The clinical outcome of prospective screening for multiple endocrine neoplasia type 2a. An 18-year experience

The New England Journal of Medicine
R F GagelS Reichlin

Abstract

An important question facing physicians who care for families with multiple endocrine neoplasia type 2a is whether prospective screening to detect early abnormalities of the thyroid, parathyroid, or adrenal glands favorably influences the ultimate course of the disease. An 18-year study of a large family has allowed us to examine the effect of early treatment on the clinical course of the disease. Of 22 patients who underwent thyroidectomy for early C-cell abnormalities, 19 remained free of detectable medullary thyroid carcinoma according to all criteria, at a mean of 11 years after thyroidectomy. None of the 22 patients had evidence of parathyroid disease either at the time of surgery or after a mean follow-up of 10 years. Prospective screening for adrenal medullary abnormalities by means of measurement of 24-hour urinary epinephrine excretion and the ratio of urinary epinephrine to norepinephrine was predictive of pheochromocytoma in 10 of 11 patients (with a false negative result in one patient) but was not useful in diagnosing adrenal medullary hyperplasia. We conclude that regular, prospective screening and early treatment of the manifestations of multiple endocrine neoplasia can prevent metastasis of medullary thyroid car...Continue Reading

References

Nov 2, 1978·The New England Journal of Medicine·K GrazeS Reichlin
Aug 1, 1977·The Surgical Clinics of North America·G W SizemoreH Heath
Oct 1, 1976·Journal of Pediatric Surgery·L L LeapeS Reichlin
May 1, 1986·The New England Journal of Medicine·D T O'Connor, L J Deftos
Jun 1, 1985·Annals of Internal Medicine·A F StewartA Vignery
May 1, 1968·Proceedings of the National Academy of Sciences of the United States of America·L J DeftosJ T Potts
Jul 12, 1969·Lancet·M B ClarkG V Foster
Aug 30, 1973·The New England Journal of Medicine·H J WolfeA H Tashjian
Apr 1, 1972·American Journal of Surgery·H H MillerA H Tashjian
Nov 1, 1971·The New England Journal of Medicine·K E MelvinA H Tashjian
Dec 1, 1971·Metabolism: Clinical and Experimental·L J Deftos
Oct 22, 1970·The New England Journal of Medicine·A H TashijanC S Hill
Dec 1, 1982·The Journal of Pediatrics·R F GagelA H Tashjian
Jul 1, 1981·The American Journal of Surgical Pathology·S H BignerJ C Eggleston

❮ Previous
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Citations

Sep 1, 1993·Seminars in Surgical Oncology·J L Pasieka
Jul 5, 1990·Klinische Wochenschrift·L SchaafK H Usadel
Sep 15, 1989·Klinische Wochenschrift·H P NeumannP Schollmeyer
May 1, 1990·The Japanese Journal of Surgery·T ShimotakeS Takai
Dec 30, 1998·Irish Journal of Medical Science·D A O'KeeffeN J O'Higgins
Aug 29, 2003·Current Treatment Options in Oncology·Jeffrey F Moley
Aug 1, 1995·Clinical Biochemistry·S A Narod
Feb 1, 1995·Critical Reviews in Oncology/hematology·Y MizukamiH Nakamura
Oct 1, 1995·Trends in Endocrinology and Metabolism : TEM·D L LearoydB G Robinson
Jun 1, 2005·Journal of the American College of Surgeons·Electron KebebewJocelyn Grunwell
Mar 20, 2002·Biochimie·Anne BachelotMartin Schlumberger
Mar 12, 2004·Cancer Letters·Masatoshi IchiharaMasahide Takahashi
May 1, 1995·Pathology, Research and Practice·G BussolatiA Pagani
Jul 11, 2001·Endocrinology and Metabolism Clinics of North America·E Puxeddu, J A Fagin
Nov 1, 1988·Baillière's Clinical Endocrinology and Metabolism·R V Thakker, B A Ponder
Jul 1, 1995·Baillière's Clinical Endocrinology and Metabolism·G J CoteR F Gagel
Aug 10, 2002·Journal of the American College of Surgeons·González Jose M RodríguezPascual Parrilla
Jan 24, 2007·Nature Clinical Practice. Endocrinology & Metabolism·Karel PacakUNKNOWN International Symposium on Pheochromocytoma
Sep 29, 1994·The New England Journal of Medicine·C J LipsM J Berends
Sep 29, 1994·The New England Journal of Medicine·R D Utiger
Oct 17, 2003·The New England Journal of Medicine·Gilbert J Cote, Robert F Gagel
Oct 1, 1995·Thyroid : Official Journal of the American Thyroid Association·D J MarshB G Robinson
Feb 1, 1997·Thyroid : Official Journal of the American Thyroid Association·G HernándezJ Mesa
Dec 17, 2005·Thyroid : Official Journal of the American Thyroid Association·H VierhapperS Baumgartner-Parzer
Jul 21, 2005·Thyroid : Official Journal of the American Thyroid Association·Maria A KouvarakiDouglas B Evans
Feb 9, 2005·Journal of Pediatric Gastroenterology and Nutrition·Jan Willem B de GrootRobert M W Hofstra
Oct 1, 1995·Journal of Internal Medicine·F RaueB Niederle
Feb 24, 2001·The Australian & New Zealand Journal of Obstetrics & Gynaecology·J V JosephR S Davis
Sep 23, 2006·Annals of Surgical Oncology·José G GuillemKenneth Offit

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