Clinical monitoring for pheochromocytoma and hyperparathyroidism in carriers of a mutation in the RET gene

Clinical monitoring for pheochromocytoma and hyperparathyroidism in carriers of a mutation in the RET gene

		Pheochromocytoma*	Hyperparathyroidism
Risk	RET codon mutation	Recommended age to begin annual screening for pheochromocytoma^¶	Recommended age to begin annual screening for hyperparathyroidism^Δ
Highest	918	11 years	Not applicable
High	634, 883	11 years	11 years
Moderate	533, 609, 611, 618, 620, 630, 666, 768, 790, 804, 891, 912	16 years	16 years

MEN2: multiple endocrine neoplasia type 2; MTC: medullary thyroid cancer; CT: computed tomography; MRI: magnetic resonance imaging; PTH: parathyroid hormone.
* Patients with MEN2 and a diagnosis of MTC (regardless of age) must have pheochromocytoma excluded prior to thyroidectomy.
¶ Screening test: free plasma metanephrines or normetanephrines, or 24-hour urinary metanephrines and normetanephrines. If biochemical results positive, adrenal imaging with CT or MRI.
Δ Screening test: serum calcium and, if elevated, PTH.

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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