RETProto-Oncogene: A Review and Update of Genotype–Phenotype Correlations in Hereditary Medullary Thyroid Cancer and Associated Endocrine Tumors
- 1 June 2005
- journal article
- review article
- Published by Mary Ann Liebert Inc in Thyroid®
- Vol. 15 (6), 531-544
- https://doi.org/10.1089/thy.2005.15.531
Abstract
Hereditary medullary thyroid carcinoma (MTC) is caused by autosomal dominant gain-of-function mutations in the RET proto-oncogene. Associations between specific RET mutations (genotype) and the aggressiveness of MTC and presence or absence of other endocrine neoplasms (phenotype) are well documented. Mutations in six exons (10, 11, 13, 14, 15, and 16) located in either cysteine-rich or tyrosine kinase domains cause one of three distinctive clinical subtypes: familial MTC, multiple endocrine neoplasia (MEN) type 2A (including variants with Hirschsprung's disease and cutaneous lichen amyloidosis), and MEN 2B. Hallmarks of MEN 2A include MTC, pheochromocytoma, and hyperparathyroidism. MEN 2B is associated with an earlier onset of MTC and pheochromocytoma, the absence of hyperparathyroidism, and the presence of striking physical stigmata (e.g., coarse facies, ganglioneuromatosis, and marfanoid habitus). Familial MTC is not associated with other endocrine neoplasms; however, the accurate distinction between familial MTC and MEN 2A may be difficult in kindreds with small size, incomplete histories, or a predominance of young individuals who may not have yet fully manifested the syndrome. Genetic testing detects greater than 95% of mutation carriers and is considered the standard of care for all first-degree relatives of patients with newly diagnosed MTC. Recommendations on the timing of prophylactic thyroidectomy and the extent of surgery are based upon a model that utilizes genotype– phenotype correlations to stratify mutations into three risk levels.Keywords
This publication has 132 references indexed in Scilit:
- RET and neuroendocrine tumorsCancer Letters, 2004
- Cancer Statistics, 2004CA: A Cancer Journal for Clinicians, 2004
- Segregation at three loci explains familial and population risk in Hirschsprung diseaseNature Genetics, 2002
- NGF Utilizes c-Ret Via a Novel GFL-Independent, Inter-RTK Signaling Mechanism to Maintain the Trophic Status of Mature Sympathetic NeuronsNeuron, 2002
- Very early detection of RET proto‐oncogene mutation is crucial for preventive thyroidectomy in multiple endocrine neoplasia type 2 childrenCancer, 2002
- Molecular Analysis of the ret and GDNF Genes in a Family with Multiple Endocrine Neoplasia Type 2A and Hirschsprung DiseaseJournal of Clinical Endocrinology & Metabolism, 1998
- Routine Measurement of Plasma Calcitonin in Nodular Thyroid DiseasesJournal of Clinical Endocrinology & Metabolism, 1997
- Early presentation of metastatic medullary carcinoma in multiple endocrine neoplasia, type IIA: Implications for therapyThe Journal of Pediatrics, 1996
- Low frequency of germline mutations in the RET proto‐oncogene in patients with apparently sporadic medullary thyroid carcinomaClinical Endocrinology, 1995
- Screening for Multiple Endocrine Neoplasia Type 2A with DNA-Polymorphism AnalysisNew England Journal of Medicine, 1989