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A Rare Case of Persistent Multifocal Cribriform-Morular Thyroid Carcinoma.
Kuenstner, William; Zhao, Po; Lee, Wen; Garcia, Carlos; Burman, Kenneth D; Shobab, Leila.
Afiliación
  • Kuenstner W; MedStar Georgetown University Hospital, Washington, D.C.
  • Zhao P; MedStar Georgetown University Hospital, Washington, D.C.
  • Lee W; MedStar Washington Hospital Center, Washington, D.C.
  • Garcia C; MedStar Washington Hospital Center, Washington, D.C.
  • Burman KD; MedStar Washington Hospital Center, Washington, D.C.
  • Shobab L; MedStar Washington Hospital Center, Washington, D.C.
AACE Clin Case Rep ; 10(2): 63-66, 2024.
Article en En | MEDLINE | ID: mdl-38523848
ABSTRACT
Background/

Objective:

Cribriform-morular thyroid carcinoma (CMTC) was considered a variant of papillary thyroid carcinoma (PTC) but is a separate entity in the 2022 World Health Organization classification. CMTC has an association with familial adenomatous polyposis (FAP). Our objective is to report a case of CMTC who was subsequently diagnosed with FAP, to highlight these associated entities and implications for management. Case Report A 15-year-old female with a history of iron-deficiency anemia and alpha-gal syndrome presented with several years of goiter and dysphagia. She also noted unintentional weight loss, abdominal pain, melena and hematochezia, and symptomatic anemia. Physical examination was significant for multiple thyroid nodules. Laboratory results revealed normal thyroid function and iron deficiency. Multiple nodules were visualized on thyroid ultrasound, and fine needle aspiration biopsy was consistent with PTC. Total thyroidectomy was performed with a revised diagnosis of multifocal CMTC, with administration of adjuvant radioactive iodine due to persistent disease. Genetic testing confirmed FAP and she was referred for upper endoscopy, colonoscopy, and an evaluation for colectomy.

Discussion:

There are no best practice guidelines for management of CMTC. Management of CMTC is guided by FAP status; sporadic cases can be managed with hemithyroidectomy, while FAP-associated cases are better managed with total thyroidectomy. Recurrence is usually managed with surgical resection. The decision to treat with adjuvant radioactive iodine is often extrapolated from management of classic PTC.

Conclusion:

Thyroid carcinoma in the setting of extensive family history of colorectal carcinoma should arouse suspicion for CMTC. Patients with CMTC should receive a referral for colonoscopy and genetic testing for FAP.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: AACE Clin Case Rep Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: AACE Clin Case Rep Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos