Cribriform – morular thyroid carcinoma: a rare entity

Czech version

Authors: Udmila Michnová ¹; Eva Traboulsi ¹; Barbora Peková ²; Aleš Ryška ³
Authors‘ workplace: Oddělení patologie, Ústřední vojenská nemocnice – Vojenská fakultní nemocnice, Praha ¹; Oddělení molekulární endokrinologie, Endokrinologický ústav, Praha ²; Fingerlandův ústav patologie, LF UK a FN, Hradec Králové ³
Published in: Čes.-slov. Patol., 58, 2022, No. 2, p. 107-110
Category: Original Articles

Overview

We present a case report of a 51-year-old patient who underwent totalization of thyroidectomy – resection of the right thyroid lobe for growth progression of the largest nodule from which a fine needle aspiration biopsy (FNAB) was performed and was cytologically suspected of malignancy. Nodule was a graywhite colored tumor with a solid structure, histologically with an unusual morphology and immunoprofile, called cribriform morular thyroid carcinoma (CMTC). Usually, the tumor behaves indolently with a good prognosis. CMTC can be familial or sporadic, predominantly as a solitary or a multifocal lesion, often associated with autosomal dominant adenomatous polyposis syndrome (FAP), so it is necessary to point this out in the report. The syndrome of familial adenomatous polyposis was ruled out, the APC gene mutation was somatic.

Keywords:

thyroid gland – cribriform-morular thyroid carcinoma – familial adenomatous polyposis

Sources

1. Lim H, Devesa S, Sosa J, et al. Trends in Thyroid Cancer Incidence and Mortality in the United States 1974-2013. JAMA 2017; 317(13): 1338-1348.

2. Goldblum J, Lamps L, McKenney J, et al. Rosai and Ackerman´s Surgical Pathology (11th ed). Philadelphia, PA: Elsevier; 2018: 297-676.

3. Lam A, Saremi N. Cribriform-morular variant of papillary thyroid carcinoma: a distinctive type of thyroid cancer. Endocr Relat Cancer 2017; R109-121.

4. Park J, Kim J, Park H, et al. Multifocality in a Patient with Cribriform-Morular Variant of Papillary Thyroid Carcinoma Is an Important Clu efor the Diagnosis of Familial Adenomatous Polyposis. Thyroid 2019; 29(11): 1606-1614.

5. Akaishi J, Kondo T, Sugino K, el al. Cribriform- Morular Variant of Papillary Thyroid Carcinoma: Clinical and Pathological Features of 30 Cases. World J Surg 2018; 42 (11): 3616- 3623.

6. Perez A, Findeis S, Agarwal S, et al. Cribriform- Morular Variant of Papillary Thyroid Carcinoma: Two Cases of a Rare Thyroid Cancer ASsociated with Familial Adenomatous Polyposis. Proc (Bayl Univ Cent) 2019; 32 (3): 399-401.

7. Aydemirli M. et al. A unique case of two somatic APC mutations in an early onset cribriform- morular variant of papillary thyroid carcinoma and overview of the literature. Fam cancer 2020; 19(1): 15-21.

8. Oliveira J, Viana D, Zanardo C, et al. Genotype- phenotype correlation in 99 familial adenomatous polyposis patients : A prospective prevention protocol. Cancer Med 2019; 8(5): 2114-2122.

9. Rosai J, Albores Savedra J, Asioli S, et al. Papillary thyroid carcinoma. In: Lloyd RV, Osamura RY, Klöppel G, eds. World Health Organization Classification of Tumours. Pathology and genetics of tumours of endocrine organs (4th ed). Lyon: IARC Press; 2017: 81–91.

10. Endomoto K et al. A rare case of the recurrent surgery for cribriform-morular variant of the papillary thyroid carcinoma. Int J Surg Case Rep 2020; 66: 385-389.

11. Cameselle-Teijero J, Peteiro-González D, Caneiro-Gómez J, et al. Cribriform-morular variant of thyroid carcinoma: a neoplasm with distinctive phenotype associated with the activation of the WNT/β-catenin pathway. Modern Pathol 2018; 31(8): 1168-1179.

12. Fujimoto T, Hirokawa M, Ota H, et al. Characteristic sonographic features of cribriform papillary thyroid carcinoma for differentiation from other thyroid nodules. J Med Ultrason 2015; 42(1): 83-87.

13. Nosé V. et al. Diagnostic Pathology: Endocrine E-Book Pathology (2nd ed). Salt Lake City: Elsevier: 2018: 211-215.

14. Hirokawa M. et al. Cribriform-morular variant of papillary thyroid carcinoma – cytological and immunocytochemical findings of 18 cases. Diagn Cytopathol 2010; 38(2): 890-896.

15. Erickson L. et al. Cribriform morular thyroid carcinoma. In: WHO Classification of Tumours Editorial Board. Endocrine and Neuroendocrine tumours (5th ed). Lyon; 2022: http://publications. iarc.fr/610.