Cribriform-morular thyroid carcinoma: A case report with review of the literature

Lahbacha, Bahaeddine; Chaabane, Abir; Nechi, Salwa; Mfarrej, Mohamed Karim; Douggaz, Amel; Kharrat, Ghada; Chelbi, Emna

doi:10.1177/01455613231152332

Cited by 2 publications

(2 citation statements)

References 22 publications

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“…1,9 IHC features of the reported cases are mentioned in Table 1. 5,8,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] TTF1 will be strongly positive in the tumor cells in the nonmorular area. PAX8 is focal, with weak reactivity in some cells of the cribriform component while negative in the morular component.…”

Section: Discussionmentioning

confidence: 99%

Cribriform Morular Thyroid Carcinoma: A Rare Case and Associated Uncommon Features

Sahu,

Shahin,

Jain

et al. 2023

Int J Surg Pathol

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Cribriform morular thyroid carcinoma has been added under tumors of uncertain histogenesis. Its peculiar clinical, histomorphological pattern, and immunohistochemical profile have been proved different from papillary thyroid carcinoma. A 59-year-old female patient had a lesion in the left lobe of the thyroid. Fine needle aspiration cytology was reported as medullary thyroid carcinoma. The total thyroidectomy specimen showed a predominantly solid tumor of size 9.5 cm in the left lobe. Microscopy showed a mixed growth pattern with the dominant cribriform and solid morular area. Nuclear features of papillary carcinoma were not seen. Squamoid morules had nuclear clearing. Marked stromal hyalinization and calcification were noted. Extrathyroidal extension, lymphovascular invasion, and lymph node metastasis were not identified. Immunohistochemically the tumor cells were diffuse and strong nuclear positive for β-catenin, TTF1, PAX8, estrogen receptor, focal, and weak positivity for CD5. Synaptophysin, calcitonin, thyroglobulin, and CDX2 were negative. We report this rare cribriform morular thyroid carcinoma case with its associated uncommon histological and immunohistochemical features.

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Section: Discussionmentioning

confidence: 99%

Cribriform Morular Thyroid Carcinoma: A Rare Case and Associated Uncommon Features

Sahu,

Shahin,

Jain

et al. 2023

Int J Surg Pathol

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“…Although a case of CMTC has been reported in a 15-year-old female with hypothyroidism secondary to neck radiotherapy due to Hodgkin's disease ( 14 ), no increased prevalence of CMTC was detected in a population exposed to ionizing radiation post-Chernobyl ( 11 ). SARS-CoV-2 infection has been reported in one sporadic case of CMTC and lymphocytic thyroiditis ( 15 ).…”

Section: Epidemiological Characteristicsmentioning

confidence: 99%

Cribriform morular thyroid carcinoma: Clinicopathological and molecular basis for both a preventive and therapeutic approach for a rare tumor (Review)

Cameselle‑García,

Abdulkader‑Nallib,

Sánchez‑Ares

et al. 2024

Oncol Rep

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Cribriform morular thyroid carcinoma (CMTC) has been included within the group of thyroid tumors of uncertain histogenesis in the recent World Health Organization classification of endocrine tumors. Most CMTCs occur in young euthyroid women with multiple (and bilateral) thyroid nodules in cases associated with familial adenomatous polyposis (FAP) or as single nodules in sporadic cases. CMTC generally behaves indolently, while aggressiveness and mortality are associated with high-grade CMTC. This tumor histologically displays a distinctive combination of growth patterns with morular structures. Strong diffuse nuclear and cytoplasmic immunostaining for β-catenin is the hallmark of CMTC. Tumor cells are also positive for thyroid transcription factor-1 and for estrogen and progesterone receptors, but negative for thyroglobulin and calcitonin. It is possible that the CMTC phenotype could result from blockage in the terminal/follicular differentiation of follicular cells (or their precursor cells) secondary to the permanent activation of the Wnt/β-catenin pathway. In CMTC, the activation of the Wnt/β-catenin pathway is the central pathogenetic event, which in FAP-associated cases results from germline mutations of the APC regulator of WNT signaling pathway ( APC ) gene, and in sporadic cases from somatic inactivating mutations in the APC, AXIN1 and CTNNB1 genes. Estrogens appear to play a tumor-promoting role by stimulating both the PI3K/AKT/mTOR and the RAS/RAF/MAPK signaling pathways. Additional somatic mutations (i.e. RET rearrangements, or KRAS, phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit α, telomerase reverse transcriptase or tumor protein 53 mutations) may further potentiate the development and progression of CMTC. While hemithyroidectomy would be the treatment of choice for sporadic cases without high-risk data, total thyroidectomy would be indicated in FAP-associated cases. There is insufficient clinical data to propose therapies targeting the Wnt/β-catenin pathway, but multikinase or selective inhibitors could be used in a manner analogous to that of conventional thyroid tumors. It is also unknown whether adjuvant antiestrogenic therapy could be useful in the subgroup of women undergoing surgery with high-risk CMTC, as well as when there is tumor recurrence and/or metastasis.

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Cribriform-morular thyroid carcinoma: A case report with review of the literature

Abstract: Cribriform-morular thyroid carcinoma (CM-TC) is a rare entity that usually occurs in association with familial adenomatous polyposis (FAP) but may be sporadic. Herein, we present a new case of cribriform-morular thyroid carcinoma occurring in a 28-year-old woman with no history of FAP.

Cited by 2 publications

References 22 publications

Cribriform Morular Thyroid Carcinoma: A Rare Case and Associated Uncommon Features

Cribriform Morular Thyroid Carcinoma: A Rare Case and Associated Uncommon Features

Cribriform morular thyroid carcinoma: Clinicopathological and molecular basis for both a preventive and therapeutic approach for a rare tumor (Review)

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