Clinical monitoring for medullary thyroid cancer and timing of thyroidectomy in carriers of a mutation in the RET gene

Clinical monitoring for medullary thyroid cancer and timing of thyroidectomy in carriers of a mutation in the RET gene

Risk	RET codon mutation	Recommended age to begin annual screening for MTC*	Recommended timing of prophylactic thyroidectomy^¶
Highest	918	Not applicable	In the first months to year of life
High	634, 883	3 years	At or before age 5 years
Moderate	533, 609, 611, 618, 620, 630, 666, 768, 790, 804, 891, 912	5 years	Childhood or young adulthood

Risk of MTC development in MEN2 depends on mutated RET codon.

MTC: medullary thyroid cancer; MEN2: multiple endocrine neoplasia type 2.
* Annual physical examination, neck ultrasound, and measurement of serum calcitonin.
¶ Patients with MEN2 and a diagnosis of MTC (regardless of age) must have pheochromocytoma excluded prior to thyroidectomy.

Data from: Wells SA Jr, Asa SL, Dralle H, et al. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid 2015; 25:567.

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