Risk profiles and penetrance estimations in multiple endocrine neoplasia type 2A caused by germline RET mutations located in exon 10

✍ Scribed by Karin Frank-Raue; Lisa A. Rybicki; Zoran Erlic; Heiko Schweizer; Aurelia Winter; Ioana Milos; Sergio P.A. Toledo; Rodrigo A. Toledo; Marcos R. Tavares; Maria Alevizaki; Caterina Mian; Heide Siggelkow; Michael Hüfner; Nelson Wohllk; Giuseppe Opocher; Šárka Dvořáková; Bela Bendlova; Małgorzata Czetwertynska; Elżbieta Skasko; Marta Barontini; Gabriela Sanso; Christian Vorländer; Ana Luiza Maia; Attila Patocs; Thera P. Links; Jan Willem de Groot; Michiel N. Kerstens; Gerlof D. Valk; Konstanze Miehle; Thomas J. Musholt; Josefina Biarnes; Svetozar Damjanovic; Mihaela Muresan; Christian Wüster; Martin Fassnacht; Mariola Peczkowska; Christine Fauth; Henriette Golcher; Martin A. Walter; Josef Pichl; Friedhelm Raue; Charis Eng; Hartmut P.H. Neumann;; for the International RET Exon 10 Consortium

• Publisher: John Wiley and Sons
• Year: 2010
• Tongue: English
• Weight: 239 KB
• Volume: 32
• Category: Article
• ISSN: 1059-7794
• DOI: 10.1002/humu.21385

✦ Synopsis

Multiple endocrine neoplasia type 2 is characterized by germline mutations in RET. For exon 10, comprehensive molecular and corresponding phenotypic data are scarce. The International RET Exon 10 Consortium, comprising 27 centers from 15 countries, analyzed patients with RET exon 10 mutations for clinical-risk profiles. Presentation, age-dependent penetrance, and stage at presentation of medullary thyroid carcinoma (MTC), pheochromocytoma, and hyperparathyroidism were studied. A total of 340 subjects from 103 families, age 4-86, were registered. There were 21 distinct single nucleotide germline mutations located in codons 609 (45 subjects), 611 (50), 618 (94), and 620 (151). MTC was present in 263 registrants, pheochromocytoma in 54, and hyperparathyroidism in 8 subjects. Of the patients with MTC, 53% were detected when asymptomatic, and among those with pheochromocytoma, 54%. Penetrance for MTC was 4% by age 10, 25% by 25, and 80% by 50. Codon-associated penetrance by age 50 ranged from 60% (codon 611) to 86% (620). More advanced stage and increasing risk of metastases correlated with mutation in codon position (609→620) near the juxtamembrane domain. Our data provide rigorous bases for timing of premorbid diagnosis and personalized treatment/prophylactic procedure decisions depending on specific RET exon 10 codons affected.