Table 1. Endocrine tumor syndromes

Syndromes Genes involved Clinical manifestations Surveillance screening
Endocrine tumor syndrome related to adrenocortical tumor
 Li–Fraumeni syndrome TP53 Adrenocortical carcinoma, breast cancer, soft tissue sarcomas, osteosarcomas, leukemia, brain tumors Abdominal ultrasound every 3 to 4 months If ultrasound is not possible, blood test every 3−4 months to measure total testosterone, dehydroepiandrosterone, and androstenedione.
 Beckwith-Wiedemann syndrome Abnormal methylation at 11p15.5, CDKN1C Macroglossia, hemihyperplasia, omphalocele, neonatal hypoglycemia, macrosomia, embryonal tumors Limited data on the utility of these screening methods Clinical evaluations for hormone excess
 Multiple endocrine neoplasia type 1 RET Neoplasia of the parathyroid glands, the anterior pituitary gland, neuroendocrine tissue of gastro-entero-pancreatic organ systems Abdominal imaging with CT or MRI is recommended every 3 years
 Bilateral macronodular and micronodular adrenal cortical disease ARMC5 PRKAR1A, PRKACA, PDE11A, PDE8B Bilateral adrenal hyperplasia associated with one or more adrenal nodules, Cushing syndrome
Endocrine tumor syndrome related to pheochromocytoma and paraganglioma
 Von Hippel-Lindau syndrome VHL Hemangioblastomas of the retina, cerebellum, and spine, renal cell carcinoma, pheochromocytoma, paraganglioma, pancreatic cysts, neuroendocrine tumors Annual abdominal imaging and plasma metanephrine and normetanephrine testing starting at 5 years of age
 Multiple endocrine neoplasia type 2 RET Medullary thyroid cancer, PHEO, primary hyperparathyroidism Calcium or ionized calcium with PTH levels, plasma metanephrines and normetanephrines or 24-hour urinary metanephrines and normetanephrines starting at 11 years for those in the high and highest categories and 16 years for those in the moderate category
 Neurofibromatosis type 1 NF1 Plexiform neurofibromas, malignant peripheral nerve sheath tumors, optic pathway gliomas, breast cancer Limited data on the utility of these screening methods
 SDH-related disease SDHA, SDHB, SDHC, SDHD Early onset, multifocal disease, high rate of recurrence and metastasis Recommended timing of initial tumor screening between the ages of 6 and 10 years in SDHB defects; between the ages of 10 and 15 years in SDHA, SDHC, and SDHD defects
PHEO, pheochromocytoma; SDH, succinate dehydrogenase.