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Skinner MA _ et al_. (2005) Prophylactic thyroidectomy in multiple endocrine neoplasia type 2A. _N Engl J Med_ 353: 1105–1113 Researchers at Duke University School of Medicine and Washington
University school of Medicine have recently published the results of a study on prophylactic thyroidectomy in children genetically at risk of developing medullary thyroid carcinoma (MTC).
The paper, published in the _New England Journal of Medicine_, reports a 100% success rate when this procedure was performed in children younger than 8 years of age. Skinner and co-workers
initiated a genetic screening programme to identify at-risk patients with mutations in the _RET_ proto-oncogene, which has been identified as the cause of multiple endocrine neoplasia type
2A (MEN-2A), type 2B (MEN-2B), and familial MTC. Almost all patients with one of these conditions go on to develop MTC. Fifty patients under the age of 19, identified as having MEN-2A,
underwent total thyroidectomy with resection of the surrounding lymph nodes. Patients were followed up 5–10 years after surgery with physical examination and provocative testing for plasma
calcitonin levels. In 88% of patients, plasma calcitonin was undetectable, indicating no evidence of disease. Postoperative elevation of plasma calcitonin was recorded in 21% of children who
were at least 8 years old at the time of surgery, whereas levels of this tumor marker remained undetectable in all patients who underwent surgery aged 7 years or younger (_P_ = 0.03). The
authors concluded that total thyroidectomy is an effective treatment for children who are at risk of developing MTC, but that the timing of the procedure is crucial. CHANGE HISTORY * _ 17
MAY 2018 This article was published with the same DOI as a previous publication. A new DOI has been assigned and registered at Crossref, and has been corrected in the article. _ Authors *
Alexandra King View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE King,
A. Prophylactic thyroidectomy: effective against medullary thyroid carcinoma in children. _Nat Rev Endocrinol_ 2, 9 (2006). https://doi.org/10.1038/ncponc0332x Download citation * Issue
Date: January 2006 * DOI: https://doi.org/10.1038/ncponc0332x SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a
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