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A short(ish) writeup of Mogreth's Hollow World analogue is exactly what I'm thinking about right now. It makes the most sense to base it off of the Second Empire of the BC 2300 era, rather than the Carnifex-dominated First Empire of the Blackmoorian period, because of the amount of already-written material I can draw from. That's not to say a "Last Carnifex" can't be added to the mix as a secret villain for the PCs to defeat, because such a being would probably be aware of the Spell of Preservation and may even know how to manipulate it to their advantage.
Mogreth in the Hollow Worldby Geoff Gander
As things stand in my head right now, Ka would have scooped up a couple of villages, or maybe a town, in Mogreth prior to the flood that wiped it out. Being an ascended reptile, Ka has sympathies towards all lizardfolk and given that he did have (covert) worshippers in that land he would want Mogreth's unique culture to be salvaged as much as possible. He probably had to argue for it forcefully in Pandius (despite being Mr. Hollow World himself) before the other Hierarchs gave him a green light to do it. So he grabbed a community of lizard men and troglodyte faithful and deposited them in the Hollow World. Naturally, a few devotees of Other Beings managed to sneak in as well, because there's nothing Yurrgh-Thal and his ilk like more than a good cosmic joke, and, well, the Burrowers hadn't done their jobs properly thus far.
However, the other Hierarchs wanted the Mogrethians set down in a place remote enough that, should their darker tendencies reassert themselves, they wouldn't mess up other cultures. However, leaving them *too* isolated might allow them to become a dominating force in the Hollow World...
...Just like the Selhomarrians were threatening to become, after ~5000 years on Suridal...
...you can see where I'm going with this.