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

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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.

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Correspondence to Roswitha Pfragner PhD.

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Weinhäusel, A., Behmel, A., Ponder, B.A.J. et al. Long-term follow up of a “sporadic” unilateral pheochromocytoma revealing multiple endocrine neoplasia MEN2A-2 in an elderly woman. Endocr Pathol 14, 375–382 (2003). https://doi.org/10.1385/EP:14:4:375

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