CALCA and medullary thyroid gland carcinoma: In summary, considering recently published evidence [8,10] for the timing of pre-emptive thyroidectomy it may be concluded, that the ATA MTC guidelines constituted a positive stimulus to publish further evidence for Ct-guided preemptive thyroidectomy for RET gene mutation carriers and the conclusion is drawn on the basis of experience expressed in Lisbon and published later evidence that the integrated algorithm based on age - calcitonin - type of RET mutation should be considered at the decision of pre-emptive thyroidectomy.