Papillary Thyroid Carcinoma With a Rare TFG-MET Fusion in a Chernobyl Survivor: A Case Report

Papillary thyroid carcinoma (PTC) is the most common malignant thyroid tumor, with several histologic subtypes, including the follicular subtype (follicular variant of papillary thyroid carcinoma (FVPTC)). While BRAF V600E mutations are frequently associated with PTC, alternative molecular alterations have been identified, particularly following radiation. Here, we present a case of FVPTC in a 43-year-old female with a history of childhood nuclear radiation exposure from the Chernobyl disaster. Although radiation exposure is a known risk factor for thyroid malignancies, the molecular features of such cases remain an area of ongoing study. Sequencing of this patient's tumor revealed a TFG-MET fusion, a rare genetic alteration that has been reported in only isolated cases of thyroid carcinoma. MET fusions are not well characterized in thyroid tumors, especially in the context of radiation exposure. This case contributes to the limited literature on kinase fusion-driven thyroid carcinomas, particularly those with follicular architecture arising after radiation exposure. Recognizing such rare genetic findings may help refine our understanding of the molecular diversity seen in radiation-associated thyroid cancers.