An infant is diagnosed with MEN-2B trait. Which the following will be best line of management?
**Core Concept**
Multiple Endocrine Neoplasia type 2B (MEN-2B) is a rare genetic disorder characterized by the presence of medullary thyroid carcinoma, pheochromocytoma, and other associated features. It is caused by a mutation in the RET proto-oncogene, leading to the development of these tumors.
**Why the Correct Answer is Right**
The best line of management for an infant diagnosed with MEN-2B is prophylactic thyroidectomy. This is because medullary thyroid carcinoma is a common feature of MEN-2B and is often present at birth or develops early in life. Early surgical removal of the thyroid gland can prevent the development of this cancer and improve survival rates. Additionally, prophylactic thyroidectomy can also prevent the production of calcitonin, a hormone produced by medullary thyroid carcinoma cells that can be used as a tumor marker.
**Why Each Wrong Option is Incorrect**
**Option A:** Waiting for symptoms to develop is not a recommended approach, as MEN-2B can be associated with aggressive cancer that can cause significant morbidity and mortality.
**Option B:** Screening for pheochromocytoma is important in MEN-2B, but it is not the best line of management for an infant with this condition.
**Option C:** Genetic counseling is essential for families with a history of MEN-2B, but it is not the primary management strategy for an infant with this condition.
**Clinical Pearl / High-Yield Fact**
Infants with MEN-2B should undergo genetic testing for the RET proto-oncogene mutation, and those with a positive result should undergo prophylactic thyroidectomy to prevent medullary thyroid carcinoma.
**Correct Answer:** C. Prophylactic thyroidectomy.