title: Integrated DNA-based/biochemical screening for early diagnosis of multiple endocrine neoplasia type 2A (MEN2A).
abstract: Multiple endocrine neoplasia type 2A (MEN2A), a subtype of MEN2, is characterized by medullary thyroid cancer, pheochromocytoma, and primary hyperparathyroidism. A Han Chinese pedigree with MEN2A was investigated following confirmation of the proband's diagnosis by pathological findings and DNA/biochemical screening. DNA samples from 4 other family members were collected and exon 5, 8, 10, 11, 13, 16 and 18 of the RET proto-oncogene were sequenced and then analyzed. A missense mutation of TGG (Trp) to TGC (Cys) at codon 634 (the classic MEN2A mutation) in exon 11 of the RET gene was detected in 3 family members, including the proband. Sequencing data were compared with the human gene mutation database. Elevated serum calcitonin level was detected initially; medullary thyroid carcinoma was revealed in the 3 cases and adrenal pheochromocytoma was also found in the proband. Elective operations were successfully performed on the adrenal and thyroid glands because of pheochromocytoma and medullary thyroid carcinoma. Our case study confirms that integrated DNA-based/biochemical screening is crucial for early diagnosis of MEN2A and is helpful in the screening of their relatives. In addition, DNA-based screening may occasionally uncover a previously unknown RET sequence.
authors.affiliation: Department of Geriatrics, Department of Cadres, Tong Ling People's Hospital, Tongling, Anhui 244000, China;
authors.forename: Qin
authors.initials: Q
authors.lastname: Cui
authors.forename: Wen
authors.initials: W
authors.lastname: Wang
authors.forename: Zhenzhen
authors.initials: Z
authors.lastname: Fu
authors.forename: Xin
authors.initials: X
authors.lastname: Shao
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Zhang
authors.forename: Mei
authors.initials: M
authors.lastname: Zhang
authors.forename: Xianxia
authors.initials: X
authors.lastname: Ju
authors.forename: Kunlin
authors.initials: K
authors.lastname: Wang
authors.forename: Jiawei
authors.initials: J
authors.lastname: Chen
authors.forename: Hongwen
authors.initials: H
authors.lastname: Zhou
keywords: Calcitonin screening; Chinese; DNA-based screening; MEN-2A; RET mutation; RET proto-oncogene; medullary thyroid carcinoma
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