World Journal of Endocrine Surgery

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VOLUME 12 , ISSUE 2 ( May-August, 2020 ) > List of Articles

CASE REPORT

Hürthle Cell Carcinoma in an Extraordinary Location: A Case Report

Darrel S Au, Krishanth Naidu, Usama Majeed

Keywords : Ectopic thyroid tissue, Endocrine surgery, Hürthle cell carcinoma, Oncocytic thyroid carcinoma, Thyroid carcinoma

Citation Information : Au DS, Naidu K, Majeed U. Hürthle Cell Carcinoma in an Extraordinary Location: A Case Report. World J Endoc Surg 2020; 12 (2):96-97.

DOI: 10.5005/jp-journals-10002-1292

License: CC BY-NC 4.0

Published Online: 16-01-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: To present a case of Hürthle cell carcinoma at an extraordinary site, and to contribute to the understanding and management of this tumor. Background: Hürthle cell carcinomas are a dangerous but uncommon variant of thyroid follicular carcinoma, exhibiting invasive potential, they have a propensity to metastasis to distant sites. Therefore, swift diagnosis and management with multidisciplinary input are warranted. We humbly present a case of Hürthle cell carcinoma in the supraclavicular region. Case description: A 44-year-old woman, with a prior history of follicular thyroid adenoma, was found to have a mass measuring 20 × 15 × 18 mm on the left supraclavicular region. Magnetic resonance imaging (MRI) and fine needle aspiration biopsy were suspicious of follicular thyroid neoplasm. Positron emission tomography-computed tomography (PET–CT) revealed two lesions with avid fluorodeoxyglucose (FDG)-avid uptake, one corresponding to the original supraclavicular location and one in the left iliac crest. Subsequently, histological analysis following surgical excision of the supraclavicular mass revealed a lobulated Hürthle cell tumor. The patient underwent further cervical lymph node dissection, with one supraclavicular node demonstrating infiltration by Hürthle cell carcinoma. Postoperatively, the patient underwent radioactive iodine (RAI) therapy to which she responded well, and currently remains well at follow-up. Conclusion: Hürthle cell carcinomas are a rare but aggressive variant of follicular thyroid carcinomas. Known for their malignant potential, this case underscores the vigilance required for the diagnosis and management of these tumors as their sites of metastasis may be most extraordinary, as illustrated in this report. Swift diagnosis and multidisciplinary management of these tumors are paramount. Clinical significance: Hürthle cell carcinomas have been demonstrated to metastasize to the most extraordinary sites, we present a unique case of Hürthle cell carcinoma which reinforces the notion and hope to contribute to its understanding.


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