SEARCH

SEARCH BY CITATION

Keywords:

  • medullary thyroid carcinoma;
  • RET 790 mutation;
  • prophylactic thyroidectomy;
  • calcitonin;
  • multiple endocrine neoplasia

Abstract

Background

We describe a family harboring RET 790 mutation and review the role of prophylactic thyroidectomy for medullary thyroid carcinoma.

Methods

We evaluated in detail both clinical and biological follow-up and reviewed literature reports.

Results

Among 86 family members, 15 of 22 members screened harbored the 790 mutation. Abnormal calcitonin levels were found in 8/15. Total thyroidectomy with lymph node dissection cured the 5 operated patients (range, 45–76 years). Tumor staging was pT1N0M0. Among 10 carriers who did not undergo surgery, 3 patients had abnormal calcitonin levels. For the others, calcitonin levels remained <30 pg/mL. Two asymptomatic carriers were older than 70 years. Four subjects were lost to follow-up.

Conclusions

In RET codon 790 mutations families, a case-by-case decision instead of systematic prophylactic thyroidectomy should be discussed. Difficulties of follow-up should be taken into account and represent the main challenge. © 2011 Wiley Periodicals, Inc. Head Neck, 2012