Skip to main content
Log in

Characterization of V804M-mutated RET proto-oncogene associated with familial medullary thyroid cancer, report of the largest Turkish family

  • Original Article
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

Purpose

Analysis of the RET proto-oncogen is very important for diagnosis and prognosis of medullary thyroid cancer (MTC). Genotype–phenotype correlation is also well known. Here we report features of the largest known family in Turkey with the V804M-mutated RET proto-oncogene.

Methods

Thirty members from three generations were evaluated. A RET proto-oncogen mutation, calcitonin (Ct) measurement and thyroid ultrasound were performed on all individuals. Seventeen members had V804M mutation. Fourteen of these patients underwent total thyroidectomy and additional central lymph node dissection for five subjects.

Results

The mean age of patients with MTC was 46.5 (30–61) years. The mean calcitonin level of RET positive members was 13.27 pg/mL (1–49.8 pg/mL). Three had a basal Ct level above normal limits. Seven of the 14 patients were diagnosed with MTC, and two were diagnosed with papillary thyroid cancer without MTC. One patient had central neck metastasis. Hyperparathyroidism or pheochromocytoma was not detected in any case. Patients who were RET negative, had normal Ct levels and no suspected nodule on ultrasound examination.

Conclusions

Our study revealed a relatively good prognosis in patients with V804M mutation. Despite the surgery was performed in older age no advance disease was observed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Kloos RT, Eng C, Evans DB, Francis GL, Gagel RF, Gharib H, Moley JF, Pacini F, Ringel MD, Schlumberger M, Wells SA Jr (2009) Medullary thyroid cancer: management guidelines of the American Thyroid Association. Thyroid 19:565–612

    Article  PubMed  Google Scholar 

  2. Marsh DJ, Learoyd DL, Robinson BG (1995) Medullary thyroid carcinoma: recent advances and management update. Thyroid 5:407–424

    Article  CAS  PubMed  Google Scholar 

  3. Wells SA Jr, Pacini F, Robinson BG, Santoro M (2013) Multiple endocrine neoplasia type 2 and familial medullary thyroid carcinoma: an update. J Clin Endocrinol Metab 98:3149–3164

    Article  CAS  PubMed  Google Scholar 

  4. Machens A, Lorenz K, Dralle H (2014) Progression of medullary thyroid cancer in RET carriers of ATA class A and C mutations. J Clin Endocrinol Metab 99:286–292

    Article  Google Scholar 

  5. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, McIver B, Pacini F, Schlumberger M, Sherman SI, Steward DL, Tuttle RM (2009) American Thyroid Association (ATA) guidelines taskforce on thyroid nodules and differentiated thyroid cancer. revised american thyroid association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19:1167–1214

    Article  PubMed  Google Scholar 

  6. Edge SB, Compton CC (2010) The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 17:1471–1474

    Article  PubMed  Google Scholar 

  7. Krampitz GW, Norton JA (2014) RET gene mutations (genotype and phenotype) of multiple endocrine neoplasia type 2 and familial medullary thyroid carcinoma. Cancer 120:1920–1931

    Article  CAS  PubMed  Google Scholar 

  8. Castellone MD, Santoro M (2008) Dysregulated RET signaling in thyroid cancer. Endocrinol Metab Clin North Am 37:363–374

    Article  CAS  PubMed  Google Scholar 

  9. Shifrin AL, Ogilvie JB, Stang MT et al (2010) Single nucleotide polymorphisms act as modifiers and correlate with the development of medullary and simultaneous medullary/papillary thyroid carcinomas in 2 large, non-related families with the RET V804M proto-oncogene mutation. Surgery 148:1274–1280

    Article  PubMed  Google Scholar 

  10. Elisei R, Cosci B, Romei C et al (2008) Prognostic significance of somatic RET proto-oncogene mutations in sporadic medullary thyroid cancer: a 10-year follow-up study. J Clin Endocrinol Metab 93:682–687

    Article  CAS  PubMed  Google Scholar 

  11. Machens A, Niccoli-Sire P, Hoegel J et al (2003) Early malignant progression of hereditary medullary thyroid carcinoma. N Engl J Med 349:1517–1525

    Article  CAS  PubMed  Google Scholar 

  12. Fink M, Weinh€usel A, Niederle B, Haas OA (1996) Distinction between sporadic and hereditary medullary thyroid carcinoma (MTC) by mutation analysis of the RET proto-oncogene. ‘‘Study Group Multiple Endocrine Neoplasia Austria (SMENA)’’. Int J Cancer 69:312–316

    Article  CAS  PubMed  Google Scholar 

  13. Feldman GL, Edmonds MW, Ainsworth PJ et al (2000) Variable expressivity of familial medullary thyroid carcinoma (FMTC) due to a RET V804M (GTG–>ATG) mutation. Surgery 128:93–98

    Article  CAS  PubMed  Google Scholar 

  14. Shifrin A, Xenachis Cristina, Fay Angela et al (2009) One hundred and seven family members with the rearranged during transfection V804M proto-oncogene mutation presenting with simultaneous medullary and papillary thyroid carcinomas, rare primary hyperparathyroidism, and no pheochromocytomas: is this a new syndrome—MEN 2C? Surgery 146:998–1005

    Article  PubMed  Google Scholar 

  15. Learoyd DL, Gosnell J, Elston MS et al (2005) Experience of prophylactic thyroidectomy in multiple endocrine neoplasia type 2A kindreds with RET codon 804 mutations. Clin Endocrinol (Oxf) 63:636–641

    Article  CAS  Google Scholar 

  16. Brauckhoff M, Gimm O, Hinze R, Ukkat J, Brauckhoff K, Dralle H (2002) Papillary thyroid carcinoma in patients with RET proto-oncogene germline mutation. Thyroid 12:557–561

    Article  CAS  PubMed  Google Scholar 

  17. Dionigi G, Castano P, Bertolini V et al (2007) Simultaneous medullary and papillary thyroid cancer: two case reports. J Med Case Reports 1:133

    Article  PubMed Central  Google Scholar 

  18. Lantieri F, Caroli F, Ceccherini I, Griseri P (2013) The involvement of the RET variant G691S in medullary thyroid carcinoma enlightened by a meta-analysis study. Int J Cancer 132:2808–2819

    Article  CAS  PubMed  Google Scholar 

  19. Figlioli G, Landi S, Romei C, Elisei R, Gemignani F (2013) Medullary thyroid carcinoma (MTC) and RET proto-oncogene: mutation spectrum in the familial cases and a meta-analysis of studies on the sporadic form. Mutat Res 752:36–44

    Article  CAS  PubMed  Google Scholar 

  20. Lesueur F, Corbex M, McKay JD, Lima J, Soares P et al (2002) Specific haplotypes of the RET proto-oncogene are over-represented in patients with sporadic papillary thyroid carcinoma. J Med Genet 39:260–265

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Lonn S, Bhatti P, Alexander BH, Pineda MA, Doody MM et al (2007) Papillary thyroid cancer and polymorphic variants in TSHR- and RET-related genes: a nested case-control study within a cohort of U.S. radiologic technologists. Cancer Epidemiol Biomarkers Prev 16:174–177

    Article  PubMed  Google Scholar 

  22. Lecube A, Hernandez C, Oriola J et al (2002) V804M RET mutation and familial medullary thyroid carcinoma: report of a large family with expression of the disease only in the homozygous gene carriers. Surgery 131:509–514

    Article  PubMed  Google Scholar 

  23. Santos M, Azevedo T, Martins T, Rodrigues FJ, Lemos MC (2014) Association of RET genetic polymorphisms and haplotypes with papillary thyroid carcinoma in the portuguese population: a case-control study. PLoS One 9(10):e109822

    Article  PubMed Central  PubMed  Google Scholar 

  24. Recasens M, Oriola J, Fernández-Real JM et al (2007) Asymptomatic bilateral adrenal pheochromocytoma in a patient with a germline V804M mutation in the RET proto-oncogene. Clin Endocrinol (Oxf) 67:29–33

    Article  CAS  Google Scholar 

  25. Feldman GL, Edmonds MW, Ainsworth PJ, Schuffenecker I, Lenoir GM, Saxe AW, Talpos GB, Roberson J, Petrucelli N, Jackson CE (2000) Variable expressivity of familial medullary thyroid carcinoma (FMTC) due to a RET V804M (GTG–>ATG) mutation. Surgery 128:93–98

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

Conflict of interest

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. M. Tuna.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Basaran, M.N., Tuna, M.M., Karakılıç, E. et al. Characterization of V804M-mutated RET proto-oncogene associated with familial medullary thyroid cancer, report of the largest Turkish family. J Endocrinol Invest 38, 541–546 (2015). https://doi.org/10.1007/s40618-014-0224-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40618-014-0224-0

Keywords

Navigation