Coleman G1, Roman R2, Newbrough B2 and Milan S1*
1Department of Surgery, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, Texas 79905, USA
2Department of Surgery, William Beaumont Army Medical Center, Texas 79920, USA
Papillary thyroid cancer is a common diagnosis in young patients that generally confers an excellent long term prognosis. Several variants exist which confer important clinical implications. The Cribriform Morular Variant of Papillary Thyroid Cancer (CMV-PTC) is a rare variant that is sometimes associated with Familial Adenomatous Polyposis (FAP). Here we describe an additional case of this rare subtype and review of the literature, focusing on the frequency of association with FAP and recommendations for subsequent management, including consideration for colonoscopy and genetic testing. CMV-PTC is associated with FAP in approximately 39% of cases in reports in the literature, however cases that are not associated with FAP are likely under reported and thus the true estimation of CMV-PTC in FAP positive and negative cohorts is likely unknown. CMV-PTC is often diagnosed significantly earlier than colon cancer in patients with FAP and represents an opportunity for early detection colon cancer. Given the reports of non-FAP colon polyps in patients with CMV-PTC, colonoscopy should be performed when the diagnosis of CMV-PTC is rendered with consideration for genetic testing as well depending on family history and patient preferences in a shared decision making framework.
Coleman G, Roman R, Newbrough B, Milan S. Cribriform Morular Variant of Papillary Thyroid Cancer: An Indication for Colonoscopy and Genetic Testing? Clin Surg. 2017; 2: 1669.