Cribriform-morular variant of papillary thyroid carcinoma (CMVPTC) usually occurs in the setting of familial adenomatous polyposis (FAP) although it can rarely arise sporadically. Poorly differentiated thyroid carcinoma (PDTC) is a follicular cell-derived neoplasm with more aggressive behavior than well-differentiated carcinomas such as CMVPTC. We report the case of a 35-year-old woman without FAP history who presented a left neck mass and complained of back pain. Imagiological examinations revealed a nodule in the left lobe of thyroid and multiple nodular lesions in the bone and lungs suggestive of metastases. The patient was submitted to total thyroidectomy and radioactive iodine. The tumor was composed of CMVPTC and PDTC components that shared the same somatic APC gene mutation (p.Cys520Tyr_fsX534). Besides this mutation, no CTNNB1, BRAF, N-RAS, and H-RAS gene mutations were detected in any of the 2 components. To the best of our knowledge, this is the first report of a sporadic CMVPTC with transformation into PDTC. Although the majority of CMVPTCs carry an indolent clinical outcome, the coexistence of poorly differentiated areas may justify the aggressiveness of the CMVPTC reported here.

Objectives: Pleomorphic adenomas are benign tumors that rarely involve nonsalivary glands. We report an uncommon case of ala nasi pleomorphic adenoma. We discuss the clinical and histopathologic characteristics, and review the literature on nasal pleomorphic adenoma. Method: A 20-year-old man presented with a painless slow growing lobulated mass located on the right ala nasi extending into the nasal vestibule. Results: Complete surgical excision was performed. Histologic examination found a mixed cellular component: epithelial and myoepithelial cells with chondromyxoid stroma. This was consistent with the diagnosis of a typical pleomorphic adenoma. There was no evidence of recurrence at 18 months after the surgery. Conclusions: Pleomorphic adenomas located in the external nose are extremely rare. In such case, pleomorphic adenoma could originate from ectopic minor salivary gland. Complete surgical excision with long-term follow-up is recommended due to the potential risk of recurrence and malignant transformation.

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