Lymph node clearance at level VI may be omitted in patients younger than 1 year old with MEN2B syndrome and in patients younger than 5 years old with MEN2A and FMTC undergoing total prophylactic thyroidectomy, unless there are nodules larger than 5 mm, increased calcitonin levels, or signs of lymph node metastasis [6,7]. The gene discussed is CALCA; the disease is metastatic malignant neoplasm in the lymph nodes.