The hepatic metastases of MTC are one of the few metastases that tend to be hyperechogenic in US, but they may also be hypoechoic or mixed [25].The most common findings in US of the hepatic metastatic lesions among our MEN2 patients were multiple hyperechogenic lesions, mainly similar to what we found in MEN1 group (Fig 1).The only difference between MEN1 and MEN2 lesions were the presence of calcifications. The gene discussed is MEN1; the disease is medullary thyroid gland carcinoma.