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Answer to your Health Question

Question (06/09/2012):

Question posted at: Medwhat.com

Title: Nodules on the left side of my tongue | Multiple endocrine neoplasia (MEN)

I still have 2-3 nodules on the left side of my tongue after taking out 1.2cm of nodules on the right, should I take them out?

If taken out, are they likely to keep recurring?

My endocrinologist assured me that if I don't have multiple endocrine neoplasia (MEN) now, I would not get it in the future.

Since I do not have MEN now, what is the % risk of MEN in the future?

Should I send my son age 14 for a checkup also if I do not have MEN now?

When a person gets MEN, what are the chances of survival if we go for regular checkups?

Answer:

Abnormalities of the tongue can present a diagnostic and therapeutic dilemma for physicians.

Tongue growths usually require biopsy to differentiate benign lesions (e.g., granular cell tumors, fibromas, lymphoepithelial cysts) from premalignant leukoplakia or squamous cell carcinoma.

If the condition is a Squamous cell carcinoma, with the following clinical presentation: Thickened white or red patch or plaque, may develop nodularity or ulceration, usually on lateral tongue,biopsy is critical to confirm the diagnosis and allow for prompt treatment before extensive local invasion occurs. Treatment typically requires surgery and radiation therapy.

Squamous cell carcinoma doesn't have an extremely high recurrence rate, meaning it isn't extremely likely that the cancer will come back after treatment

The term multiple endocrine neoplasia (MEN) encompasses several distinct syndromes featuring tumors of endocrine glands, each with its own characteristic pattern.

Multiple endocrine neoplasia (MEN) type I is disease passed down through families in which one or more of the endocrine glands are overactive or form a tumor.

People with multiple endocrine neoplasia type 1 are born with one mutated copy of the MEN1 gene in each cell. Then, during their lifetime, the other copy of the gene is mutated in a small number of cells. These genetic changes result in no functionalcopies of the MEN1 gene in selected cells, allowing the cells to divide with little control and form tumors.

Individuals with a combination of endocrine neoplasias suggestive of the MEN1 syndrome are recommended to have a mutational analysis of the MEN1 gene if additional diagnostic criteria are sufficiently met, mainly including:

-age <40 years
-positive family history
-multifocal or recurrent neoplasia
-two or more organ systems affected

In MEN2 Medullary thyroid carcinoma is the primary concern for those testing positive for the RET gene mutations. The survival rate 10 years after the initial diagnosis for Medullary thyroid carcinoma is 46%. If the cancer is detected using genetic screening before the patient shows signs of having the disease, surgical removal of the thyroid gland can cure MTC.



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