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MEN1-associated insulinoma — SCE Endocrinology MCQ

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HardNeuroendocrine/MENMEN1-associated insulinomaSCE Endocrinology

A neonate is found to carry the RET M918T variant associated with MEN2B. There is no clinical thyroid lesion yet. What is the appropriate thyroid-management principle?

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Correct answer: A — Arrange prophylactic thyroidectomy in early infancy through a specialist team

RET M918T confers the highest risk of very early medullary thyroid carcinoma. Prophylactic thyroidectomy should be arranged in infancy in a specialist MEN2 team rather than waiting for a structural lesion or biochemical progression. Radioiodine is ineffective for medullary thyroid carcinoma because C cells do not concentrate iodine.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/diabetes-and-other-endocrinal-nutritional-and-metabolic-conditions