Surgical remission of diabetes in a patient with mutation of RET proto-oncogene.

Abstract Objective In pheochromocytomas, accelerated catecholamines production can cause secondary diabetes. The gene responsible for multiple endocrine neoplasia type 2 (MEN 2)-related pheochromocytomas is RET proto-oncogene. The objective of this report is to describe a unique case of surgical remission of misdiagnosed type 2 diabetes mellitus (T2DM) in a woman with bilateral pheochromocytoma and documented RET proto-oncogene mutation. Methods Clinical examination, urinary metanephrines levels, a triple-phase abdominal computed tomography (CT) with adrenal protocol, positron emission tomography with fluorine-18 fluorodeoxyglucose integrated with CT (18F-FDG PET/CT), surgical pathology and genetic testing were performed. Results A 46-year-old woman with a 5-year history of apparent T2DM complicated by neuropathy, without contributory family history, presented with occasional headaches, weight loss and abdominal pain. A 24-hour urinary metanephrines at 5mg (reference range, 0.05-1) was found. Abdominal CT showed bilateral adrenal masses with Conclusion This is the first report of a patient with RET proto-oncogene mutation experiencing remission of diabetes after surgical resection of bilateral pheochromocytomas. Timely recognition and treatment of the underlying condition is important to potentially achieve diabetes remission and prevent its long-term complications.