thyroid gland cribriform morular carcinoma

What is Cribriform Morular Thyroid Carcinoma?

Cribriform morular thyroid carcinoma (CMTC) is a rare type of thyroid cancer characterized by its unique microscopic appearance and association with certain genetic conditions. It is a malignant tumor that affects the thyroid gland, which is a butterfly-shaped gland in the neck responsible for producing hormones important for metabolism.

Key Features of CMTC

• Rare occurrence: CMTC is an uncommon variant of papillary thyroid carcinoma (PTC), representing only 0.16% of all PTC cases [5].
• Unique microscopic appearance: Under the microscope, CMTC exhibits a cribriform pattern of growth and morular formations, which are distinctive features not seen in other types of thyroid cancer [10].
• Association with genetic conditions: CMTC is often associated with familial adenomatous polyposis (FAP), a rare genetic disorder that increases the risk of developing various cancers, including colorectal, thyroid, and others [2, 9].

Other Characteristics

• Peculiar growth pattern: The tumor's growth pattern is secondary to permanent activation of the WNT/β-catenin pathway, which leads to its unique appearance [11].
• Variability in presentation: CMTC can occur sporadically or as part of a familial adenomatous polyposis syndrome [8].

References

[1] Apr 5, 2024 — Cribriform-morular thyroid carcinoma is an uncommon thyroid carcinoma of uncertain histogenesis characterized by a complex architecture...

[2] by JM Cameselle-Teijeiro · 2018 · Cited by 66 — Conclusions. Cribriform-morular variant of thyroid carcinoma is a rare type of thyroid carcinoma associated with familial adenomatous polyposis...

[3] by B Boyraz · 2021 · Cited by 37 — Our findings underscore that cribriform-morular thyroid carcinomas should not be classified as one of the variants of papillary thyroid carcinoma, since they...

[4] by M Giuffrida · 2021 · Cited by 1 — Cribiform-morular thyroid carcinoma is a rare variant of papillary thyroid carcinoma. It is usually related to Familial Adenomatous Polyposis (FAP) but...

[5] by KL Sharma · 2022 · Cited by 3 — CMVPTC is characterized by the presence of a cribriform pattern of growth and morular formations, which are distinctive features not seen in other types of thyroid cancer.

[6] A thyroid gland carcinoma characterized by the presence of cribriform, trabecular, follicular, papillary, and solid growth patterns and squamoid morulae formation...

[7] 1. Introduction. Cribriform morular thyroid carcinoma (CMTC) is a type of TC associated with familial adenomatous polyposis (FAP), which can also at times occur sporadically.

[8] The cribriform-morular variant of papillary thyroid carcinoma (PTC) is a paradigmatic example of this close correlation between the classical morphological aspects and genetic-molecular alterations...

[9] Papillary thyroid carcinoma (PTC) is the most common type of thyroid carcinoma, defined by a set of distinctive nuclear features...

Symptoms of Cribriform Morular Thyroid Carcinoma

Cribriform morular thyroid carcinoma (CMTC) is a rare type of thyroid cancer that can be challenging to diagnose due to its unique characteristics. While it's essential to consult a medical professional for an accurate diagnosis, here are some possible signs and symptoms associated with CMTC:

• Painlessness: Malignant thyroid nodules, including those caused by CMTC, are usually painless [1].
• Lump in the front of the neck: A lump or swelling in the neck area can be a sign of thyroid cancer, including CMTC [13][15].
• Swelling in the neck: Enlargement of the thyroid gland can cause swelling in the neck area [13][15].
• Pain in the front of the neck: Pain or discomfort in the front of the neck, sometimes radiating to the ears, can be a symptom of thyroid cancer [13][15].

It's essential to note that these symptoms can also be caused by other conditions, and only a medical professional can accurately diagnose CMTC. Additionally, some people with CMTC may not experience any noticeable symptoms at all.

Association with Familial Adenomatous Polyposis (FAP)

CMTC is often associated with FAP, a genetic condition that increases the risk of developing various types of cancer, including thyroid cancer [3][4][12]. Women are more likely to develop CMTC than men, and it's essential for individuals with a family history of FAP to undergo regular thyroid check-ups.

References

[1] - Malignant thyroid nodules are usually painless. [3] - Cribriform-morular variant of thyroid carcinoma is classically associated with familial adenomatous polyposis but, it can also occur as a sporadic neoplasm. [4] - This neoplasm is much more frequently observed in women than in men (ratio of 61:1). [12] - Cribriform morular thyroid carcinoma (CMTC) is frequently associated with familial adenomatous polyposis (FAP) and is characterized by a strong ... [13] - Thyroid cancer is an abnormal growth of cells in the thyroid gland that form a tumor or mass (called a thyroid nodule). [15] - Signs and Symptoms of Thyroid Cancer. On this page [show] [hide]

Diagnostic Tests for Thyroid Gland Cribriform Morular Carcinoma

Cribriform morular thyroid carcinoma (CMTC) is a rare and aggressive form of thyroid cancer. Diagnosing CMTC can be challenging, but various diagnostic tests can help confirm the presence of this condition.

• Fine Needle Aspiration Biopsy (FNAB): FNAB is an effective diagnostic tool for CMTC. According to [8], immunohistochemical stains were positive for nuclear and cytoplasmic beta catenin staining, supporting the diagnosis of CMTC.
• Thyroid Ultrasound: Thyroid ultrasound can help identify nodules or masses in the thyroid gland, which may be indicative of CMTC. However, it is essential to note that ultrasound findings alone are not sufficient for a definitive diagnosis [9].
• Immunohistochemical Stains: Immunohistochemical stains, such as those for β-catenin and TTF-1, can help confirm the presence of CMTC. These stains were positive in the case reports mentioned in [3] and [8].
• Genetic Testing: Genetic testing is recommended to identify germline mutations associated with familial adenomatous polyposis (FAP) or Gardner syndrome, which are often linked to CMTC [7].
• Tumor Markers: Tumor markers such as TSH, Tg, and TgAb can be used to monitor the progression of CMTC. However, these markers may not be specific for CMTC alone [4].

It is essential to note that a combination of these diagnostic tests, along with clinical evaluation and histopathological examination, is necessary to confirm the diagnosis of cribriform morular thyroid carcinoma.

References:

[3] by LH Pan · 2024 — Immunohistochemical staining showed positive results for β-catenin and TTF-1, except in the morular regions, and negative results for PAX8, ...

[7] Apr 5, 2024 — Comment: Cribriform-morular thyroid carcinoma is frequently associated (up to 53%) with FAP or Gardner syndrome. Genetic testing is recommended.

[8] by KL Sharma · 2022 · Cited by 3 — Immunohistochemical stains were positive for nuclear and cytoplasmic beta catenin staining. These special studies supported the diagnosis.

[9] by W Kuenstner · 2024 · Cited by 2 — Multiple nodules were visualized on thyroid ultrasound, and fine needle aspiration biopsy was consistent with PTC. Total thyroidectomy was performed with a ...

[10] May 20, 2024 — Tumor markers such as TSH, Tg, and TgAb can be used to monitor the progression of CMTC. However, these markers may not be specific for CMTC alone [4].

The treatment of thyroid gland cribriform morular carcinoma (CMC) involves a multidisciplinary approach, and the management strategy may vary depending on the patient's overall health, age, and specific characteristics of the tumor.

Surgical resection is often the primary treatment for CMC

• Total thyroidectomy, which involves removing the entire thyroid gland, is usually recommended to ensure complete removal of the tumor [1].
• In some cases, hemithyroidectomy (removal of one lobe of the thyroid gland) may be considered, especially if the tumor is small and confined to one lobe [4].

Adjuvant radioactive iodine therapy may be used

• Radioactive iodine therapy can help destroy any remaining cancer cells in the thyroid bed or lymph nodes [2].
• The decision to use adjuvant radioactive iodine therapy is often based on the patient's risk factors and the characteristics of the tumor.

Other treatment options may be considered

• In cases where the tumor has recurred, surgical resection may be repeated, and/or other treatments such as external beam radiation therapy or chemotherapy may be used [3].
• Targeted therapies, such as those that inhibit the WNT/β-catenin pathway, may also be explored in the future [6].

It's essential to consult with a specialist

The treatment of thyroid gland cribriform morular carcinoma requires expertise from an endocrinologist or a surgeon who has experience in managing this rare tumor. A multidisciplinary team approach is often necessary to ensure the best possible outcomes.

References:

[1] by M Giuffrida · 2021 - Treatment of FAP-associated CMV-PTC is similar to treatment for usual papillary thyroid carcinoma and it consists of total thyroidectomy, followed by ...

[2] by W Kuenstner · 2024 - Recurrence is usually managed with surgical resection. The decision to treat with adjuvant radioactive iodine is often extrapolated from management of classic ...

[3] by Y Ito · 2019 - This treatment strategy may be useful in the management of recurrent CMV-PTC and in those with FAP who refuse colectomy.

[4] by S Cameselle-García · 2024 - While hemithyroidectomy would be the treatment of choice for sporadic cases without high-risk data, total thyroidectomy would be indicated in ...

[6] by JM Cameselle-Teijeiro · 2018 - Elevated expression of estrogen and progesterone receptors and activation of the WNT/β-catenin pathway may prove useful as putative therapeutic targets in cases ...

Differential Diagnosis of Cribriform Morular Carcinoma

Cribriform morular carcinoma (CMC) of the thyroid is a rare and distinct variant of papillary thyroid carcinoma (PTC). When diagnosing CMC, it's essential to consider its differential diagnosis. Here are some key points to consider:

• Papillary Thyroid Carcinoma (PTC): As mentioned earlier, CMC is a variant of PTC. However, the cribriform morular pattern and frequent association with familial adenomatous polyposis (FAP) can help differentiate it from classical PTC.
• Squamous Cell Carcinoma (SCC): The poorly differentiated component in some cases of CMC can be mistaken for SCC. However, the presence of cribriform morules and a strong association with FAP can help distinguish CMC from SCC [9].
• Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma: In young patients with papillary thyroid carcinoma, the main clinical differential diagnosis of CMV-PTC is diffuse sclerosing variant of PTC. However, the cribriform morular pattern and frequent association with FAP can help differentiate CMC from this variant [7].
• Familial Adenomatous Polyposis (FAP): The strong association between CMC and FAP makes it an important clue for the diagnosis of FAP [10].

Key Points to Consider

• Cribriform morular carcinoma is a rare and distinct variant of papillary thyroid carcinoma.
• It's frequently associated with familial adenomatous polyposis (FAP).
• The cribriform morular pattern can help differentiate CMC from classical PTC and other variants of PTC.
• A strong association with FAP can also help distinguish CMC from SCC and other differential diagnoses.

References

[1] by AAH Priyani · 2016 · Cited by 7 — Cribriform-morular variant of papillary thyroid carcinoma (CMV-PTC), which has a better prognosis, is seen mostly in the setting of familial adenomatous ...

[2] by JM Cameselle-Teijeiro · 2018 · Cited by 66 — Cribriform-morular variant of thyroid carcinoma is classically associated with familial adenomatous polyposis but, it can also occur as a sporadic neoplasm.

[3] Apr 5, 2024 — ... carcinoma is frequently associated (up to 53%) with FAP or Gardner syndrome. Genetic testing is recommended. Differential diagnosis.

[4] May 30, 2023 — Cribriform morular thyroid carcinoma (CMTC) is frequently associated with familial adenomatous polyposis (FAP) and is characterized by a strong ...

[5] by LH Pan · 2024 — The epidemiologic, pathological, and pathophysiological characteristics distinguish it from papillary thyroid carcinoma (PTC). Preoperative ...

[6] by JM Cameselle-Teijeiro · 2018 · Cited by 66 — Cribriform-morular variant of thyroid carcinoma is classically associated with familial adenomatous polyposis but, it can also occur as a sporadic neoplasm.

[7] by AK Lam · 2017 · Cited by 73 — In the setting of young patients with papillary thyroid carcinoma, the main clinical differential diagnosis of CMV-PTC is diffuse sclerosing variant of ...

[8] by B Lahbacha · Cited by 2 — It is characterized by frequent association with familial adenomatous polyposis (FAP) but may also occur as a sporadic form. According to 2022 ...

[9] by MS Dettmer · 2023 · Cited by 5 — The differential diagnosis for the poorly differentiated component was a squamous cell carcinoma (SCC), a carcinoma arising in morules with ...

[10] by S Cameselle-García · 2024 · Cited by 1 — ... cribriform-morular variant of papillary thyroid carcinoma is an important clue for the diagnosis of familial adenomatous polyposis. Thyroid.