Zou Hong-Jin, Li Yu-Shu, Shan Zhong-Yan
Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China.
Oncol Lett. 2016 Oct;12(4):2657-2659. doi: 10.3892/ol.2016.5028. Epub 2016 Aug 16.
Multiple endocrine neoplasia 2A (MEN2A) is characterized by the coexistence of tumors that involve two or more endocrine glands within the same patient, and is defined as the occurrence of medullary thyroid carcinoma in association with pheochromocytoma (PHEO) and parathyroid tumors or hyperparathyroidism. The pathogenesis of MEN2A is due to the mutation of a tyrosine kinase receptor that is encoded by the rearrangement during transfection (RET) proto-oncogene. The mutation often occurs in exon 10q11.2. The present study reports the case of a 73-year-old man with severe hypercalcemia, bilateral adrenal PHEO and a thyroid nodule. A genetic panel was obtained, and the RET mutation was indicated. The pedigree of the patient was also studied. Genetic testing of the patient's son indicated heterozygosity for the same mutation at codon 634. The first symptom of the two patients was PHEO, which is uncommon. In addition, varied phenotypes were identified in the two patients. In the present study, the association between the phenotypic variation of the RET gene and the occurrence of MEN2A is discussed.
多发性内分泌腺瘤病2A(MEN2A)的特征是同一患者体内存在累及两个或更多内分泌腺的肿瘤,其定义为甲状腺髓样癌与嗜铬细胞瘤(PHEO)及甲状旁腺肿瘤或甲状旁腺功能亢进同时发生。MEN2A的发病机制是由于转染重排(RET)原癌基因编码的酪氨酸激酶受体发生突变。该突变常发生在外显子10q11.2。本研究报告了一例73岁男性患者,患有严重高钙血症、双侧肾上腺嗜铬细胞瘤和一个甲状腺结节。进行了基因检测,结果显示存在RET突变。还对患者的家系进行了研究。对患者儿子的基因检测表明,其第634密码子存在相同突变的杂合性。这两名患者的首发症状均为嗜铬细胞瘤,这并不常见。此外,在这两名患者中发现了不同的表型。在本研究中,讨论了RET基因表型变异与MEN2A发生之间的关联。