Molecular Pathology of Thyroid Tumors: Old Problems and New Concepts

Area of Science:

• Endocrinology
• Oncology
• Molecular Pathology

Background:

• Molecular signatures of thyroid tumors are increasingly understood.
• These discoveries are shifting diagnostic and classification paradigms in clinical practice.

Purpose of the Study:

• To present recent findings on molecular insights in thyroid tumors.
• To emphasize the impact of molecular data on understanding specific tumor types.
• To discuss the role of immunohistochemistry in detecting actionable alterations in advanced thyroid cancer.

Main Methods:

• Review of recent molecular studies on thyroid neoplasms.
• Emphasis on specific tumor categories: RAS mutant nodules, Hürthle cell neoplasms, and rare tumors.
• Discussion of immunohistochemistry for actionable molecular alterations.

Main Results:

• Molecular signatures are changing the understanding and classification of thyroid tumors.
• Specific insights into RAS mutant nodules, Hürthle cell neoplasms, and rare tumors (hyalinizing trabecular tumor, secretory carcinoma, sclerosing mucoepidermoid carcinoma with eosinophilia).
• Immunohistochemistry shows utility in identifying actionable targets in aggressive thyroid cancers.

Conclusions:

• Molecular pathology is transforming thyroid cancer diagnosis and management.
• Understanding molecular alterations is crucial for classifying and treating diverse thyroid neoplasms.
• Targeted molecular detection aids in managing advanced and aggressive thyroid cancer.