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Kamani T, Charkhchi P, Zahedi A, Akbari MR. Genetic susceptibility to hereditary non-medullary thyroid cancer. Hered Cancer Clin Pract 2022; 20:9. [PMID: 35255942 PMCID: PMC8900298 DOI: 10.1186/s13053-022-00215-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 02/21/2022] [Indexed: 11/10/2022] Open
Abstract
Non-medullary thyroid cancer (NMTC) is the most common type of thyroid cancer. With the increasing incidence of NMTC in recent years, the familial form of the disease has also become more common than previously reported, accounting for 5-15% of NMTC cases. Familial NMTC is further classified as non-syndromic and the less common syndromic FNMTC. Although syndromic NMTC has well-known genetic risk factors, the gene(s) responsible for the vast majority of non-syndromic FNMTC cases are yet to be identified. To date, several candidate genes have been identified as susceptibility genes in hereditary NMTC. This review summarizes genetic predisposition to non-medullary thyroid cancer and expands on the role of genetic variants in thyroid cancer tumorigenesis and the level of penetrance of NMTC-susceptibility genes.
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Affiliation(s)
- Tina Kamani
- Women's College Research Institute, University of Toronto, 76 Grenville St. Room 6421, Toronto, ON, M5S 1B2, Canada
| | - Parsa Charkhchi
- Women's College Research Institute, University of Toronto, 76 Grenville St. Room 6421, Toronto, ON, M5S 1B2, Canada
| | - Afshan Zahedi
- Women's College Research Institute, University of Toronto, 76 Grenville St. Room 6421, Toronto, ON, M5S 1B2, Canada
| | - Mohammad R Akbari
- Women's College Research Institute, University of Toronto, 76 Grenville St. Room 6421, Toronto, ON, M5S 1B2, Canada. .,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada. .,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M7, Canada.
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Abstract
This review of the familial tumor syndromes involving the endocrine organs is focused on discussing the main updates on the upcoming fifth edition of the WHO Classification of Endocrine and Neuroendocrine Tumors. This review emphasizes updates on histopathological and molecular genetics aspects of the most important syndromes involving the endocrine organs. We describe the newly defined Familial Cancer Syndromes as MAFA-related, MEN4, and MEN5 as well as the newly reported pathological findings in DICER1 syndrome. We also describe the updates done at the new WHO on the syndromic and non-syndromic familial thyroid diseases. We emphasize the problem of diagnostic criteria, mention the new genes that are possibly involved in this group, and at the same time, touching upon the role of some immunohistochemical studies that could support the diagnosis of some of these conditions. As pathologists play an important role in identifying tumors within a familial cancer syndrome, we highlight the most important clues for raising the suspicious of a syndrome. Finally, we highlight the challenges in defining these entities as well as determining their clinical outcome in comparison with sporadic tumors. Instead of the usual subject review, we present the highlights of the updates on familial cancer syndromes by answering select questions relevant to practicing pathologists.
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Affiliation(s)
- Vania Nosé
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
| | | | - José Manuel Cameselle Teijeiro
- Clinical University Hospital Santiago de Compostela and Medical Faculty, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Aurel Perren
- Institute of Pathology, University of Bern, Bern, Switzerland
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Sánchez-Ares M, Cameselle-García S, Abdulkader-Nallib I, Rodríguez-Carnero G, Beiras-Sarasquete C, Puñal-Rodríguez JA, Cameselle-Teijeiro JM. Susceptibility Genes and Chromosomal Regions Associated With Non-Syndromic Familial Non-Medullary Thyroid Carcinoma: Some Pathogenetic and Diagnostic Keys. Front Endocrinol (Lausanne) 2022; 13:829103. [PMID: 35295987 PMCID: PMC8918666 DOI: 10.3389/fendo.2022.829103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 02/07/2022] [Indexed: 12/05/2022] Open
Abstract
Thyroid cancer is the malignant tumor that is increasing most rapidly in the world, mainly at the expense of sporadic papillary thyroid carcinoma. The somatic alterations involved in the pathogenesis of sporadic follicular cell derived tumors are well recognized, while the predisposing alterations implicated in hereditary follicular tumors are less well known. Since the genetic background of syndromic familial non-medullary carcinoma has been well established, here we review the pathogenesis of non-syndromic familial non-medullary carcinoma emphasizing those aspects that may be useful in clinical and pathological diagnosis. Non-syndromic familial non-medullary carcinoma has a complex and heterogeneous genetic basis involving several genes and loci with a monogenic or polygenic inheritance model. Most cases are papillary thyroid carcinoma (classic and follicular variant), usually accompanied by benign thyroid nodules (follicular thyroid adenoma and/or multinodular goiter). The possible diagnostic and prognostic usefulness of the changes in the expression and/or translocation of various proteins secondary to several mutations reported in this setting requires further confirmation. Given that non-syndromic familial non-medullary carcinoma and sporadic non-medullary thyroid carcinoma share the same morphology and somatic mutations, the same targeted therapies could be used at present, if necessary, until more specific targeted treatments become available.
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Affiliation(s)
- María Sánchez-Ares
- Department of Pathology, Clinical University Hospital of Santiago de Compostela, Health Research Institute of Santiago de Compostela, Galician Healthcare Service (SERGAS), Santiago de Compostela, Spain
| | - Soledad Cameselle-García
- Department of Medical Oncology, University Hospital Complex of Ourense, Galician Healthcare Service (SERGAS), Ourense, Spain
| | - Ihab Abdulkader-Nallib
- Department of Pathology, Clinical University Hospital of Santiago de Compostela, Health Research Institute of Santiago de Compostela, Galician Healthcare Service (SERGAS), Santiago de Compostela, Spain
- School of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Gemma Rodríguez-Carnero
- Department of Endocrinology and Nutrition, Clinical University Hospital of Santiago de Compostela, Galician Healthcare Service (SERGAS), Santiago de Compostela, Spain
| | - Carolina Beiras-Sarasquete
- Department of Surgery, Clinical University Hospital of Santiago de Compostela, Galician Healthcare Service (SERGAS), Santiago de Compostela, Spain
| | - José Antonio Puñal-Rodríguez
- School of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
- Department of Surgery, Clinical University Hospital of Santiago de Compostela, Galician Healthcare Service (SERGAS), Santiago de Compostela, Spain
| | - José Manuel Cameselle-Teijeiro
- Department of Pathology, Clinical University Hospital of Santiago de Compostela, Health Research Institute of Santiago de Compostela, Galician Healthcare Service (SERGAS), Santiago de Compostela, Spain
- School of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
- *Correspondence: José Manuel Cameselle-Teijeiro,
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Abstract
Cancer derived from thyroid follicular epithelial cells is common; it represents the most common endocrine malignancy. The molecular features of sporadic tumors have been clarified in the past decade. However the incidence of familial disease has not been emphasized and is often overlooked in routine practice. A careful clinical documentation of family history or familial syndromes that can be associated with thyroid disease can help identify germline susceptibility-driven thyroid neoplasia. In this review, we summarize a large body of information about both syndromic and non-syndromic familial thyroid carcinomas. A significant number of patients with inherited non-medullary thyroid carcinomas manifest disease that appears to be sporadic disease even in some syndromic cases. The cytomorphology of the tumor(s), molecular immunohistochemistry, the findings in the non-tumorous thyroid parenchyma and other associated lesions may provide insight into the underlying syndromic disorder. However, the increasing evidence of familial predisposition to non-syndromic thyroid cancers is raising questions about the importance of genetics and epigenetics. What appears to be "sporadic" is becoming less often truly so and more often an opportunity to identify and understand novel genetic variants that underlie tumorigenesis. Pathologists must be aware of the unusual morphologic features that should prompt germline screening. Therefore, recognition of harbingers of specific germline susceptibility syndromes can assist in providing information to facilitate early detection to prevent aggressive disease.
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Affiliation(s)
- José Manuel Cameselle-Teijeiro
- Department of Pathology, Galician Healthcare Service (SERGAS), Clinical University Hospital, Travesía Choupana s/n, 15706, Santiago de Compostela, Spain.
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
- Medical Faculty, University of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Ozgur Mete
- Department of Pathology and Endocrine Oncology Site, University Health Network, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sylvia L Asa
- Department of Pathology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Virginia LiVolsi
- Department of Pathology and Laboratory Medicine, Perelmann School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
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Abstract
Inherited thyroid tumours are an important group which need clarification. This is partly because of the common use of the term Familial Non-Medullary Thyroid Cancer when some of the specific entities included under this heading really represent inherited benign tumours with a risk of progression to malignancy. The subject is briefly reviewed, and one syndromic and one non-syndromic type of inherited thyroid tumours of follicular cell origin discussed in more detail to emphasise the point that each of these groups need to be treated as separate entities.
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