid tissue, which can contain traces of cancer.

• #15 Hurthle Cell Tumours – Endocrinesurgery.net.au

  http://www.endocrinesurgery.net.au/hurthle-cell-tumours/

  With regards to surgery, most advocate an initial hemithyroidectomy, with completion thyroidectomy if HCC is found on pathology. […] Radioactive iodine treatment is used for patients with most of the Hrthle cell cancers after total and near-total thyroidectomy (to destroy any residual thyroid cells) and in the treatment of patients with recurrent and metastatic Hrthle cell carcinoma. […] Thyroxine suppression therapy is also indicated, being managed in a similar way to other thyroid cancers, according to the postoperative risk category of the cancer.

• #16 Hurthle Cell Cancer Treatment

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

  Hurthle cell cancer surgery must be considered in several different lights when you think about the neck. Surgery of the thyroid gland itself and surgery for the surrounding soft tissues and lymph nodes around the thyroid gland. […] Hurthle cell cancer can be approached by three basics types of thyroid gland surgery: […] In this surgery, the entire thyroid gland is removed. […] Why should you consider removing the entire thyroid gland (total thyroidectomy)? […] Hurthle cell cancer can sometimes be more aggressive locally when it presents. […] The removal of the lymph nodes of the central neck should be performed initially when the thyroid gland is removed in the treatment of hurthle cell cancer on the side of the cancer or hurthle cell neoplasm. […] In hurthle cell cancer when it is recurrent or persistent, these surgeries are complex, difficult, and complicated with the risk of further recurrence. These surgeries should only be undertaken by the most skilled of thyroid cancer surgeons.

• #17 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  Total thyroidectomy is usually recommended for patients with Hrthle cell carcinomas, whereas patients with Hrthle cell adenomas are generally treated with a thyroid lobectomy. […] Although total thyroidectomy is generally considered the treatment of choice for Hrthle cell carcinoma, a lobectomy is usually performed first; if histologic sections show Hrthle cell carcinoma, as evidenced by vascular and/or capsular invasion, then a complete thyroidectomy is performed in a second surgery. […] Intraoperative frozen section examination of the thyroid gland has variable diagnostic value, based on institutional experience. […] Standard surgical wound care is usually appropriate. Postoperative care includes careful monitoring for the following: Infection, Hematoma, Signs of recurrent laryngeal nerve injury (eg, hoarseness), Airway compromise, Signs of hypoparathyroidism and hypocalcemia; check calcium levels at least every 12-24 hours. If hypocalcemia is present, immediately treat the patient.

• #18 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  Total thyroidectomy is usually recommended for patients with Hrthle cell carcinomas, whereas patients with Hrthle cell adenomas are generally treated with a thyroid lobectomy. […] Although total thyroidectomy is generally considered the treatment of choice for Hrthle cell carcinoma, a lobectomy is usually performed first; if histologic sections show Hrthle cell carcinoma, as evidenced by vascular and/or capsular invasion, then a complete thyroidectomy is performed in a second surgery. […] Intraoperative frozen section examination of the thyroid gland has variable diagnostic value, based on institutional experience. […] Standard surgical wound care is usually appropriate. Postoperative care includes careful monitoring for the following: Infection, Hematoma, Signs of recurrent laryngeal nerve injury (eg, hoarseness), Airway compromise, Signs of hypoparathyroidism and hypocalcemia; check calcium levels at least every 12-24 hours. If hypocalcemia is present, immediately treat the patient.

• #19 Hurthle Cell Cancer Treatment

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

  Hurthle cell cancer surgery must be considered in several different lights when you think about the neck. Surgery of the thyroid gland itself and surgery for the surrounding soft tissues and lymph nodes around the thyroid gland. […] Hurthle cell cancer can be approached by three basics types of thyroid gland surgery: […] In this surgery, the entire thyroid gland is removed. […] Why should you consider removing the entire thyroid gland (total thyroidectomy)? […] Hurthle cell cancer can sometimes be more aggressive locally when it presents. […] The removal of the lymph nodes of the central neck should be performed initially when the thyroid gland is removed in the treatment of hurthle cell cancer on the side of the cancer or hurthle cell neoplasm. […] In hurthle cell cancer when it is recurrent or persistent, these surgeries are complex, difficult, and complicated with the risk of further recurrence. These surgeries should only be undertaken by the most skilled of thyroid cancer surgeons.

• #20 Hurthle Cell Carcinoma | Thyroid Cancers

  https://thyroidcancers.in/hurthle-cell-carcinoma/

  Treatment for Hurthle cell thyroid cancer therapy depends on the stage and extent of the cancer. Common treatment options include: […] Surgery: The primary approach for Hurthle cell carcinoma is the surgical removal of the thyroid gland. At MACS Clinic, we use the revolutionary Robotic-Assisted Breast-Axillo Insufflation Thyroidectomy (RABIT) technique. Developed by Dr. Sandeep Nayak, RABIT employs the Da Vinci robotic system to perform the procedure through small, discreet incisions in the armpit. This method provides enhanced precision, magnification, and 3D vision, leading to superior surgical results and minimal scarring. […] Lymph node dissection: If the cancer has spread to nearby lymph nodes, they are removed during surgery. This helps to ensure that any cancerous cells in the lymphatic system are addressed, reducing the risk of recurrence and improving overall treatment effectiveness.

• #21 Hurthle Cell Cancer Treatment

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

  Hurthle cell cancer surgery must be considered in several different lights when you think about the neck. Surgery of the thyroid gland itself and surgery for the surrounding soft tissues and lymph nodes around the thyroid gland. […] Hurthle cell cancer can be approached by three basics types of thyroid gland surgery: […] In this surgery, the entire thyroid gland is removed. […] Why should you consider removing the entire thyroid gland (total thyroidectomy)? […] Hurthle cell cancer can sometimes be more aggressive locally when it presents. […] The removal of the lymph nodes of the central neck should be performed initially when the thyroid gland is removed in the treatment of hurthle cell cancer on the side of the cancer or hurthle cell neoplasm. […] In hurthle cell cancer when it is recurrent or persistent, these surgeries are complex, difficult, and complicated with the risk of further recurrence. These surgeries should only be undertaken by the most skilled of thyroid cancer surgeons.

• #22 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  Management of thyroid cancer is a team effort, and the following consultations should be obtained: Endocrinologist, Surgeon, Nuclear medicine specialist, Pathologist, Radiation oncologist. […] No particular diet is recommended, but an iodide-free diet is recommended at least 1 week prior to scanning to minimize the interference. Activity may be performed as tolerated. […] Surgical complications include laryngeal nerve injury and transient or permanent hypoparathyroidism. Other surgical complications are infection and hematoma. Surgical scars in the neck can be cosmetically disturbing in certain individuals. […] Hypothyroidism can occur if replacement therapy is inadequate. Hyperthyroidism can occur if the patient is overtreated with levothyroxine. […] The risk of secondary carcinoma or leukemia is increased only in patients who have received a high cumulative dose of 131I (500 mCi) and in those who also receive external radiation therapy.

• #23 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  Total thyroidectomy is usually recommended for patients with Hrthle cell carcinomas, whereas patients with Hrthle cell adenomas are generally treated with a thyroid lobectomy. […] Although total thyroidectomy is generally considered the treatment of choice for Hrthle cell carcinoma, a lobectomy is usually performed first; if histologic sections show Hrthle cell carcinoma, as evidenced by vascular and/or capsular invasion, then a complete thyroidectomy is performed in a second surgery. […] Intraoperative frozen section examination of the thyroid gland has variable diagnostic value, based on institutional experience. […] Standard surgical wound care is usually appropriate. Postoperative care includes careful monitoring for the following: Infection, Hematoma, Signs of recurrent laryngeal nerve injury (eg, hoarseness), Airway compromise, Signs of hypoparathyroidism and hypocalcemia; check calcium levels at least every 12-24 hours. If hypocalcemia is present, immediately treat the patient.

• #24 Hurthle Cell Cancer Radioactive Iodine Treatment

  https://www.thyroidcancer.com/thyroid-cancer/hurthle/radioactive-iodine

  Radioactive iodine treatment for hurthle cell cancer was, in fact, one of the first real targeted therapies ever to be developed for any cancer. […] In the treatment of hurthle cell cancer, this can be taken advantage of by having the patient swallow an iodine pill that has been radioactively charged. […] Hurthle cell cancer, historically, is not highly responsive to radioactive iodine therapy. However, it still remains a mainstay of treatment today. […] Indications for treatment with radioactive iodine for hurthle cell cancers include whether the cancer has grown into blood vessels, spread outside of the thyroid gland itself or spread into the lymph nodes of the neck or distant sites in the body. […] Although radioactive iodine is used commonplace in the treatment of hurthle cell cancer, its effectiveness is frequently questioned.

• #25 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  Compared with other thyroid carcinomas, Hrthle cell cancer has a lower avidity for 131I; therefore, treatment with radioactive iodide has limited efficacy. Reportedly, approximately 10% of metastases take up radioiodine, compared with 75% of metastases from follicular carcinoma; thus, radioactive iodide treatment, which is the most useful nonsurgical therapy for recurrent well-differentiated thyroid carcinoma, is not always useful in patients with Hrthle cell carcinoma. This causes difficulty in the treatment of recurrences. Nevertheless, radioactive iodide treatment is used for most patients with Hrthle cell cancers after total and near-total thyroidectomy and in the treatment of patients with recurrent and metastatic Hrthle cell carcinoma. […] Jillard et al reported that post-thyroidectomy 131I therapy improves survival in patients with Hrthle cell carcinoma. In their review of 1909 cases, patients who received 131I (n=1162) had superior 5-year and 10-year survival compared with patients who did not (88.9 vs. 83.1% and 74.4 vs. 65.0%, respectively, P 0.001). These authors conclude that their finding suggest that radioactive iodine therapy should be advocated for patients with tumors 2 cm, and those with nodal and distant metastatic disease.

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

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

  Hrthle cell thyroid cancer has certain features that set it apart from other types of thyroid cancer. Its more aggressive and has a higher chance of coming back compared to papillary or follicular thyroid cancer. Additionally, it does not absorb radioactive iodine as well, which makes traditional radioactive iodine therapy less effective for this type of cancer. […] Managing Hrthle cell thyroid cancer usually involves multiple approaches, starting with surgery as the main treatment. Doctors typically recommend removing the entire thyroid gland through a procedure called total thyroidectomy. The extent of surgery may vary depending on factors like tumor size, location, and whether the cancer has spread to lymph nodes. After surgery, additional treatments like radioactive iodine therapy, external beam radiation therapy, or targeted therapies may be considered based on the individuals risk.

• #27 Hürthle cell thyroid carcinoma | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/hurthle-cell-thyroid-carcinoma-3?lang=us

  Surgery, including thyroid lobectomy or total thyroidectomy, is the primary treatment for Hrthle cell tumors. Adjuvant radioactive iodine is used for high-risk features such as size 2 cm, locoregional cervical lymph node involvement, positive margins or microvascular invasion. […] It is estimated that only around 10% of patients with Hrthle cell carcinoma lesions take up radioiodine; hence responses to treatment with radioactive iodine are much lower in these patients when compared to other types of thyroid carcinomas. […] Overall survival for Hrthle cell carcinoma is similar to that of comparably staged follicular cell carcinoma. Increasing age, male sex, and increasing tumor size substantially diminish survival in patients with Hrthle cell carcinoma.

• #28 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  Compared with other thyroid carcinomas, Hrthle cell cancer has a lower avidity for 131I; therefore, treatment with radioactive iodide has limited efficacy. Reportedly, approximately 10% of metastases take up radioiodine, compared with 75% of metastases from follicular carcinoma; thus, radioactive iodide treatment, which is the most useful nonsurgical therapy for recurrent well-differentiated thyroid carcinoma, is not always useful in patients with Hrthle cell carcinoma. This causes difficulty in the treatment of recurrences. Nevertheless, radioactive iodide treatment is used for most patients with Hrthle cell cancers after total and near-total thyroidectomy and in the treatment of patients with recurrent and metastatic Hrthle cell carcinoma. […] Jillard et al reported that post-thyroidectomy 131I therapy improves survival in patients with Hrthle cell carcinoma. In their review of 1909 cases, patients who received 131I (n=1162) had superior 5-year and 10-year survival compared with patients who did not (88.9 vs. 83.1% and 74.4 vs. 65.0%, respectively, P 0.001). These authors conclude that their finding suggest that radioactive iodine therapy should be advocated for patients with tumors 2 cm, and those with nodal and distant metastatic disease.

• #29 Use of RAI in Large-Sized Hürthle Cell Carcinoma | Duke Health Referring Physicians

  https://physicians.dukehealth.org/articles/use-rai-large-sized-h%C3%BCrthle-cell-carcinoma

  Radioactive iodine therapy (RAI) should be used in patients with Hrthle cell carcinoma whose tumors are larger than 2 cm in size as well as in patients with nodal and distant metastatic disease, according to study results from Duke Health investigators. […] The implication for clinical practice is that, based on these new data, unless contraindicated, clinicians can now recommend that patients with Hrthle cell cancers of at least 2 cm or those with local and/or distant metastases undergo post-thyroidectomy RAI treatment, Sosa says. […] Greater 5- and 10-year survival rates were found among participants who received RAI (88.9% and 74.4%, respectively) compared with those who did not (83.1% and 65.0%, respectively; P .001 for both). […] A 30% reduction in mortality was independently linked to RAI administration. […] In a related article in Endocrine Today highlighting the study, Sosa warns that the observed variation in RAI administration implies inconsistent quality of care nationally for patients with Hrthle cell carcinoma.

• #30 Radioactive iodine therapy has no clear benefit on survival in patients with hürthle-cell thyroid cancer

  https://www.thyroid.org/patient-thyroid-information/ct-for-patients/august-2023/vol-16-issue-8-p-13-14/

  Radioactive iodine therapy has no clear benefit on survival in patients with hrthle-cell thyroid cancer. […] Usual therapy includes a total thyroidectomy and many also undergo radioactive iodine therapy. […] The aim of this study was to evaluate whether radioactive iodine therapy after total thyroidectomy improves prognosis and survival in patients with HCC. […] There was no difference in CSS rates between patients who received radioactive iodine therapy and those who did not when examining the entire group or the matched group. […] However, there was no difference in cancer-specific survival noted between patients who received and those who did not receive radioactive iodine therapy after total thyroidectomy.

• #31 Hurthle Cell Cancer Radioactive Iodine Treatment

  https://www.thyroidcancer.com/thyroid-cancer/hurthle/radioactive-iodine

  RAI treatment is primarily beneficial only when the patient has undergone a total thyroidectomy (complete removal of the thyroid gland) in the surgery for their hurthle cell cancer. […] RAI treatment or therapy should only be used in instances where the risk of the hurthle cell cancer coming back is greater than the potential risks of RAI therapy itself. […] The hurthle cell cancer must have the symporter for iodine and take up iodine to be effective. […] Hurthle cell cancers that take up iodine are called iodine avid. […] Clear evidence for the benefit of radioactive iodine in hurthle cell cancer is, in fact, quite lacking when critically analyzing Zimmerman’s 2015 review of the literature in the journal Thyroid Research. […] Hurthle cell cancer indications for RAI treatment include: Hurthle cell cancer evidence of invasion (or extension) outside of the thyroid gland capsule (called soft tissue extension), Any hurthle cell cancer that has spread to a lymph node in the neck (in any area of the neck), The hurthle cell cancer team desire to destroy any additional thyroid tissue (which is producing thyroglobulin), Hurthle cell cancer that has spread to distant sites (lungs, bones, and liver).

• #32 Hurthle Cell Cancer Radioactive Iodine Treatment

  https://www.thyroidcancer.com/thyroid-cancer/hurthle/radioactive-iodine

  RAI treatment is primarily beneficial only when the patient has undergone a total thyroidectomy (complete removal of the thyroid gland) in the surgery for their hurthle cell cancer. […] RAI treatment or therapy should only be used in instances where the risk of the hurthle cell cancer coming back is greater than the potential risks of RAI therapy itself. […] The hurthle cell cancer must have the symporter for iodine and take up iodine to be effective. […] Hurthle cell cancers that take up iodine are called iodine avid. […] Clear evidence for the benefit of radioactive iodine in hurthle cell cancer is, in fact, quite lacking when critically analyzing Zimmerman’s 2015 review of the literature in the journal Thyroid Research. […] Hurthle cell cancer indications for RAI treatment include: Hurthle cell cancer evidence of invasion (or extension) outside of the thyroid gland capsule (called soft tissue extension), Any hurthle cell cancer that has spread to a lymph node in the neck (in any area of the neck), The hurthle cell cancer team desire to destroy any additional thyroid tissue (which is producing thyroglobulin), Hurthle cell cancer that has spread to distant sites (lungs, bones, and liver).

• #33 Hürthle-Cell cancer with extensive vascular invasion has a higher risk of recurrence than follicular-cell cancer

  https://www.thyroid.org/patient-thyroid-information/ct-for-patients/september-2022/vol-15-issue-9-p-11-12/

  Hurthle-cell carcinoma appears to be a more severe cancer subtype than follicular thyroid cancer. […] The degree of vascular invasion is a particularly important factor that affects the behaviour of Hrthle-cell cancer, as Hrthle-cell cancers with significant vascular invasion have high recurrence rates and more frequent spread outside of the neck. Therefore, Hrthle-cell carcinoma may require more aggressive treatment strategies such as total thyroidectomy and radioactive iodine therapy.

• #34 Hurthle Cell Cancer Radioactive Iodine Treatment

  https://www.thyroidcancer.com/thyroid-cancer/hurthle/radioactive-iodine

  Hurthle cell cancer patients must be taken off of levothyroxine thyroid hormone (T4 hormone) for a minimum of four weeks, taken off of liothyrionine thyroid hormone (T3 hormone) for a minimum of two weeks, or receive a medication which is TSH. […] The potential risks of RAI treatment include: Dry mouth and or eyes, Narrowing of the drainage duct of the eyes tears leading to excessive tearing down the cheek, Decreased production of blood cells by the bone marrow (with very high RAI doses), Swelling in your cheeks from inflammation or damage to the saliva producing glands (the spit glands), Short term changes to taste and smell (usually resolve in 4-8 weeks), Lowered testosterone levels in males (usually resolves within the first year), Change in periods (menstruation) in women (usually resolves within the first year), Second tumors (these are rare and can be discussed with your thyroid cancer treatment team).

• #35 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  Management of thyroid cancer is a team effort, and the following consultations should be obtained: Endocrinologist, Surgeon, Nuclear medicine specialist, Pathologist, Radiation oncologist. […] No particular diet is recommended, but an iodide-free diet is recommended at least 1 week prior to scanning to minimize the interference. Activity may be performed as tolerated. […] Surgical complications include laryngeal nerve injury and transient or permanent hypoparathyroidism. Other surgical complications are infection and hematoma. Surgical scars in the neck can be cosmetically disturbing in certain individuals. […] Hypothyroidism can occur if replacement therapy is inadequate. Hyperthyroidism can occur if the patient is overtreated with levothyroxine. […] The risk of secondary carcinoma or leukemia is increased only in patients who have received a high cumulative dose of 131I (500 mCi) and in those who also receive external radiation therapy.

• #36 Hurthle Cell Cancer Radioactive Iodine Treatment

  https://www.thyroidcancer.com/thyroid-cancer/hurthle/radioactive-iodine

  The hurthle cell cancer treatment dose of radioactive iodine ranges from about 30 millicuries to approximately 150 millicuries. […] There is evidence now that radioactive iodine will benefit you if your Hurthle cell cancer has spread to lymph nodes, invaded blood vessels or soft tissue. […] Hurthle cell cancers can also be treated with radioactive iodine based upon a method called dosimetry.

• #37 Treatment and outcome of 32 patients with distant metastases of Hürthle cell thyroid carcinoma: a single-institution experience | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-016-2179-3

  Surgery is the mainstay of the treatment of HCTC. […] Total or near-total thyroidectomy is considered a proper surgical procedure for HCTC. […] RAI was used for the ablation of thyroid remnant tissue in 30 (94 %) patients. […] RAI was used also for treating of distant metastases and inoperable locoregional recurrences with empiric dose of 3.77.4 GBq (100200 mCi). […] Altogether 13 patients were treated with chemotherapy. […] EBRT was done in a total of 19 patients, of whom twelve received EBRT to the neck and superior mediastinum (3 after R2 resection and 9 after R1 resection). […] Our data support their observation that postoperative EBRT prevents the recurrence of advanced resected tumors. […] Surgical procedure is another useful treatment option for distant metastasis in selected cases.

• #38 Hurthle Cell Cancer Radioactive Iodine Treatment

  https://www.thyroidcancer.com/thyroid-cancer/hurthle/radioactive-iodine

  Hurthle cell cancer patients must be taken off of levothyroxine thyroid hormone (T4 hormone) for a minimum of four weeks, taken off of liothyrionine thyroid hormone (T3 hormone) for a minimum of two weeks, or receive a medication which is TSH. […] The potential risks of RAI treatment include: Dry mouth and or eyes, Narrowing of the drainage duct of the eyes tears leading to excessive tearing down the cheek, Decreased production of blood cells by the bone marrow (with very high RAI doses), Swelling in your cheeks from inflammation or damage to the saliva producing glands (the spit glands), Short term changes to taste and smell (usually resolve in 4-8 weeks), Lowered testosterone levels in males (usually resolves within the first year), Change in periods (menstruation) in women (usually resolves within the first year), Second tumors (these are rare and can be discussed with your thyroid cancer treatment team).

• #39 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  Management of thyroid cancer is a team effort, and the following consultations should be obtained: Endocrinologist, Surgeon, Nuclear medicine specialist, Pathologist, Radiation oncologist. […] No particular diet is recommended, but an iodide-free diet is recommended at least 1 week prior to scanning to minimize the interference. Activity may be performed as tolerated. […] Surgical complications include laryngeal nerve injury and transient or permanent hypoparathyroidism. Other surgical complications are infection and hematoma. Surgical scars in the neck can be cosmetically disturbing in certain individuals. […] Hypothyroidism can occur if replacement therapy is inadequate. Hyperthyroidism can occur if the patient is overtreated with levothyroxine. […] The risk of secondary carcinoma or leukemia is increased only in patients who have received a high cumulative dose of 131I (500 mCi) and in those who also receive external radiation therapy.

• #40 Mayo Clinic Health Library – Hurthle cell cancer | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20373556

  Treatment for Hurthle cell cancer usually involves surgery to remove the thyroid. Other treatments may be recommended, depending on your situation. […] Total or near-total removal of the thyroid (thyroidectomy) is the most common treatment for Hurthle cell cancer. […] During thyroidectomy, the surgeon removes all or nearly all of the thyroid gland and leaves tiny edges of thyroid tissue near small adjacent glands (parathyroid glands) to lessen the chance of injuring them. […] After surgery, your health care provider will prescribe the hormone levothyroxine (Synthroid, Unithroid, others) to replace the hormone produced by the thyroid. You’ll need to take this hormone for the rest of your life. […] Radioactive iodine therapy may be recommended after surgery because it can help destroy any remaining thyroid tissue, which can contain traces of cancer.

• #41 Treatments for follicular thyroid cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/thyroid/treatment/follicular-thyroid-cancer

  Hormone therapy is used to replace the hormone thyroxine, which would normally be made by the thyroid. It is also used to slow down the growth of any remaining cancer cells and help prevent the cancer from coming back, or recurring. It is a standard treatment after surgery to remove all of the thyroid. […] Targeted therapy uses drugs to target specific molecules (such as proteins) on cancer cells or inside them to stop the growth and spread of cancer. You may be offered targeted therapy for metastatic or recurrent follicular (including Hurthle cell) thyroid cancer. It may also be given if the cancer doesn’t respond to other treatments. It is typically used when RAI therapy has not worked or has stopped working.

• #42 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  There is limited evidence in the literature that redifferentiation therapy with retinoic acid may restore 131I uptake in some thyroid carcinomas that have lost their capability for radioiodine concentration; however, the benefits of this approach remain uncertain. […] Levothyroxine treatment is started after the treatment dose of 131I is administered. The effective dose of T4 in adults is 2.2-2.8 mcg/kg; children require higher doses. The adequacy of therapy is monitored by measuring serum TSH about 8-12 weeks after the treatment begins. […] Hrthle cell carcinoma is considered a radiosensitive tumor. Radiation therapy may provide palliative relief from symptomatic metastases, control recurrent tumors, and prevent recurrence of advanced resected tumors. […] External radiotherapy to the neck and mediastinum is indicated only in patients in whom surgical excision is incomplete or impossible. This therapy can also be considered for tumors that do not take up 131I.

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

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

  Oncocytic carcinoma typically presents as a thyroid nodule, often occurring in middle-aged women. […] Treatment typically involves total thyroidectomy, particularly for more extensive or invasive tumors, as radioactive iodine therapy is less effective for this cancer. […] The primary treatment for oncocytic thyroid cancer is thyroidectomy, with the specific approach contingent upon the tumor’s size, location, and potential metastasis. Total thyroidectomy, involving the complete removal of the thyroid gland, is the most frequently performed procedure. This procedure is recommended for patients with tumors exceeding 4 cm, those displaying invasive characteristics, or in cases where lymph node metastasis is suspected. […] After total thyroidectomy, patients require thyroid hormone replacement, usually with levothyroxine.

• #44 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  There is limited evidence in the literature that redifferentiation therapy with retinoic acid may restore 131I uptake in some thyroid carcinomas that have lost their capability for radioiodine concentration; however, the benefits of this approach remain uncertain. […] Levothyroxine treatment is started after the treatment dose of 131I is administered. The effective dose of T4 in adults is 2.2-2.8 mcg/kg; children require higher doses. The adequacy of therapy is monitored by measuring serum TSH about 8-12 weeks after the treatment begins. […] Hrthle cell carcinoma is considered a radiosensitive tumor. Radiation therapy may provide palliative relief from symptomatic metastases, control recurrent tumors, and prevent recurrence of advanced resected tumors. […] External radiotherapy to the neck and mediastinum is indicated only in patients in whom surgical excision is incomplete or impossible. This therapy can also be considered for tumors that do not take up 131I.

• #45 Oncocytic (Hürthle Cell) Thyroid Carcinoma | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/131177

  After total thyroidectomy, patients require thyroid hormone replacement, usually with levothyroxine. Levothyroxine is dosed to suppress thyroid-stimulating hormone (TSH) production, potentially reducing the risk of residual cancer growth. […] Currently, guidelines regarding the postoperative use of radioactive iodine (RAI) are inconsistent. The largest study to date found no improvement in disease-specific or overall survival with the addition of RAI to surgery, even in patients at high risk for recurrence. […] For patients with metastatic oncocytic carcinoma who are asymptomatic and have well-differentiated tumors with slow-growing disease, observation is an acceptable option as long as they do not have brain metastases. However, for patients with symptoms or rapidly growing metastatic tumors that respond to iodine treatment, RAI is a preferable option. If the patient’s tumor is not suitable for RAI, systemic therapy with tyrosine kinase inhibitors (eg, lenvatinib or sorafenib) is considered.

• #46 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  Management of thyroid cancer is a team effort, and the following consultations should be obtained: Endocrinologist, Surgeon, Nuclear medicine specialist, Pathologist, Radiation oncologist. […] No particular diet is recommended, but an iodide-free diet is recommended at least 1 week prior to scanning to minimize the interference. Activity may be performed as tolerated. […] Surgical complications include laryngeal nerve injury and transient or permanent hypoparathyroidism. Other surgical complications are infection and hematoma. Surgical scars in the neck can be cosmetically disturbing in certain individuals. […] Hypothyroidism can occur if replacement therapy is inadequate. Hyperthyroidism can occur if the patient is overtreated with levothyroxine. […] The risk of secondary carcinoma or leukemia is increased only in patients who have received a high cumulative dose of 131I (500 mCi) and in those who also receive external radiation therapy.

• #47 What Is Hurthle Cell Carcinoma – Klarity Health Library

  https://my.klarity.health/what-is-hurthle-cell-carcinoma/

  Chemotherapy for HCC is not commonly used. In some cases, it may be used in addition to or after radiation therapy if the cancer is higher in severity and has spread to other organs, to reduce the risk of the cancer returning. […] It is important for patients with any type of cancer, including Hurthle cell carcinoma, to engage in follow-up care. This includes going for regular checkups with a healthcare provider once treatment is over. […] If HCC is treated by surgery and the thyroid has been removed, the body cannot make the thyroid hormones it needs. Thyroid hormone pills such as levothyroxine will need to be taken daily to replace the hormone and maintain normal metabolism, this can also help to lower the risk of the cancer returning.

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

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

  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). It may also be used if the whole thyroid is not removed during surgery. […] You may be offered a clinical trial as part of your treatment plan.

• #49 Mayo Clinic Health Library – Hurthle cell cancer | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20373556

  Radiation therapy may be an option if cancer cells remain after surgery and radioactive iodine treatment or if Hurthle cell cancer spreads. […] Targeted drug treatments use medications that attack specific weaknesses within cancer cells. Targeted therapy may be an option if your Hurthle cell cancer returns after other treatments or if it spreads to distant parts of your body.

• #50 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  There is limited evidence in the literature that redifferentiation therapy with retinoic acid may restore 131I uptake in some thyroid carcinomas that have lost their capability for radioiodine concentration; however, the benefits of this approach remain uncertain. […] Levothyroxine treatment is started after the treatment dose of 131I is administered. The effective dose of T4 in adults is 2.2-2.8 mcg/kg; children require higher doses. The adequacy of therapy is monitored by measuring serum TSH about 8-12 weeks after the treatment begins. […] Hrthle cell carcinoma is considered a radiosensitive tumor. Radiation therapy may provide palliative relief from symptomatic metastases, control recurrent tumors, and prevent recurrence of advanced resected tumors. […] External radiotherapy to the neck and mediastinum is indicated only in patients in whom surgical excision is incomplete or impossible. This therapy can also be considered for tumors that do not take up 131I.

• #51 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  There is limited evidence in the literature that redifferentiation therapy with retinoic acid may restore 131I uptake in some thyroid carcinomas that have lost their capability for radioiodine concentration; however, the benefits of this approach remain uncertain. […] Levothyroxine treatment is started after the treatment dose of 131I is administered. The effective dose of T4 in adults is 2.2-2.8 mcg/kg; children require higher doses. The adequacy of therapy is monitored by measuring serum TSH about 8-12 weeks after the treatment begins. […] Hrthle cell carcinoma is considered a radiosensitive tumor. Radiation therapy may provide palliative relief from symptomatic metastases, control recurrent tumors, and prevent recurrence of advanced resected tumors. […] External radiotherapy to the neck and mediastinum is indicated only in patients in whom surgical excision is incomplete or impossible. This therapy can also be considered for tumors that do not take up 131I.

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

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

  Currently, guidelines regarding the postoperative use of radioactive iodine (RAI) are inconsistent. […] For patients with metastatic oncocytic carcinoma who are asymptomatic and have well-differentiated tumors with slow-growing disease, observation is an acceptable option as long as they do not have brain metastases. […] If surgical resection is not possible or contraindicated, particularly if the cancer has spread beyond the thyroid and threatens vital structures, then external beam radiation therapy or intensity-modulated radiation therapy can be considered. […] Regular follow-up care is crucial for patients treated for oncocytic carcinoma. This typically includes physical examinations, neck ultrasounds, and monitoring of serum thyroglobulin levels.

• #53 Thyroid Cancer Treatment

  https://www.radiologyinfo.org/en/info/thyroid-cancer-treatment

  External beam therapy (EBT): EBT uses radiation to kill cancer cells or keep them from growing. EBT uses a linear accelerator to deliver high-energy x-ray beams to the tumor. The precise beam targets cancer cells while sparing the surrounding normal tissue. Patients who are unable to undergo surgery or I-131 treatment often receive EBT. Treatment is delivered for short periods of time, five days a week for four to six weeks. […] […] Chemotherapy: This treatment uses drugs to kill cancer cells or keep them from growing. Anaplastic thyroid cancer patients may receive chemotherapy with EBT. Chemotherapy is usually delivered over a set period with breaks in between to help ease any side effects. […] […] Targeted Therapy: This is a new option for patients with advanced cancer or cancer that resists treatment. Drugs attack a specific target on the cancer cells, slowing down or even reversing cancer cell growth. […] […] Alcohol ablation: This treatment uses ultrasound to guide an injection of alcohol into small thyroid cancer tumors. It treats thyroid tumors that cannot be removed with surgery and thyroid cancer that returns after being treated.

• #54 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  There is limited evidence in the literature that redifferentiation therapy with retinoic acid may restore 131I uptake in some thyroid carcinomas that have lost their capability for radioiodine concentration; however, the benefits of this approach remain uncertain. […] Levothyroxine treatment is started after the treatment dose of 131I is administered. The effective dose of T4 in adults is 2.2-2.8 mcg/kg; children require higher doses. The adequacy of therapy is monitored by measuring serum TSH about 8-12 weeks after the treatment begins. […] Hrthle cell carcinoma is considered a radiosensitive tumor. Radiation therapy may provide palliative relief from symptomatic metastases, control recurrent tumors, and prevent recurrence of advanced resected tumors. […] External radiotherapy to the neck and mediastinum is indicated only in patients in whom surgical excision is incomplete or impossible. This therapy can also be considered for tumors that do not take up 131I.

• #55 Mayo Clinic Health Library – Hurthle cell cancer | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20373556

  Radiation therapy may be an option if cancer cells remain after surgery and radioactive iodine treatment or if Hurthle cell cancer spreads. […] Targeted drug treatments use medications that attack specific weaknesses within cancer cells. Targeted therapy may be an option if your Hurthle cell cancer returns after other treatments or if it spreads to distant parts of your body.

• #56 Hurthle cell cancer | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/hurthle-cell-cancer?content_id=CON-20373556

  Radiation therapy may be an option if cancer cells remain after surgery and radioactive iodine treatment or if Hurthle cell cancer spreads. […] Targeted drug treatments use medications that attack specific weaknesses within cancer cells. Targeted therapy may be an option if your Hurthle cell cancer returns after other treatments or if it spreads to distant parts of your body.

• #57 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 main treatment is surgery. […] The main type of treatment used for HCC is surgery. This can involve a lobectomy or the removal of the entire thyroid (thyroidectomy). If cancer has spread to nearby lymph nodes, these may be removed as well. […] After surgery, radioactive iodine (RAI) may be used for cancers that have a high risk of recurrence. However, only about 10% of HCCs take up RAI. When RAI isnt an effective option, external beam radiation therapy may be used instead. […] If the cancer has metastasized, healthcare professionals may treat it with RAI, external beam radiation therapy, or targeted therapy drugs. The targeted therapy drugs used for HCC are lenvatinib (Lenvima) and sorafenib (Nexavar). […] If HCC remains localized to your thyroid, its possible for healthcare professionals to remove it entirely from your body with surgery alone. However, if your thyroid is removed, you will need to take thyroid hormone therapy for the rest of your life.

• #58 Hurthle cell carcinoma: current perspectives | OTT

  https://www.dovepress.com/huumlrthle-cell-carcinoma-current-perspectives-peer-reviewed-fulltext-article-OTT

  Currently, sorafenib and lenvatinib are the only US Food and Drug Administration-approved multi-kinase inhibitors available for RAI-refractory differentiated thyroid cancer. […] HCC is associated with more aggressive clinical behavior compared to other differentiated thyroid cancers; for example, it is more often seen with a higher rate of distant metastases.

• #59 Alliance –

  https://allianceforclinicaltrialsinoncology.org/main/public/standard.xhtml?path=/Public/News-RareTumors-Feb2017

  Hrthle Cell Thyroid Cancer – Alliance A091302 Randomized Phase II Study of Sorafenib with or without Everolimus In Patients with Radioactive Iodine Refractory Hrthle Cell Thyroid Cancer. Surgery, radioactive iodine therapy, and treatment with external beam irradiation are therapeutic options that only relieve symptoms for a subset of patients. Once tumors lose the ability to build up radioactive iodine and are not amenable to loco-regional treatments, therapeutic options are quite limited as traditional chemotherapeutic agents are relatively ineffective. Doxorubicin is the only U.S. Food and Drug Administration approved drug for the treatment of radioactive iodine-refractory thyroid cancer based on limited clinical data generated from the 1980s, and its efficacy is questionable. Treatment options for patients with recurrent and metastatic thyroid cancer not amenable to curative surgery or radioactive iodine are limited; no effective systemic therapy currently exists. Radioactive iodine is a standard therapy for metastatic Hrthle cell thyroid cancer. If the cancer continues to grow despite this treatment, patients typically receive sorafenib, a drug approved for radioactive iodine-resistant advanced thyroid cancer. In Alliance A091302, Alliance researchers will determine if giving everolimus (an immunosuppressant drug) with sorafenib versus sorafenib alone in treating patients with radioactive iodine-refractory Hrthle cell thyroid cancer will cause more shrinkage of thyroid cancer and prevent it from growing, and whether it could also cause more side effects than sorafenib alone. Patients will be randomly assigned to one of two groups: sorafenib alone (with the potential to switch to everolimus alone if the cancer continues growing) or sorafenib plus everolimus. Sorafenib works by targeting several proteins involved in cancer growth. Everolimus inhibits a molecule called mTOR, which helps cancer cells grow. Both drugs are taken orally. The study drugs should increase the time it takes the cancer to progress by four and a half months or more compared to the usual approach. About 56 people will participate in this study. To be eligible for this study (Alliance A091302), patients must meet several criteria, including but not limited to the following: Patients must have Hrthle cell thyroid cancer that cannot be surgically removed or has spread, and continues to grow despite prior treatment with radioactive iodine. […] Refer to the study protocol (Alliance A091302) to learn more about this study, including the trial design, treatment plan and patient eligibility, which can be found on the CTSU menu (ctsu.org) or the Alliance website.

• #60 Researchers Uncover Clues to Treating Rare Thyroid Cancer

  https://consultqd.clevelandclinic.org/researchers-uncover-clues-to-treating-rare-thyroid-cancer

  Studies find mTOR inhibitor may play key role in treating Hurthle cell carcinoma […] HCC is a unique type of cancer that has limited preclinical models. The researchers have recently developed seven new Hurthle cell patient-derived xenograft models and plan to develop 15-20 additional preclinical models to explore potential therapeutic targets. […] Earlier studies indicated that mTOR signaling is altered in HCC, suggesting this pathway as potential therapeutic targets. One small clinical trial found that combining the mTOR inhibitor everolimus with the kinase inhibitor sorafenib significantly improved progression-free survival over sorafenib alone. […] The researchers goal is to move into larger clinical trials to validate mTOR inhibitors are as a viable treatment for HCC. […] Currently, mTOR inhibitor combination therapy is being further studied in a phase 2 trial.

• #61 Researchers Uncover Clues to Treating Rare Thyroid Cancer

  https://consultqd.clevelandclinic.org/researchers-uncover-clues-to-treating-rare-thyroid-cancer

  Studies find mTOR inhibitor may play key role in treating Hurthle cell carcinoma […] HCC is a unique type of cancer that has limited preclinical models. The researchers have recently developed seven new Hurthle cell patient-derived xenograft models and plan to develop 15-20 additional preclinical models to explore potential therapeutic targets. […] Earlier studies indicated that mTOR signaling is altered in HCC, suggesting this pathway as potential therapeutic targets. One small clinical trial found that combining the mTOR inhibitor everolimus with the kinase inhibitor sorafenib significantly improved progression-free survival over sorafenib alone. […] The researchers goal is to move into larger clinical trials to validate mTOR inhibitors are as a viable treatment for HCC. […] Currently, mTOR inhibitor combination therapy is being further studied in a phase 2 trial.

• #62 Alliance –

  https://allianceforclinicaltrialsinoncology.org/main/public/standard.xhtml?path=/Public/News-RareTumors-Feb2017

  Hrthle Cell Thyroid Cancer – Alliance A091302 Randomized Phase II Study of Sorafenib with or without Everolimus In Patients with Radioactive Iodine Refractory Hrthle Cell Thyroid Cancer. Surgery, radioactive iodine therapy, and treatment with external beam irradiation are therapeutic options that only relieve symptoms for a subset of patients. Once tumors lose the ability to build up radioactive iodine and are not amenable to loco-regional treatments, therapeutic options are quite limited as traditional chemotherapeutic agents are relatively ineffective. Doxorubicin is the only U.S. Food and Drug Administration approved drug for the treatment of radioactive iodine-refractory thyroid cancer based on limited clinical data generated from the 1980s, and its efficacy is questionable. Treatment options for patients with recurrent and metastatic thyroid cancer not amenable to curative surgery or radioactive iodine are limited; no effective systemic therapy currently exists. Radioactive iodine is a standard therapy for metastatic Hrthle cell thyroid cancer. If the cancer continues to grow despite this treatment, patients typically receive sorafenib, a drug approved for radioactive iodine-resistant advanced thyroid cancer. In Alliance A091302, Alliance researchers will determine if giving everolimus (an immunosuppressant drug) with sorafenib versus sorafenib alone in treating patients with radioactive iodine-refractory Hrthle cell thyroid cancer will cause more shrinkage of thyroid cancer and prevent it from growing, and whether it could also cause more side effects than sorafenib alone. Patients will be randomly assigned to one of two groups: sorafenib alone (with the potential to switch to everolimus alone if the cancer continues growing) or sorafenib plus everolimus. Sorafenib works by targeting several proteins involved in cancer growth. Everolimus inhibits a molecule called mTOR, which helps cancer cells grow. Both drugs are taken orally. The study drugs should increase the time it takes the cancer to progress by four and a half months or more compared to the usual approach. About 56 people will participate in this study. To be eligible for this study (Alliance A091302), patients must meet several criteria, including but not limited to the following: Patients must have Hrthle cell thyroid cancer that cannot be surgically removed or has spread, and continues to grow despite prior treatment with radioactive iodine. […] Refer to the study protocol (Alliance A091302) to learn more about this study, including the trial design, treatment plan and patient eligibility, which can be found on the CTSU menu (ctsu.org) or the Alliance website.

• #63 Frontiers | Anti-PD-1 Immunotherapy Combined With Stereotactic Body Radiation Therapy and GM-CSF as Salvage Therapy in a PD-L1-Positive Patient With Refractory Metastatic Thyroid Hürthle Cell Carcinoma: A Case Report and Literature Review

  https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.782646/full

  Thyroid Hürthle cell carcinoma, known as thyroid eosinophilic carcinoma, is a rare pathological type of differentiated thyroid cancer (DTC), representing 3-4% of all thyroid cancers. However, given the high risk of invasion and metastasis, thyroid Hürthle cell carcinoma has a relatively poor prognosis. Traditional treatment methods have limited effects on patients with metastatic thyroid cancers. Developing a valuable therapy for advanced thyroid carcinomas is an unfilled need, and immunotherapy could represent another choice for these tumors. […] It is encouraging that PD-1 inhibitors in combination with GM-CSF and stereotactic body irradiation (SBRT) on metastatic disease have a significant anti-tumor effect. […] The clinical use of immune checkpoint inhibitors has extended to a variety of malignancies, but are not yet approved for advanced thyroid carcinoma.

• #64 Frontiers | Anti-PD-1 Immunotherapy Combined With Stereotactic Body Radiation Therapy and GM-CSF as Salvage Therapy in a PD-L1-Positive Patient With Refractory Metastatic Thyroid Hürthle Cell Carcinoma: A Case Report and Literature Review

  https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.782646/full

  This case report demonstrated the effectiveness of immunotherapy combined with SBRT and GM-CSF for HCC, but the role of the combination therapy needs further study. […] The therapies targeting MAPK pathway, PI3K/Akt-mTOR pathways, or VEGF, and immunotherapies such as CTLA-4 inhibitor and PD-1/PD-L1 inhibitor, have altered the therapeutic strategies for the aggressive types of thyroid cancer. […] Immune checkpoint inhibitors have demonstrated remarkable efficacy in recent years in the treatment of advanced thyroid carcinoma. […] The combination of radiotherapy and immunotherapy is one of the current research focuses, several cases have confirmed the synergistic effect of immunotherapy and radiation. […] This case report showed the efficacy of immunotherapy combined with distant radiotherapy and GM-CSF in a patient with thyroid Hürthle cell carcinoma. […] ICIs are emerging as possible novel therapeutics for advanced thyroid carcinomas.

• #65 Frontiers | Anti-PD-1 Immunotherapy Combined With Stereotactic Body Radiation Therapy and GM-CSF as Salvage Therapy in a PD-L1-Positive Patient With Refractory Metastatic Thyroid Hürthle Cell Carcinoma: A Case Report and Literature Review

  https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.782646/full

  This case report demonstrated the effectiveness of immunotherapy combined with SBRT and GM-CSF for HCC, but the role of the combination therapy needs further study. […] The therapies targeting MAPK pathway, PI3K/Akt-mTOR pathways, or VEGF, and immunotherapies such as CTLA-4 inhibitor and PD-1/PD-L1 inhibitor, have altered the therapeutic strategies for the aggressive types of thyroid cancer. […] Immune checkpoint inhibitors have demonstrated remarkable efficacy in recent years in the treatment of advanced thyroid carcinoma. […] The combination of radiotherapy and immunotherapy is one of the current research focuses, several cases have confirmed the synergistic effect of immunotherapy and radiation. […] This case report showed the efficacy of immunotherapy combined with distant radiotherapy and GM-CSF in a patient with thyroid Hürthle cell carcinoma. […] ICIs are emerging as possible novel therapeutics for advanced thyroid carcinomas.

• #66 Vudalimab for the Treatment of Locally Advanced or Metastatic Anaplastic Thyroid Cancer or Hurthle Cell Thyroid Cancer – NCIFacebookFollow on XInstagramYoutubeLinkedin

  https://www.cancer.gov/about-cancer/treatment/clinical-trials/search/v?id=NCI-2022-04953

  This phase II trial tests whether vudalimab works to shrink tumors in patients with anaplastic thyroid cancer or hurthle cell thyroid cancer that has spread to nearby tissue or lymph nodes (locally advanced) or has spread to other places in the body (metastatic). Immunotherapy with monoclonal antibodies, such as vudalimab, may help the body’s immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. […] Subjects enrolling in the Exploratory Cohort must have a histologically confirmed diagnosis of Hurthle cell thyroid cancer (HCC). […] Subject’s Hurthle cell thyroid cancer (HCC) must be incurable, metastatic HCC. […] Subjects with HCC must previously have received and failed, or be intolerant to, at least one line of primarily anti-VEGFR tyrosine kinase inhibitor therapy (e.g., lenvatinib).

• #67 Treatment and outcome of 32 patients with distant metastases of Hürthle cell thyroid carcinoma: a single-institution experience | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-016-2179-3

  It is generally believed that patients with Hrthle cell thyroid carcinoma (HCTC) have a poor prognosis. Furthermore, distant metastases represent the most frequent cause of thyroid cancer-related death of patients with HCTC. The aim of this study was to report the treatment and outcomes of patients with distant metastases. […] Total thyroidectomy, lobectomy, subtotal thyroidectomy and neck dissection were performed in 19, 10, 3, and 7 patients, respectively. Radioiodine (RAI) ablation of thyroid remnant was performed in 30 patients, while 20 of them had RAI therapy (median 4 times). RAI uptake in metastases was present in 16 patients and ranged from 0.05 % to 12 %. Chemotherapy was used in 13 patients and external beam radiotherapy in 19 patients. […] Ten-year disease-specific survival for all patients with metastatic Hrthle cell thyroid carcinoma, patients with pulmonary metastases and bone metastases was 60 %, 60 % and 68 %, respectively.

• #68 Treatment and outcome of 32 patients with distant metastases of Hürthle cell thyroid carcinoma: a single-institution experience | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-016-2179-3

  Surgery is the mainstay of the treatment of HCTC. […] Total or near-total thyroidectomy is considered a proper surgical procedure for HCTC. […] RAI was used for the ablation of thyroid remnant tissue in 30 (94 %) patients. […] RAI was used also for treating of distant metastases and inoperable locoregional recurrences with empiric dose of 3.77.4 GBq (100200 mCi). […] Altogether 13 patients were treated with chemotherapy. […] EBRT was done in a total of 19 patients, of whom twelve received EBRT to the neck and superior mediastinum (3 after R2 resection and 9 after R1 resection). […] Our data support their observation that postoperative EBRT prevents the recurrence of advanced resected tumors. […] Surgical procedure is another useful treatment option for distant metastasis in selected cases.

• #69 Treatments for follicular thyroid cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/thyroid/treatment/follicular-thyroid-cancer

  You may be offered the following treatments for follicular (including Hurthle cell) thyroid cancer. Your healthcare team will suggest treatments based on your needs, the stage of the cancer and the risk group. They will work with you to develop a treatment plan. […] Localized or regional follicular thyroid cancer has not spread outside of the thyroid. It is most often treated with surgery to remove part or all of the thyroid gland. Hormone therapy is used to replace the hormones normally made by the thyroid. Radiation therapy may also be used. […] Metastatic follicular thyroid cancer has spread to distant parts of the body. It may be treated with radiation therapy, hormone therapy, targeted therapy and sometimes surgery. […] Recurrent follicular thyroid cancer means that the cancer has come back after it has been treated. Treatment will depend on where the cancer recurs. If the cancer is in the neck, it may be removed with surgery if possible. Radiation therapy may also be used, either alone or with surgery. Targeted therapy or chemotherapy may be used if the cancer has spread to several places and does not respond to radiation therapy.

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

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

  Currently, guidelines regarding the postoperative use of radioactive iodine (RAI) are inconsistent. […] For patients with metastatic oncocytic carcinoma who are asymptomatic and have well-differentiated tumors with slow-growing disease, observation is an acceptable option as long as they do not have brain metastases. […] If surgical resection is not possible or contraindicated, particularly if the cancer has spread beyond the thyroid and threatens vital structures, then external beam radiation therapy or intensity-modulated radiation therapy can be considered. […] Regular follow-up care is crucial for patients treated for oncocytic carcinoma. This typically includes physical examinations, neck ultrasounds, and monitoring of serum thyroglobulin levels.

• #71 Oncocytic (Hürthle Cell) Thyroid Carcinoma | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/131177

  After total thyroidectomy, patients require thyroid hormone replacement, usually with levothyroxine. Levothyroxine is dosed to suppress thyroid-stimulating hormone (TSH) production, potentially reducing the risk of residual cancer growth. […] Currently, guidelines regarding the postoperative use of radioactive iodine (RAI) are inconsistent. The largest study to date found no improvement in disease-specific or overall survival with the addition of RAI to surgery, even in patients at high risk for recurrence. […] For patients with metastatic oncocytic carcinoma who are asymptomatic and have well-differentiated tumors with slow-growing disease, observation is an acceptable option as long as they do not have brain metastases. However, for patients with symptoms or rapidly growing metastatic tumors that respond to iodine treatment, RAI is a preferable option. If the patient’s tumor is not suitable for RAI, systemic therapy with tyrosine kinase inhibitors (eg, lenvatinib or sorafenib) is considered.

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

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

  Since Hrthle cell thyroid cancer is rare, ongoing research aims to understand its biology, genetic changes, and potential targeted treatments better. Clinical trials and studies are exploring new therapies like tyrosine kinase inhibitors and immune checkpoint inhibitors to improve outcomes for patients with advanced or recurrent Hrthle cell carcinoma.

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

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

  Since Hrthle cell thyroid cancer is rare, ongoing research aims to understand its biology, genetic changes, and potential targeted treatments better. Clinical trials and studies are exploring new therapies like tyrosine kinase inhibitors and immune checkpoint inhibitors to improve outcomes for patients with advanced or recurrent Hrthle cell carcinoma.

• #74 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  There is limited evidence in the literature that redifferentiation therapy with retinoic acid may restore 131I uptake in some thyroid carcinomas that have lost their capability for radioiodine concentration; however, the benefits of this approach remain uncertain. […] Levothyroxine treatment is started after the treatment dose of 131I is administered. The effective dose of T4 in adults is 2.2-2.8 mcg/kg; children require higher doses. The adequacy of therapy is monitored by measuring serum TSH about 8-12 weeks after the treatment begins. […] Hrthle cell carcinoma is considered a radiosensitive tumor. Radiation therapy may provide palliative relief from symptomatic metastases, control recurrent tumors, and prevent recurrence of advanced resected tumors. […] External radiotherapy to the neck and mediastinum is indicated only in patients in whom surgical excision is incomplete or impossible. This therapy can also be considered for tumors that do not take up 131I.

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

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

  Fortunately, patients with follicular and Hurthle cell cancer rarely need chemotherapy or traditional external beam radiation therapy. There are three main parts to the treatment of follicular and Hurthle cell cancer: […] The best treatment for thyroid cancer is almost always total thyroidectomy (i.e. removal of the entire thyroid). […] Ultimately, if a patient has a follicular or Hurthle cell cancer, they will need to have their entire thyroid removed. […] After removal of the entire thyroid, patients will need to take thyroid hormone replacement pills (usually one pill a day for the rest of their lives) in order to replace the hormone that the thyroid would normally make. […] Depending on the final pathology, the patient may need RAI ablation or what some doctors call remnant ablation. […] Fortunately, patients with follicular and Hurthle cell thyroid cancer rarely need chemotherapy or traditional external beam radiation therapy. […] After surgery for follicular or Hurthle cell thyroid cancer, it is important to be examined regularly for signs that the cancer may have recurred.

• #76 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  Outpatient care includes the following: Monitor for signs of hypothyroidism after surgical treatment. Levothyroxine therapy should usually be started after the treatment dose of 131I is administered. […] Thyroid bed and lymph node areas should be examined routinely. Ultrasonography is recommended in patients at high risk for recurrent disease and in any patient with suspicious clinical findings. […] In the follow-up care of patients, thyroglobulin is used as a marker of residual disease, of disease recurrence, and as a prognostic factor. Thyroglobulin is produced only by normal or neoplastic thyroid follicular cells and should be undetectable in patients who have been treated with surgery and radioablation. […] If any uptake is detected on the 131I total-body scan or the serum thyroglobulin concentration rises above the previous level, 131I therapy should be administered or a positron emission tomography (PET) scan should be considered to localize the metastasis/recurrence.

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

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

  Currently, guidelines regarding the postoperative use of radioactive iodine (RAI) are inconsistent. […] For patients with metastatic oncocytic carcinoma who are asymptomatic and have well-differentiated tumors with slow-growing disease, observation is an acceptable option as long as they do not have brain metastases. […] If surgical resection is not possible or contraindicated, particularly if the cancer has spread beyond the thyroid and threatens vital structures, then external beam radiation therapy or intensity-modulated radiation therapy can be considered. […] Regular follow-up care is crucial for patients treated for oncocytic carcinoma. This typically includes physical examinations, neck ultrasounds, and monitoring of serum thyroglobulin levels.

• #78 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  Outpatient care includes the following: Monitor for signs of hypothyroidism after surgical treatment. Levothyroxine therapy should usually be started after the treatment dose of 131I is administered. […] Thyroid bed and lymph node areas should be examined routinely. Ultrasonography is recommended in patients at high risk for recurrent disease and in any patient with suspicious clinical findings. […] In the follow-up care of patients, thyroglobulin is used as a marker of residual disease, of disease recurrence, and as a prognostic factor. Thyroglobulin is produced only by normal or neoplastic thyroid follicular cells and should be undetectable in patients who have been treated with surgery and radioablation. […] If any uptake is detected on the 131I total-body scan or the serum thyroglobulin concentration rises above the previous level, 131I therapy should be administered or a positron emission tomography (PET) scan should be considered to localize the metastasis/recurrence.

• #79 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  In the absence of 131I uptake, a CT scan of the neck and lungs, bone scintigraphy, and scintigraphy using a less-specific tracer (eg, thallium, tetrofosmin, fluorodeoxyglucose) and particularly PET scan should be considered strongly in patients with Hrthle cell carcinoma who are known to have no or low uptake.

• #80 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Guidelines: Guidelines Summary, Treatment

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

  The ATA does not have comprehensive guidelines for the treatment of follicular thyroid cancer (FTC) and Hrthle cell carcinoma as separate entities from papillary thyroid cancer; however, there are several individual recommendations that apply decision-making principles to these conditions. […] If the cytology report indicates Hrthle cell neoplasm or suspicious for papillary carcinoma, the ATA recommends a lobectomy or thyroidectomy, depending on nodule size and other risk factors. […] The treatment of choice for differentiated thyroid cancers is surgery, whenever possible, followed by radioiodine (131I) in selected patients and thyrotropin suppression in most patients, according to the National Comprehensive Cancer Network (NCCN) guidelines. […] The NCCN guidelines recommend lobectomy plus isthmusectomy as the initial surgery for patients with follicular neoplasms and Hrthle cell carcinomas, with prompt completion of thyroidectomy if invasive cancer is found on the final histologic section.

• #81 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Guidelines: Guidelines Summary, Treatment

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

  The ATA does not have comprehensive guidelines for the treatment of follicular thyroid cancer (FTC) and Hrthle cell carcinoma as separate entities from papillary thyroid cancer; however, there are several individual recommendations that apply decision-making principles to these conditions. […] If the cytology report indicates Hrthle cell neoplasm or suspicious for papillary carcinoma, the ATA recommends a lobectomy or thyroidectomy, depending on nodule size and other risk factors. […] The treatment of choice for differentiated thyroid cancers is surgery, whenever possible, followed by radioiodine (131I) in selected patients and thyrotropin suppression in most patients, according to the National Comprehensive Cancer Network (NCCN) guidelines. […] The NCCN guidelines recommend lobectomy plus isthmusectomy as the initial surgery for patients with follicular neoplasms and Hrthle cell carcinomas, with prompt completion of thyroidectomy if invasive cancer is found on the final histologic section.

• #82 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Guidelines: Guidelines Summary, Treatment

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

  The ATA does not have comprehensive guidelines for the treatment of follicular thyroid cancer (FTC) and Hrthle cell carcinoma as separate entities from papillary thyroid cancer; however, there are several individual recommendations that apply decision-making principles to these conditions. […] If the cytology report indicates Hrthle cell neoplasm or suspicious for papillary carcinoma, the ATA recommends a lobectomy or thyroidectomy, depending on nodule size and other risk factors. […] The treatment of choice for differentiated thyroid cancers is surgery, whenever possible, followed by radioiodine (131I) in selected patients and thyrotropin suppression in most patients, according to the National Comprehensive Cancer Network (NCCN) guidelines. […] The NCCN guidelines recommend lobectomy plus isthmusectomy as the initial surgery for patients with follicular neoplasms and Hrthle cell carcinomas, with prompt completion of thyroidectomy if invasive cancer is found on the final histologic section.

• #83 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Guidelines: Guidelines Summary, Treatment

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

  While ESMO guidelines consider thyroidectomy to be standard of care for other thyroid tumors, they recommend proposing active ultrasound surveillance of every 612 months for unifocal papillary microcarcinomas (10 mm) with no evidence of extracapsular extension or lymph node metastases. […] NCCN guidelines recommend radioiodine (131I) therapy if any of the following are present: Extrathyroidal extension, Tumor 4 cm in diameter, Postoperative unstimulated thyroglobulin (Tg) level 5-10 ng/mL. […] The ATA recommends radioiodine therapy for all patients if any of the following are present: Distant metastases, Extrathyroidal extension of the tumor regardless of tumor size, Primary tumor size 4 cm even in the absence of other higher-risk features. […] Radioiodine therapy is also recommended for selected patients with 1-4 cm thyroid cancers confined to the thyroid who have documented lymph node metastases or other higher risk features, when the combination of age, tumor size, lymph node status, and individual histology predicts an intermediate to high risk of recurrence or death from thyroid cancer. […] The ATA and NCCN guidelines recommend treatment with levothyroxine to suppress thyroid-stimulating hormone (TSH) levels.

• #84 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Guidelines: Guidelines Summary, Treatment

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

  While ESMO guidelines consider thyroidectomy to be standard of care for other thyroid tumors, they recommend proposing active ultrasound surveillance of every 612 months for unifocal papillary microcarcinomas (10 mm) with no evidence of extracapsular extension or lymph node metastases. […] NCCN guidelines recommend radioiodine (131I) therapy if any of the following are present: Extrathyroidal extension, Tumor 4 cm in diameter, Postoperative unstimulated thyroglobulin (Tg) level 5-10 ng/mL. […] The ATA recommends radioiodine therapy for all patients if any of the following are present: Distant metastases, Extrathyroidal extension of the tumor regardless of tumor size, Primary tumor size 4 cm even in the absence of other higher-risk features. […] Radioiodine therapy is also recommended for selected patients with 1-4 cm thyroid cancers confined to the thyroid who have documented lymph node metastases or other higher risk features, when the combination of age, tumor size, lymph node status, and individual histology predicts an intermediate to high risk of recurrence or death from thyroid cancer. […] The ATA and NCCN guidelines recommend treatment with levothyroxine to suppress thyroid-stimulating hormone (TSH) levels.

• #85

• #86 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. […] Surgery is the most common treatment for this condition. Depending on your situation, surgeons may remove all or part of your thyroid gland. They may also remove affected lymph nodes. Thyroid surgery may eliminate the cancer. […] After surgery, you may receive medication that stops your thyroid from making hormones that increase the chance cancer will come back. Other treatments include: Hormone therapy: Hormone therapy removes cancer cells or stops them from growing. Radioactive iodine therapy: This treatment kills thyroid cancer cells. […] Yes, it is. Surgery to remove all or part of your thyroid eliminates the cancer. If you have this surgery, you’ll take medication to replace your thyroid hormones.

• #87 Hurthle Cell Cancer Treatment

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

  Hurthle cell cancer treatment depends upon the stage of the cancer (How big it is, where the cancer is located within the body, and what it looks like under the microscope), the patients overall health, and the patients desires. This section discusses the typical treatment options for your hurthle cell cancer. Treatment decision making is based upon three important factors: […] Hurthle cell cancer surgery is introduced here. The correct operation depends upon the hurthle cell cancer, patient evaluation, and surgeons expertise. What is most important, is that all of the hurthle cell cancer is removed from the neck in the initial surgery! […] For hurthle cell cancer, surgery, by far, is the most common first treatment. In fact, hurthle cell cancer surgery is not only the first treatment but is commonly the only treatment that may be indicated. It is critical that a highly experienced surgeon and the correct surgery is obtained the first time. Hurthle cell cancer surgery should only be done by expert surgeons.

• #88 Q&A: Treatment for Hurthle cell thyroid cancer

  https://medicalxpress.com/news/2018-10-qa-treatment-hurthle-cell-thyroid.html

  Regardless of whether you have a partial or total thyroidectomy, there will be some risk of the cancer coming back, and you’ll likely need follow-up appointments on a regular basis to check for cancer recurrence. […] As you consider your options, it’s best to seek care from an expert thyroid surgeon who sees a high volume of Hurthle cell cancer cases—ideally completing more than 20 or 30 thyroid surgeries a year.

• #89 Hurthle Cell Carcinoma (Oncocytic Carcinoma) Treatment & Management: Medical Care, Surgical Care, Consultations

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

  Outpatient care includes the following: Monitor for signs of hypothyroidism after surgical treatment. Levothyroxine therapy should usually be started after the treatment dose of 131I is administered. […] Thyroid bed and lymph node areas should be examined routinely. Ultrasonography is recommended in patients at high risk for recurrent disease and in any patient with suspicious clinical findings. […] In the follow-up care of patients, thyroglobulin is used as a marker of residual disease, of disease recurrence, and as a prognostic factor. Thyroglobulin is produced only by normal or neoplastic thyroid follicular cells and should be undetectable in patients who have been treated with surgery and radioablation. […] If any uptake is detected on the 131I total-body scan or the serum thyroglobulin concentration rises above the previous level, 131I therapy should be administered or a positron emission tomography (PET) scan should be considered to localize the metastasis/recurrence.

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

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

  Since Hrthle cell thyroid cancer is rare, ongoing research aims to understand its biology, genetic changes, and potential targeted treatments better. Clinical trials and studies are exploring new therapies like tyrosine kinase inhibitors and immune checkpoint inhibitors to improve outcomes for patients with advanced or recurrent Hrthle cell carcinoma.

Zobacz więcej