Cribriform-morular thyroid carcinoma

Abstract

Along with classic papillary thyroid cancer, there are rare histological variants with special clinical features, and often physicians are not well informed about them. We present a clinical case of 25 years-old female, who was diagnosed with papillary thyroid cancer based on neck ultrasound and fine needle aspiration biopsy followed by thyroidectomy. The histological and immunohistochemical investigation (expression of cytokeratin-19, CD 56, thyroglobulin, β-catenin) were performed and cribriform-morular carcinoma was identified. It’s believed that this type of papillary thyroid cancer in the majority of cases is associated with familial adenomatous polyposis of the colon. This disease with an autosomal dominant type of inheritance is caused by the mutation of the APC suppressor gene and characterized by the presence of multiple adenomatous polyps in the colon with a 100% risk of malignancy and colon cancer. The patient underwent an additional examination with colonoscopy which revealed polyps in all parts of the colon ranging in size from 1 mm to 3.5 cm. We identified mutation in gene APC — p.S1104X and performed a preventive coloproctectomy. The histological examination verified tubular and tubulovillous adenomas with moderate epithelial dysplasia. During 6 years of follow-up of patient, structural and biochemical remission of thyroid cancer was observed.