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Long-term follow up of a "sporadic" unilateral pheochromocytoma revealing multiple endocrine neoplasia MEN2A-2 in an elderly woman.

Abstract
A unilateral, apparently sporadic pheochromocytoma was removed from the right adrenal of a 73-yr-old Caucasian woman. At the time of surgery, germline DNA from the patient was not available. However, a continuous cell line (KNA) established from the tumor showed a heterozygous sequence variant TGC (cysteine) to TGG (tryptophan) in exon 10, codon 611 of the RET proto-oncogene. Subsequent genetic testing of the patient and her offspring revealed the same base-change in herself, one daughter, one son, and the only grandson, confirming hereditary disease classified as MEN2A-2. Clinical follow up of the patient revealed elevated serum calcitonin after 6 yr. Thyroidectomy was performed and revealed a small medullary thyroid carcinoma. The patient's children thus far show no evidence of MEN2, but C-cell hyperplasia has been diagnosed in the grandson. Our serendipitous finding of a MEN2A-2 mutation in a patient with initial diagnosis of late onset, unilateral, "sporadic" pheochromocytoma would argue for routine mutation screening of even elderly patients presenting with a pheochromocytoma.
AuthorsAndreas Weinhäusel, Annemarie Behmel, Bruce A J Ponder, Oskar A Haas, Bruno Niederle, Alois Gessl, Heinrich Vierhapper, Roswitha Pfragner
JournalEndocrine pathology (Endocr Pathol) Vol. 14 Issue 4 Pg. 375-82 ( 2003) ISSN: 1046-3976 [Print] United States
PMID14739494 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't, Review)
Chemical References
  • MAS1 protein, human
  • Proto-Oncogene Mas
  • Proto-Oncogene Proteins
  • Calcitonin
  • Proto-Oncogene Proteins c-ret
  • Receptor Protein-Tyrosine Kinases
Topics
  • Adrenal Gland Neoplasms (genetics)
  • Aged
  • Calcitonin (blood)
  • Carcinoma, Medullary (genetics, surgery)
  • Female
  • Heterozygote
  • Humans
  • Male
  • Multiple Endocrine Neoplasia Type 2a (genetics)
  • Mutation
  • Pheochromocytoma (genetics)
  • Proto-Oncogene Mas
  • Proto-Oncogene Proteins (genetics)
  • Proto-Oncogene Proteins c-ret
  • Receptor Protein-Tyrosine Kinases (genetics)
  • Thyroid Neoplasms (genetics, surgery)
  • Thyroidectomy
  • Tumor Cells, Cultured

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