Definition
Multiple endocrine neoplasia type 2 (MEN2), first described by Sipple in 1961, is an autosomal dominant syndrome with two types (2A and 2B). MEN2A is more common and is characterized by medullary thyroid carcinoma, pheochromocytoma, and primary hyperparathyroidism due to parathyroid adenomas. Cutaneous lichen amyloidosis is also a rare manifestation. MEN2A may be categorized into four subtypes as follows: (i) classical MEN2A, (ii) MEN2A with cutaneous lichen amyloidosis, (iii) MEN2A with Hirschsprung disease, and (iv) familial medullary thyroid cancer. The far less common but more aggressive MEN2B (also known as MEN3) is characterized by medullary thyroid carcinoma, pheochromocytoma, a “Marfanoid” body habitus, as well as mucosal or gastrointestinal neuromas.
Clinical Features
Incidence
MEN2 occurs in about 1 in 200,000 live births.
Age
In MEN2B, medullary thyroid carcinoma may develop...
References and Further Reading
Brandi, M. L., Gagel, R. F., Angeli, A., Bilezikian, J. P., Beck-Peccoz, P., Bordi, C., Conte-Devolx, B., Falchetti, A., Gheri, R. G., Libroia, A., Lips, C. J., Lombardi, G., Mannelli, M., Pacini, F., Ponder, B. A., Raue, F., Skogseid, B., Tamburrano, G., Thakker, R. V., Thompson, N. W., Tomassetti, P., Tonelli, F., Wells, S. A., Jr., & Marx, S. J. (2001). Guidelines for diagnosis and therapy for MEN type 1 and type 2. Journal of Clinical Endocrinology and Metabolism, 86, 5658.
Castinetti, F., Waguespack, S. G., Machens, A., Uchino, S., Hasse-Lazar, K., Sanso, G., Else, T., Dvorakova, S., Qi, X. P., Elisei, R., Maia, A. L., Glod, J., Lourenco, D. M., Jr., Valdes, N., Mathiesen, J., Wohllk, N., Bandgar, T. R., Drui, D., Korbonits, M., Druce, M. R., Brain, C., Kurzawinski, T., Patocs, A., Bugalho, M. J., Lacroix, A., Caron, P., Fainstein-Day, P., Borson Chazot, F., Klein, M., Links, T. P., Letizia, C., Fugazzola, L., Chabre, O., Canu, L., Cohen, R., Tabarin, A., Spehar Uroic, A., Maiter, D., Laboureau, S., Mian, C., Peczkowska, M., Sebag, F., Brue, T., Mirebeau-Prunier, D., Leclerc, L., Bausch, B., Berdelou, A., Sukurai, A., Vlcek, P., Krajewska, J., Barontini, M., Vaz Ferreira Vargas, C., Valerio, L., Ceolin, L., Akshintala, S., Hoff, A., Godballe, C., Jarzab, B., Jimenez, C., Eng, C., Imai, T., Schlumberger, M., Grubbs, E., Dralle, H., Neumann, H. P., & Baudin, E. (2019). Natural history, treatment, and long-term follow up of patients with multiple endocrine neoplasia type 2B: An international, multicentre, retrospective study. The Lancet Diabetes and Endocrinology, 7, 213–220.
Costante, G., Durante, C., Francis, Z., Schlumberger, M., & Filetti, S. (2009). Determination of calcitonin levels in C-cell disease: Clinical interest and potential pitfalls. Nature Clinical Practice Endocrinology and Metabolism, 5, 35–44.
Duan, K., & Mete, O. (2017). Hereditary endocrine tumor syndromes: The clinical and predictive role of molecular histopathology. AJSP: Reviews & Reports, 22, 246–268.
Elisei, R., Romei, C., Cosci, B., Agate, L., Bottici, V., Molinaro, E., Sculli, M., Miccoli, P., Basolo, F., Grasso, L., Pacini, F., & Pinchera, A. (2007). RET genetic screening in patients with medullary thyroid cancer and their relatives: Experience with 807 individuals at one center. Journal of Clinical Endocrinology and Metabolism, 92, 4725–4729.
Eng, C., Clayton, D., Schuffenecker, I., Lenoir, G., Cote, G., Gagel, R. F., can Amstel, H. K., Lips, C. J., Nishisho, I., Takai, S. I., Marsh, D. J., Robinson, B. G., Frank-Raue, K., Raue, F., Xue, F., Noll, W. W., Romei, C., Pacini, F., Fink, M., Niederle, B., Zedenius, J., Nordenskjold, M., Komminoth, P., Hendy, G. N., & Mulligan, L. M. (1996). The relationship between specific RET proto-oncogene mutations and disease phenotype in multiple endocrine neoplasia type 2. International RET mutation consortium analysis. JAMA, 20, 1575–1579.
Kiernan, C. M., & Grubbs, E. G. (2019). Surgical management of multiple endocrine Neoplasia 1 and multiple endocrine Neoplasia 2. Surgical Clinics of North America, 99, 693–709.
Kloos, R. T., Eng, C., Evans, D. B., Francis, G. L., Gagel, R. F., Gharib, H., Moley, J. F., Pacini, F., Ringel, M. D., Schlumberger, M., & Wells, S. A., Jr. (2009). Medullary thyroid cancer: Management guidelines of the American Thyroid Association. Thyroid, 19, 565–612.
Mete, O., Essa, A., Bramdev, A., Govender, N., & Chetty, R. (2017). MEN2 syndrome-related medullary thyroid carcinoma with focal tyrosine hydroxylase expression: Does it represent a hybrid cellular phenotype or functional state of tumor cells? Endocrine Pathology, 28(4), 362–366.
Neumann, H. P. H., Young, W. F., Jr., & Eng, C. (2019). Pheochromocytoma and Paraganglioma. New England Journal of Medicine, 381, 552–565.
Seri, M., Celli, I., Betsos, N., Claudiani, F., Camera, G., & Romeo, G. (1997). A Cys634Gly substitution of the RET proto-oncogene in a family with recurrence of multiple endocrine neoplasia type 2A and cutaneous lichen amyloidosis. Clinical Genetics, 51, 86–90.
Skinner, M. A., DeBenedetti, M. K., Moley, J. F., Norton, J. A., & Wells, S. A., Jr. (1996). Medullary thyroid carcinoma in children with multiple endocrine neoplasia types 2A and 2B. Journal of Pediatric Surgery, 31, 177–181; discussion 181-182.
Takahashi, M., Asai, N., Iwashita, T., Murakami, H., & Ito, S. (1998). Molecular mechanisms or development of multiple endocrine neoplasia 2 by RET mutations. Journal of Internal Medicine, 243, 509–513.
Thosani, S., Ayala-Ramirez, M., Palmer, L., Hu, M. I., Rich, T., Gagel, R. F., Cote, G., Waquespack, S. G., Habra, M. A., & Jimenez, C. (2013). The characterization of pheochromocytoma and its impact on overall survival in multiple endocrine neoplasia type 2. Journal of Clinical Endocrinology and Metabolism, 98, E1813–E1819.
Wells, S. A., Jr., Asa, S. L., Dralle, H., Elisei, R., Evans, D. B., Gagel, R. F., Lee, N., Machens, A., Moley, J. F., Pacini, F., Raue, F., Frank-Raue, K., Robinson, B., Rosenthal, M. S., Santoro, M., Schlumberger, M., Shah, M., Waguespack, S. G., & American Thyroid Association Guidelines Task Force on Medullary Thyroid Carcinoma. (2015). Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid, 25, 567–610.
Wray, C. J., Rich, T. A., Waguespack, S. G., Lee, J. E., Perrier, N. D., & Evans, D. B. (2008). Failure to recognize multiple endocrine neoplasia 2B: More common than we think? Annals of Surgical Oncology, 15, 293–301.
Yasir, M., & Kasi, A. (2019). Multiple endocrine Neoplasias, Type 2 (MEN II, Pheochromocytoma and Amyloid Producing Medullary Thyroid Carcinoma, Sipple Syndrome) [Updated 2019 Nov 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519054/
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Hodgson, A., Pakbaz, S., Mete, O. (2020). Multiple Endocrine Neoplasia Type 2 (MEN2). In: van Krieken, J. (eds) Encyclopedia of Pathology. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-28845-1_5224-1
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DOI: https://doi.org/10.1007/978-3-319-28845-1_5224-1
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