Hurthle cell neoplasm

Lauren06790
Lauren06790 Member Posts: 3
edited March 2014 in Thyroid Cancer #1
I have been diagnosed with Hashimotos Thyroidosis. Up till now all biopsies indicated the nodule I have on the right lobe was not malignant. On my most recent biopsy it states there are rare groups of Hurthle cells and no colloid present. Differential diagnosis was hurthle cell neoplasm. Up till now I paid no attention to the issue and nodule as the doctor stated it was benign and common with Hashimotos. I had never heard the term hurthle cell. I am not even on meds. I have now read and researched and realize my situation is potentially serious. I am now scheduled to go for another FNB. I don't know what to think or expect and I am afraid. I would really appreciate feedback on what to expect and what to do.
Thanks
Lauren

Comments

  • loispol1
    loispol1 Member Posts: 84
    #2
    Hi Lauren
    You can get a lot of information at the thyroid cancer hurthle cell cancer area here. You can also subscribe to the thyca (thyroid cancer) yahoo discussion group where there are lots of people writing all the time about any questions you could possibly ever have. Thyca.org has a lot of information, so you can start there. I had a hurthle cell neoplasm on FNA. I had hasimotos for years and have been on thyroid medication since 1993. I had over 8 nodules by ultrasound since then and only had a recent FNA this year. They tested three areas. I had an abnormal ultrasound of a new visable nodule in the front of my neck. It turned out a small right lobe nodule was discovered as the hurthle cell neoplasm. I had a TT due to all of the nodules and my desire to not have to have an additional operation in the future if it turned out cancerous, my problems with hasimotos and already being on full replacement medication. My pathology result came back as a hurthle cell adenoma with multinodular hyperplasia throughout the gland. I requested a second pathology as I know hurthle cell cancer can be hard to identify from an adenoma. My second pathology came back as multinodular adenomatous goiter with hurthle cell changes in right and left lobes. I am even considering a third opinion by a hurthle cell expert pathologist. My journey with this since December of '09 was nerve wracking. This site and the other I mentioned really, really helped me understand my situation. I also read everything I could get my hands on research wise here on the internet. I am wishing you well and please keep us updated as to your next FNA results! Lois
  • Lauren06790
    Lauren06790 Member Posts: 3
    #3
    loispol1 said:

    Hi Lauren
    You can get a lot of information at the thyroid cancer hurthle cell cancer area here. You can also subscribe to the thyca (thyroid cancer) yahoo discussion group where there are lots of people writing all the time about any questions you could possibly ever have. Thyca.org has a lot of information, so you can start there. I had a hurthle cell neoplasm on FNA. I had hasimotos for years and have been on thyroid medication since 1993. I had over 8 nodules by ultrasound since then and only had a recent FNA this year. They tested three areas. I had an abnormal ultrasound of a new visable nodule in the front of my neck. It turned out a small right lobe nodule was discovered as the hurthle cell neoplasm. I had a TT due to all of the nodules and my desire to not have to have an additional operation in the future if it turned out cancerous, my problems with hasimotos and already being on full replacement medication. My pathology result came back as a hurthle cell adenoma with multinodular hyperplasia throughout the gland. I requested a second pathology as I know hurthle cell cancer can be hard to identify from an adenoma. My second pathology came back as multinodular adenomatous goiter with hurthle cell changes in right and left lobes. I am even considering a third opinion by a hurthle cell expert pathologist. My journey with this since December of '09 was nerve wracking. This site and the other I mentioned really, really helped me understand my situation. I also read everything I could get my hands on research wise here on the internet. I am wishing you well and please keep us updated as to your next FNA results! Lois

    Thank you Lois
    I drove over two hours to get this biopsy and they cancelled when I arrived. I have to go back on Wednesday. Because I had never heard the term Hurthle cell I reread biopsies I had in the past. Indeed it was present in at least one. I remembered I had a biopsy in May 09 and never read the results. My endo said nothing and I assumed all was well. I requested that report yesterday and found In May 09 it came back negative and there was no mention of hurthle cells at all. I am going to wait to see what happens with this ultra sound FNB but have already scheduled appointments with surgeons. What gets me is the endo has never once mentioned hurthle cell. I am wondering why not. If I had not taken initiative to research I would still know nothing. Thank you so much for responding to my post.
    lauren
  • Lauren06790
    Lauren06790 Member Posts: 3
    #4
    loispol1 said:

    Hi Lauren
    You can get a lot of information at the thyroid cancer hurthle cell cancer area here. You can also subscribe to the thyca (thyroid cancer) yahoo discussion group where there are lots of people writing all the time about any questions you could possibly ever have. Thyca.org has a lot of information, so you can start there. I had a hurthle cell neoplasm on FNA. I had hasimotos for years and have been on thyroid medication since 1993. I had over 8 nodules by ultrasound since then and only had a recent FNA this year. They tested three areas. I had an abnormal ultrasound of a new visable nodule in the front of my neck. It turned out a small right lobe nodule was discovered as the hurthle cell neoplasm. I had a TT due to all of the nodules and my desire to not have to have an additional operation in the future if it turned out cancerous, my problems with hasimotos and already being on full replacement medication. My pathology result came back as a hurthle cell adenoma with multinodular hyperplasia throughout the gland. I requested a second pathology as I know hurthle cell cancer can be hard to identify from an adenoma. My second pathology came back as multinodular adenomatous goiter with hurthle cell changes in right and left lobes. I am even considering a third opinion by a hurthle cell expert pathologist. My journey with this since December of '09 was nerve wracking. This site and the other I mentioned really, really helped me understand my situation. I also read everything I could get my hands on research wise here on the internet. I am wishing you well and please keep us updated as to your next FNA results! Lois

    Thank you Lois
    I drove over two hours to get this biopsy and they cancelled when I arrived. I have to go back on Wednesday. Because I had never heard the term Hurthle cell I reread biopsies I had in the past. Indeed it was present in at least one. I remembered I had a biopsy in May 09 and never read the results. My endo said nothing and I assumed all was well. I requested that report yesterday and found In May 09 it came back negative and there was no mention of hurthle cells at all. I am going to wait to see what happens with this ultra sound FNB but have already scheduled appointments with surgeons. What gets me is the endo has never once mentioned hurthle cell. I am wondering why not. If I had not taken initiative to research I would still know nothing. Thank you so much for responding to my post.
    lauren
  • FCT2010
    FCT2010 Member Posts: 21
    #5
    Hi Lauren.

    My FNA earlier this year came back as "inconclusive", and my ENDO said it'd be best to have it removed to rule out thyroid cancer. I didn't find out until my ENT appt the following month that my FNA found a Hurthle Cell neoplasm, with a 20-30% chance of being malignant. Through internet and book research I found out that:
    1. HCC (hurthle cell carcinoma) is normally found in people over 45 years of age. I am 40.
    2. HCC doesn't necessarily respond to RAI (radiation iodine therapy).
    3. There is no way to confirm if the HCN is malignant (HCC) or not until pathology from the surgery comes back; if it is HCC, they will need to go back in an remove the rest of your thyroid b/c it tends to show up on the other lobe as well.

    From my second surgery, it was discovered that I had three papillary cancer foci, but no HCC. I questioned my ENDO about the possibility of the HCC not taking up the radioactive iodine treatment, and he said in my case it would probably work since I was diagnosed under the age of 45. I'm waiting to hear back the results from my RAI and the two follow up whole body scans.

    Before I went through the first surgery I was able to get a 2nd opinion biopsy. It came back the same, but also noted that it was vascular. Once again I was recommended for a lobectomy, and a completion thyroidectomy if it turned out to be HCC.

    Just try to remain as positive a possible. Ask as many questions of your ENDO and ENT until you feel comfortable making the decisions you need to make.

    Good luck!
  • weberdns
    weberdns Member Posts: 154
    #6
    I had a Hurthle Cell Neoplasm
    With a hurthle cell neoplasm, there is absolutely no way for them to determine if it malignant or benign without removing the thyroid (or at least the half with the tumor) and doing a COMPLETE dissectionn of the tumor. There is also a non proven theory that Hurthle Cell Neoplasms that are benign will eventually turn malignant. I would suggest instead of a FNA you consult a surgeon for removal. In 30% of all cases (I have read some statistics that say up to 45%) the neoplasm is malignant. I wasn't one of the lucky 70% quoted by my surgeon, but ended up with a diagnosis of cancer. I have had my RAI and because it was caught early my doctors are hoping for a full cure!
  • sullnancy
    sullnancy Member Posts: 1
    #7
    loispol1 said:

    Hi Lauren
    You can get a lot of information at the thyroid cancer hurthle cell cancer area here. You can also subscribe to the thyca (thyroid cancer) yahoo discussion group where there are lots of people writing all the time about any questions you could possibly ever have. Thyca.org has a lot of information, so you can start there. I had a hurthle cell neoplasm on FNA. I had hasimotos for years and have been on thyroid medication since 1993. I had over 8 nodules by ultrasound since then and only had a recent FNA this year. They tested three areas. I had an abnormal ultrasound of a new visable nodule in the front of my neck. It turned out a small right lobe nodule was discovered as the hurthle cell neoplasm. I had a TT due to all of the nodules and my desire to not have to have an additional operation in the future if it turned out cancerous, my problems with hasimotos and already being on full replacement medication. My pathology result came back as a hurthle cell adenoma with multinodular hyperplasia throughout the gland. I requested a second pathology as I know hurthle cell cancer can be hard to identify from an adenoma. My second pathology came back as multinodular adenomatous goiter with hurthle cell changes in right and left lobes. I am even considering a third opinion by a hurthle cell expert pathologist. My journey with this since December of '09 was nerve wracking. This site and the other I mentioned really, really helped me understand my situation. I also read everything I could get my hands on research wise here on the internet. I am wishing you well and please keep us updated as to your next FNA results! Lois

    I just had half of my
    I just had half of my thyroid removed due to FNA showing follicular cells. My surgery pathology came back as "Hurthle cell adenoma" but I think I may want a second opinion on the pathology. Just wondering...how did you go about getting your second opinion on your pathology? Did you talk with your endocrinologist about it or surgeon? Thanks for any advise!
  • Dadoonerm
    Dadoonerm Member Posts: 1
    #8
    weberdns said:

    I had a Hurthle Cell Neoplasm
    With a hurthle cell neoplasm, there is absolutely no way for them to determine if it malignant or benign without removing the thyroid (or at least the half with the tumor) and doing a COMPLETE dissectionn of the tumor. There is also a non proven theory that Hurthle Cell Neoplasms that are benign will eventually turn malignant. I would suggest instead of a FNA you consult a surgeon for removal. In 30% of all cases (I have read some statistics that say up to 45%) the neoplasm is malignant. I wasn't one of the lucky 70% quoted by my surgeon, but ended up with a diagnosis of cancer. I have had my RAI and because it was caught early my doctors are hoping for a full cure!

    I too had a Hurthle Cell Neoplasm and half of thyroid removed

    I concur that at the time of my post the only way to determine if your Hurthle Cell Neoplasm is cancerous is to remove the impacted thyroid and study in the lab. There is hope that soon this determination will be able to be performed through a biopsy in the near future but until then your options will be either have the thyroid taken out (or half as in may case) Or monitor regularly for changes. Since benign hurthle cells can turn cancerous I opted to get it out. Plus I wanted to own ow for sure if it was or wasn't cancer for my peace of mind.  I had the thyroid half removed and went in today for a checkup ultrasound. So far the remaining thyroid is still nodual free but they want to do a nuclear medicine check to verify that there are not any hurtle cells present that ultrasound cannot see. For those who have been given a recurrent diagnoses of hurthle cell neoplasm I want to say first, relax its not as bad as it sounds. Worst case is you have your thyroid removed and you are on synthroid or armor thyroid(what I take.  It's from pigs and I believe that Mother Nature is a better chemist so I trust that over the man made crap). This shouldn't be anything new to you as most people with hurthle cell have Hashimotos syndrome and are on some form of thyroid replacement theropy anyway. 

     

    You will be ok and I speak from personal experience. 

     

    Regards

    Dadoo

  • Kat220
    Kat220 Member Posts: 1
    #9
    Hurthle cell neoplasm

    I was recently diagnosed with Hurthle cell neoplasm. Hashimoto was ruled out. I had a FNA, ultrasound and CT scan completed. I have numerous swollen lymph nodes throughout my body as picked up by CT scan. The two in my neck are very hard. The right thyroid is very swollen and sticking out in my neck. The left thyroid is full of small nodules. The right thyroid has a 3.1 cm node and a 1.3 cm node. I have an appointment with the surgeon this Wednesday. I'm afraid this stuff has entered my lymph system. Has anyone else experienced this? Please do not hesitate to talk candid.

  • MarthaNP
    MarthaNP Member Posts: 6
    edited April 2019 #10

    My question: Do you have Hurthle Cells on FNAB and had removal and NO cancer?

    Background: I am new to this discussion. I am a 37 yo white female who has had a nodule for 9 years on my right thyroid. It was biopsed 8 years ago, and was completely benign. It was followed for 7 years with totally normal, unchanged ultrasounds. Then, one month ago I had an irregular ultrasound showing the nodule was the same size, but different SHAPE. The only way to describe it is to say it was once round, and now it looks like "mickey mouse". The report showed "interpolar region thyroid mass on the RIGHT, based on the sonographic appearence, this is "intermediate probability" for thyroid malignancy based on the ATA criteria. Measurement of the nodules: On the right, there is a tri-lobe mass, measuring 10mmx9mmx10mm. On the left there is a tiny hypoechoic lesion in the lower pole measuring 4 mm in greatest dimension. This may be a cyst with a small intracystic nodule." I was told to have it bioped again. The biopsy showed "intermediate cellular specimen contains a prominent population of Hurthle cells, which are discohesive with midly enlraged nuclei. There is also a smaller population of unremarkable follicular cells. Scanty colloid and scatted lymphocytes are in the background. The nodule may represent a benign lesion with Hurthle cell metaplasia, but a Hurthle cell neoplasm cannot be completely ruled out."

     

    With all this being said, I received two opinions (one general surgeon, one ENT) and am electively having a partial thyroidectomy on Thursday this week by ENT specialist at Dartmouth. I have read all about Hurthle cells and looked in this forum. It was quite confusing at first. I was curious if there is anyone here who had Hurthle cells, that did not turn out to be cancer? Should I still have a PET scan? I know Hurthle cells CAN (possibly, by some theories) turn cancerous and read the other information that removing the nodules is possibly a good idea. I see some of you have been through so much. I just was curious what your specifications were for your initial diagnosis? Does it sound similar to my reports? I have to wait about 2 weeks for full pathology reports. I am terrified. I am a medical professional and I am reading the evidence based informatoin about the Hurthle Cell cancer diagnoses and I am fearful that is what I will be diagnosed with. In addition, I have "enlarged lymph nodes upper end of normal". Thanks for any input and sharing your brave stories. I am so frightened of it all. 

  • MarthaNP
    MarthaNP Member Posts: 6
    edited April 2019 #11
    Kat220 said:

    Hurthle cell neoplasm

    I was recently diagnosed with Hurthle cell neoplasm. Hashimoto was ruled out. I had a FNA, ultrasound and CT scan completed. I have numerous swollen lymph nodes throughout my body as picked up by CT scan. The two in my neck are very hard. The right thyroid is very swollen and sticking out in my neck. The left thyroid is full of small nodules. The right thyroid has a 3.1 cm node and a 1.3 cm node. I have an appointment with the surgeon this Wednesday. I'm afraid this stuff has entered my lymph system. Has anyone else experienced this? Please do not hesitate to talk candid.

    Kat - what is the update?

    I know this was 2013, but what was your outcome? Thank you.

  • MarthaNP
    MarthaNP Member Posts: 6
    edited April 2019 #12
    loispol1 said:

    Hi Lauren
    You can get a lot of information at the thyroid cancer hurthle cell cancer area here. You can also subscribe to the thyca (thyroid cancer) yahoo discussion group where there are lots of people writing all the time about any questions you could possibly ever have. Thyca.org has a lot of information, so you can start there. I had a hurthle cell neoplasm on FNA. I had hasimotos for years and have been on thyroid medication since 1993. I had over 8 nodules by ultrasound since then and only had a recent FNA this year. They tested three areas. I had an abnormal ultrasound of a new visable nodule in the front of my neck. It turned out a small right lobe nodule was discovered as the hurthle cell neoplasm. I had a TT due to all of the nodules and my desire to not have to have an additional operation in the future if it turned out cancerous, my problems with hasimotos and already being on full replacement medication. My pathology result came back as a hurthle cell adenoma with multinodular hyperplasia throughout the gland. I requested a second pathology as I know hurthle cell cancer can be hard to identify from an adenoma. My second pathology came back as multinodular adenomatous goiter with hurthle cell changes in right and left lobes. I am even considering a third opinion by a hurthle cell expert pathologist. My journey with this since December of '09 was nerve wracking. This site and the other I mentioned really, really helped me understand my situation. I also read everything I could get my hands on research wise here on the internet. I am wishing you well and please keep us updated as to your next FNA results! Lois

    Lois - could you help me?



    My question: Do you have Hurthle Cells on FNAB and had removal and NO cancer?

    Background: I am new to this discussion. I am a 37 yo white female who has had a nodule for 9 years on my right thyroid. It was biopsed 8 years ago, and was completely benign. It was followed for 7 years with totally normal, unchanged ultrasounds. Then, one month ago I had an irregular ultrasound showing the nodule was the same size, but different SHAPE. The only way to describe it is to say it was once round, and now it looks like "mickey mouse". The report showed "interpolar region thyroid mass on the RIGHT, based on the sonographic appearence, this is "intermediate probability" for thyroid malignancy based on the ATA criteria. Measurement of the nodules: On the right, there is a tri-lobe mass, measuring 10mmx9mmx10mm. On the left there is a tiny hypoechoic lesion in the lower pole measuring 4 mm in greatest dimension. This may be a cyst with a small intracystic nodule." I was told to have it bioped again. The biopsy showed "intermediate cellular specimen contains a prominent population of Hurthle cells, which are discohesive with midly enlraged nuclei. There is also a smaller population of unremarkable follicular cells. Scanty colloid and scatted lymphocytes are in the background. The nodule may represent a benign lesion with Hurthle cell metaplasia, but a Hurthle cell neoplasm cannot be completely ruled out."

     

    With all this being said, I received two opinions (one general surgeon, one ENT) and am electively having a partial thyroidectomy on Thursday this week by ENT specialist at Dartmouth. I have read all about Hurthle cells and looked in this forum. It was quite confusing at first. I was curious if there is anyone here who had Hurthle cells, that did not turn out to be cancer? Should I still have a PET scan? I know Hurthle cells CAN (possibly, by some theories) turn cancerous and read the other information that removing the nodules is possibly a good idea. I see some of you have been through so much. I just was curious what your specifications were for your initial diagnosis? Does it sound similar to my reports? I have to wait about 2 weeks for full pathology reports. I am terrified. I am a medical professional and I am reading the evidence based informatoin about the Hurthle Cell cancer diagnoses and I am fearful that is what I will be diagnosed with. In addition, I have "enlarged lymph nodes upper end of normal". Thanks for any input and sharing your brave stories. I am so frightened of it all. 




  • MarthaNP
    MarthaNP Member Posts: 6
    #13
    Lauren06790 said:

    Thank you Lois
    I drove over two hours to get this biopsy and they cancelled when I arrived. I have to go back on Wednesday. Because I had never heard the term Hurthle cell I reread biopsies I had in the past. Indeed it was present in at least one. I remembered I had a biopsy in May 09 and never read the results. My endo said nothing and I assumed all was well. I requested that report yesterday and found In May 09 it came back negative and there was no mention of hurthle cells at all. I am going to wait to see what happens with this ultra sound FNB but have already scheduled appointments with surgeons. What gets me is the endo has never once mentioned hurthle cell. I am wondering why not. If I had not taken initiative to research I would still know nothing. Thank you so much for responding to my post.
    lauren

    Lauren, what is your update?

    Just curious, what is the update on your case, I know it wa 2010, but could you share what happened?

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