Hürthle cell carcinoma (HCC) is a distinct subtype of differentiated thyroid cancer, accounting for ~3–5% of cases. Although related to follicular tumors, it behaves differently and requires specific management considerations.
🧠 Key characteristics of Hürthle cell carcinoma
Composed of oncocytic (Hürthle) cells rich in mitochondria More common in older patients Less likely to spread to lymph nodes More likely to spread hematogenously (lungs, bone) in higher-risk disease Often less iodine-avid than papillary or follicular thyroid cancer
🔍 How is it diagnosed?
Ultrasound and FNA may suggest a Hürthle cell neoplasm Definitive diagnosis requires surgery, based on: Capsular invasion Vascular invasion
➡️ Cytology alone cannot reliably distinguish benign from malignant Hürthle cell tumors.
⚖️ How is Hürthle cell carcinoma treated?
Management is risk-adapted and may include:
Thyroid lobectomy for small, minimally invasive tumors Total thyroidectomy for larger or invasive disease Radioactive iodine selectively (often less effective than in other subtypes) Close long-term surveillance
📈 Prognosis
Excellent outcomes for minimally invasive disease Prognosis worsens with: Extensive vascular invasion Large tumor size Distant metastases
🦋 Careful pathology review and individualized treatment are essential.
👨⚕️ Dr. Rodrigo Arrangoiz, MD
Surgical Oncologist – Thyroid, Head & Neck, Breast
Mount Sinai Medical Center
📌 Take-home message:
Hürthle cell carcinoma is uncommon but highly treatable when managed by an experienced thyroid team.
📚 References
Haugen BR et al. ATA Guidelines for Differentiated Thyroid Cancer. Thyroid Lloyd RV et al. WHO Classification of Tumours of Endocrine Organs Ganly I et al. Hürthle cell carcinoma outcomes. J Clin Endocrinol Metab
Rodrigo Arrangoiz MS, MD, FACS, FSSO 