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Cribriform-morular variant of Papillary Thyroid Carcinoma: Clue to Early Detection of Familial Adenomatous Polyposis-associated Colon Cancer

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Abstract

The cribriform-morular variant (CMV) of papillary thyroid carcinoma (PTC) is a rare histologic subtype of PTC that shows a combination of growth patterns including cribriform and spindle cell areas. The thyroid cancer with this unique histology was originally reported in patients with familial adenomatous polyposis (FAP), although it was later found in patients without polyposis as well. Because of its rarity, its clinical features are not clear. We reviewed seven patients with CMV-PTC who were found among 4194 patients with PTC in our pathology files between June 1991 and March 2003. The prevalence of CMV was 0.16% among all PTCs. We invited these patients to our hospital so we could obtain a detailed family history and recommend colonoscopic examination and germline APC gene analysis. Two patients without subjective symptoms had polyposis of the colon and colon cancers. Germline APC gene mutations were found in both patients. The father of a patient who refused the invitation was revealed to have undergone surgery for colon polyposis. In the remaining four patients, neither polyposis nor APC gene mutation was found. Common clinical features included a young age (mean 25 years), predominance of females, circumscribed tumors, negative node metastasis, and no recurrence of the thyroid cancer after surgery. Two of the three patients with colon polyposis had bilateral multiple thyroid tumors, whereas the remaining four (without polyposis) had a solitary tumor. The histopathology of CMV in patients with PTC should arouse a suspicion of FAP, especially if there are multiple tumors. This finding can lead to early detection of colon cancer.

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References

  1. F Cetta MR Pelizzo MC Curia et al. (1999) ArticleTitleGenetics and clinicopathological findings in thyroid carcinomas associated with familial adenomatous polyposis Am. J. Pathol. 155 7–9 Occurrence Handle1:STN:280:DyaK1MzisVaruw%3D%3D Occurrence Handle10393829

    CAS  PubMed  Google Scholar 

  2. B Bell EL Mazzaferri (1993) ArticleTitleFamilial adenomatous polyposis (Gardner’s syndrome) and thyroid carcinoma: a case report and review of the literature Dig. Dis. Sci. 38 185–190 Occurrence Handle1:STN:280:ByyC3s%2FntVI%3D Occurrence Handle8420756

    CAS  PubMed  Google Scholar 

  3. MR Camiel JE Mule LL Alexander et al. (1968) ArticleTitleAssociation of thyroid carcinoma with Gardner’s syndrome in siblings N. Engl. J. Med. 278 1056–1058 Occurrence Handle1:STN:280:CCeC1MvptVM%3D Occurrence Handle5644968

    CAS  PubMed  Google Scholar 

  4. HR Harach GT Williams ED Williams (1994) ArticleTitleFamilial adenomatous polyposis associated thyroid carcinoma: a distinct type of follicular cell neoplasm Histopathology 25 549–561 Occurrence Handle1:STN:280:ByqB3M3pvFw%3D Occurrence Handle7698732

    CAS  PubMed  Google Scholar 

  5. Baloch ZW, Lovolsi VA. Pathology of the Thyroid Gland: Endocrine Pathology, New York, Churchill Livingstone, 2002;61–88

  6. KP Nugent AD Spigelman RK Philips (1996) ArticleTitleRisk of extracolonic cancer in familial adenomatous polyposis Br. J. Surg. 83 1121–1122 Occurrence Handle1:STN:280:ByiD383ps1Y%3D Occurrence Handle8869322

    CAS  PubMed  Google Scholar 

  7. RO Plail HJ Bussey G Glazer et al. (1987) ArticleTitleAdenomatous polyposis: an association with carcinoma of the thyroid Br. J. Surg. 74 377–380 Occurrence Handle1:STN:280:BiiB2czitVc%3D Occurrence Handle3036290

    CAS  PubMed  Google Scholar 

  8. J Cameselle-Teijeiro JK Chan (1999) ArticleTitleCribiriform-morular variant of papillary carcinoma: a distinctive variant representing the sporadic counterpart of familial adenomatous polyposis-associated thyroid carcinoma? Mod. Pathol. 12 400–411 Occurrence Handle1:STN:280:DyaK1M3ksVGisw%3D%3D Occurrence Handle10229505

    CAS  PubMed  Google Scholar 

  9. B Xu A Miyauiti S Uchino et al. (2003) ArticleTitleA predominant increase in the APC gene isoform with exon 9a in a case of attenuated familial adenomatous polyposis Clin. Genet. 63 71–72 Occurrence Handle10.1034/j.1399-0004.2003.630111.x Occurrence Handle1:STN:280:DC%2BD3s%2FivFemtg%3D%3D Occurrence Handle12519375

    Article  CAS  PubMed  Google Scholar 

  10. B Xu K Yoshimoto A Miyauchi et al. (2003) ArticleTitleCribriform-morular variant of papillary thyroid carcinoma: a pathological and molecular genetic study with evidence of frequent somatic mutataion in exon 3 of the β-catenin gene J. Pathol. 199 58–67 Occurrence Handle10.1002/path.1225 Occurrence Handle12474227

    Article  PubMed  Google Scholar 

  11. S Bulow T Faurschou Nielson C Bulow (1996) ArticleTitleThe incidence rate of familial adenomatous polyposis: result from Danish polyposis register Int. J. Colorectal Dis. 11 88–91 Occurrence Handle10.1007/s003840050027 Occurrence Handle1:STN:280:BymA3M%2Fht1c%3D Occurrence Handle8739833

    Article  CAS  PubMed  Google Scholar 

  12. F Cetta S Olschwang M Petracci et al. (1998) ArticleTitleGenetic alterations in thyroid carcinoma associated with familial adenomatous polyposis: clinical implications and suggestions for early detection World J. Surg. 22 1231–1236 Occurrence Handle10.1007/s002689900550 Occurrence Handle1:STN:280:DyaK1M%2FmsF2msQ%3D%3D Occurrence Handle9841749

    Article  CAS  PubMed  Google Scholar 

  13. SB Ng K Sittampalam YH Goh et al. (2003) ArticleTitleCribriform-morular variant of papillary carcinoma: the sporadic counterpart of familial adenomatous polyposis associated thyroid carcinoma: a case report with clinical and molecular genetic correlation Pathology (Phila.) 35 42–46 Occurrence Handle1:CAS:528:DC%2BD3sXivVWlu74%3D

    CAS  Google Scholar 

  14. F Cetta G Montalto M Gori et al. (2000) ArticleTitleGermline mutations of the APC gene in patients with familial adenomatous polyposis-associated thyroid carcinoma: results of a European co-operative study J. Clin. Endocrinol. Metab. 85 286–292 Occurrence Handle10.1210/jc.85.1.286 Occurrence Handle1:CAS:528:DC%2BD3cXjtl2msQ%3D%3D Occurrence Handle10634400

    Article  CAS  PubMed  Google Scholar 

  15. PJ Morin AB Sparks V Korinek et al. (1997) ArticleTitleActivation of beta-catenin-Tcf signaling in colon cancer by mutations in beta-catenin or APC Science 275 1790–1792 Occurrence Handle10.1126/science.275.5307.1790 Occurrence Handle1:CAS:528:DyaK2sXitVGrtbY%3D Occurrence Handle9065403

    Article  CAS  PubMed  Google Scholar 

  16. H Dierick A Bejsovec (1999) ArticleTitleCellular mechanisms of wingless/Wnt signal transduction Curr. Top. Dev. Biol. 43 153–190 Occurrence Handle1:CAS:528:DyaK1MXpsFOm Occurrence Handle9891886

    CAS  PubMed  Google Scholar 

  17. M Peifer P Polakis (2000) ArticleTitleWnt signaling in oncogenesis and embryogenesis: a look outside the nucleus Science 287 1606–1609

    Google Scholar 

  18. JR Miller AM Hocking JD Brown et al. (1999) ArticleTitleMechanism and function of signal transduction by the Wnt/β-catenin and Wnt/Ca pathways Oncogene 18 7860–7872 Occurrence Handle10.1038/sj.onc.1203245 Occurrence Handle1:CAS:528:DC%2BD3cXks1Kmtg%3D%3D Occurrence Handle10630639

    Article  CAS  PubMed  Google Scholar 

  19. K Kurihara S Shimizu J Chong et al. (2000) ArticleTitleNuclear localization of immunoreactive β-catenin is specific to familial adenomatous polyposis in papillary thyroid carcinoma Jpn. J. Cancer Res. 91 1100–1102 Occurrence Handle1:CAS:528:DC%2BD3cXosVGrs7c%3D Occurrence Handle11092973

    CAS  PubMed  Google Scholar 

  20. N Perrier JA Heerden Particlevan JR Goellner et al. (1998) ArticleTitleThyroid cancer in patients with familial adenomatous polyposis World J. Surg. 22 738–743 Occurrence Handle10.1007/s002689900462 Occurrence Handle1:STN:280:DyaK1c3ntV2rsA%3D%3D Occurrence Handle9606291

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Kuma Hospital, 8-2-535 Shimoyamate-dori, Chuo-ku, 650-0011, Kobe, Japan

    Chisato Tomoda M.D., Akira Miyauchi M.D., Takashi Uruno M.D., Yuuki Takamura M.D., Yasuhiro Ito M.D., Akihiro Miya M.D., Kaoru Kobayashi M.D., Fumio Matsuzuka M.D., Seiji Kuma M.D. & Kanji Kuma M.D.

  2. Department of Pathology, Wakayama Medical University, Kimiideri 811-1, 641-8509, Wakayama, Japan

    Kennichi Kakudo M.D.

Authors
  1. Chisato Tomoda M.D.
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  2. Akira Miyauchi M.D.
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  3. Takashi Uruno M.D.
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  4. Yuuki Takamura M.D.
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  5. Yasuhiro Ito M.D.
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  6. Akihiro Miya M.D.
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  7. Kaoru Kobayashi M.D.
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  8. Fumio Matsuzuka M.D.
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  9. Seiji Kuma M.D.
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  10. Kanji Kuma M.D.
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  11. Kennichi Kakudo M.D.
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Correspondence to Chisato Tomoda M.D..

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Tomoda, C., Miyauchi, A., Uruno, T. et al. Cribriform-morular variant of Papillary Thyroid Carcinoma: Clue to Early Detection of Familial Adenomatous Polyposis-associated Colon Cancer. World J. Surg. 28, 886–889 (2004). https://doi.org/10.1007/s00268-004-7475-4

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