As genetic testing is a relatively new technique, hereditary RET-oncogene mutation MTCs are sometimes detected de-novo with no family history, while somatic RET point mutations have also been identified in up to 50% of patients with sporadic MTC.3 For de-novo cases, ultrasound is often the initial diagnostic test, meaning maximising sensitivity for MTC is imperative in identifying cancer in this high-risk group. The gene discussed is RET; the disease is cancer.