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RET Proto-Oncogene Mutations Affecting Codon 790/791: A Mild Form of Multiple Endocrine Neoplasia Type 2A Syndrome?

RET Proto-Oncogene Mutations Affecting Codon 790/791: A Mild Form of Multiple Endocrine Neoplasia Type 2A Syndrome?

Oliver Gimm, Barbara E Niederle, Theresa Weber, Maximilian Bockhorn, Jörg Ukkat, Michael Brauckhoff, Phuong Nguyen Thanh, Andreja Frilling, Ernst Klar, Bruno Niederle, Henning Dralle

Surgery. 2002 Dec;132(6):952-9; discussion 959.

PMID: 12490841

Abstract:

Background:
In patients with multiple endocrine neoplasia type 2A syndrome, prophylactic thyroidectomy is generally recommended at the age of 5 to 6 years. Whether this recommendation is justified for exon 13 mutations is unknown.
Methods:
We analyzed the clinical data from 40 patients harboring RET codon 790/791 mutations (exon 13) who had been treated in 4 specialized centers.
Results:
Mean age was 35.2 +/- 21.6 years (range, 5.1-69.0 years). Thirteen patients were index patients (mean age, 57.7 +/- 11.3 years), 27 patients were screening patients (mean age, 24.4 +/- 16.5 years). In the index group, pT-category was: T0, n = 2; T1, n = 6; T2, n = 2; T3, n = 1; and T4, n = 2. Lymph node metastases were found in 5 patients and distant metastases in 1 patient. Postoperatively, 69% of index patients were biochemically cured. In the screening group, pT-category was: T0, n = 19; T1, n = 7; and T2, n = 1. Lymph node metastases were found in 2 patients. Postoperatively, 93% of screening patients were biochemically cured. The youngest patient with medullary thyroid carcinoma was 13.8 years, the youngest patient with lymph node metastases was 46.4 years.
Conclusions:
Patients with RET codon 790/791 mutations seemed to have a less aggressive clinical course compared with patients with classic multiple endocrine neoplasia type 2A syndrome. Still, index patients had a lower biochemic cure rate in comparison with screening patients. Timely total thyroidectomy including lymph node dissection is warranted.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
IAR42136	pH PT			Price

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