Our experience of treatment of cribriform morular variant of papillary thyroid carcinoma; difference in clinicopathological features of FAP-associated and sporadic patients

Abstract

abstract. Cribriform-morular variant (CMV) is a comparably rare histological subtype of papillary thyroid carcinoma (PTC). This can be associated with familial adenomatous polyposis (FAP) due to APC gene mutations. In this study, we investigated the difference in the biological characteristics between FAP-associated and sporadic CMV. Between 1991 and 2010, 32 patients with CMV were treated in Kuma Hospital. Thirty-one of these underwent initial surgery for CMV in Kuma Hospital. Twelve patients were FAP-associated and the remaining 19 were sporadic CMV. All patients were female. Tumors of FAP-associated CMV were more frequently multiple than those of sporadic CMV. Patient age and tumor size did not differ between the two groups. Of 12 FAP-associated CMV, 5 were detected by thyroid nodule (thyroid precedent group) and 7 were detected by FAP (polyposis precedent group) as an initial manifestation. Patient age was younger and tumor size was smaller in the polyposis group than in the thyroid nodule group. All patients lacked extrathyroid extension on intraoperative finding and were node-negative on pathological examination. To date, two patients with FAP-associated CMV who initially underwent hemithyroidectomy (one in Kuma Hospital and one in another hospital) showed recurrence to the remnant thyroid during follow-up. None of the patients showed recurrence to other regions or died of carcinoma. Taken together, CMV is considered an indolent disease in our series. FAP-associated CMV showed multiple tumors more frequently than sporadic CMV. Total thyroidectomy is recommended for FAP-associated CMV, but extensive lymph node dissection is not necessary.

Prognosis and growth activity depend on patient age in clinical and subclinical papillary thyroid carcinoma [Review]

“…A cribriform morular variant is almost typical in young female patients, many cases of which are hereditary and associated with familial polyposis of the colon. However, its prognosis is quite excellent and in our series, none of the patients died of thyroid carcinoma [37,38].…”

Cribriform-morular variant of papillary thyroid carcinoma: Characteristic histologic feature of adenomatous polyposis. A case report

“…This explains why total thyroidectomy is required, yet extensive node dissection would not be necessary [20]. These conclusions have been based on series including a small number of patients.…”

Cribriform-morular variant of papillary thyroid carcinoma: a distinctive type of thyroid cancer

“…This group of authors have reported CMV-PTC in different overlapping periods in a few publications. The largest series form this group was reported by Ito and coworkers in 2011 who had found 32 CMV-PTCs in the period 1991-2010 (Ito et al 2011). However, no detailed information or prevalence of the disease was recorded in the publication.…”