Multiple Endocrine Neoplasia Type 2

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Abstract
MULTIPLE endocrine neoplasia type 2 (MEN 2) is an autosomal dominant syndrome that is characterized by medullary thyroid carcinoma (MTC), pheochromocytoma, and hyperparathyroidism (HPT). MEN 2 is divided into subtypes depending on the presence or absence of tissue-specific tumors and phenotypic characteristics, and the number of affected family members (Table 1).1 Rare variants of MEN 2 have been associated with Hirschsprung disease (HSCR) and cutaneous lichen amyloidosis (CLA).2,3 Medullary thyroid carcinoma, which has a penetrance of greater than 90% and is usually the first manifestation of MEN 2,4,5 has been confirmed in thyroidectomy specimens from patients as young as 17 months.6 The prognosis of MEN 2 is related to the aggressiveness of the MTC, which can develop early lymph node metastases. These metastases have been found in patients as young as 3 years.7 Germline mutations in the RET proto-oncogene cause MEN 2.8,9 Analysis of the RET mutation status of at-risk patients allows for effective screening and improved clinical management.10