DICER1 and toxic multinodular goitre: In 2011, Rio et al. evaluated the association between familial TFND and DICER1 mutations, concluding that individuals who carry a DICER1 germline mutation have increased predisposition to develop TFND/MNG, which is among the most highly penetrant phenotypes of the disorder with an associated significantly increased risk of developing thyroid cancer compared to the general population [47].