Dynamic RET.V.C.U.G is an excellent study for the evaluation of the lower urinary tract. By performing this simple study, the radiologist is able to evaluate the entire uREThra as well as the bladder.In this paper, I will discuss important data including normal variations, spasm, strictures neoplasms, post surgical complications, bladder abnormalities, several unusual cases of uREThral stone, post-traumatic changes and their important complications including fistula formations and other unusual cases will be discussed. I should mention that the entire films included in this presentation are from my own personal file.

A hypothesis is proposed here that RET rearrangements in papillary thyroid cancers are related to the disease duration and tumor progression. The most common RET rearrangements are RET/PTC1 and RET/PTC3. RET/PTC1 is more prevalent in classic papillary thyroid carcinoma (PTC), its diffuse sclerosing variant, and papillary microcarcinoma; while RET/PTC3 is frequently found in less differentiated solid PTC. RET/PTC3 is associated with larger tumor size and multifocality in sporadic pediatric PTC. The RET rearrangements; especially RET/PTC3, which is frequently detected among Chernobyl thyroid cancers is developed after exposure to radiation at an early age, is proposed to be a potential trigger of malignancy. There are many late-stage tumors among the first-wave Chernobyl PTCs that tend to be larger and less differentiated than those detected later. The high proportion of late-stage cases shortly after the accident is explained by the neglected cases in the screening process and also by the fact that some non-exposed patients were registered as radiation-exposed. The screening was productive because of the reservoir of undiagnosed cases in the population: registered incidence of thyroid cancer (TC) among children and adolescents prior to the Chernobyl disaster was low in the Soviet Union; compared to other developed countries. In conclusion, RET rearrangements, especially RET/PTC3, were correlated with the tumor progression. If the hypothesis defended here is correct, a low prevalence of RET/PTC3 among sporadic TC is circumstantial evidence of efficient cancer diagnosis and early detection.

Medullary thyroid carcinoma (MTC) occurs both sporadically and in the autosomal dominantly inherited multiple endocrine neoplasia (MEN) type 2 syndromes. The distinction between true sporadic MTC and a new mutation familial case is important for future clinical management of both the patient and family. The susceptibility gene for hereditary MTC is the RET proto-oncogene. DNA analysis for germline mutations of the RET proto-oncogene was performed in a series of24 patients with MTC [apparently sporadic MTC (20 cases), familial MTC (2 cases), MEN 2A (one case) and MEN 2B (one case)] to determine whether they were true sporadic cases or hereditary forms. Genomic DNA was amplified using polymerase chain reaction (PCR) and oligonucleotide primers for exons 10& 11. The PCR products were examined by restriction enzymes analysis to detect the mutations. One of the 20 patients with apparent sporadic MTC had exon 10 mutation (Cys-620 Arg); and exon 11mutation (Cys- 634 Trp) was also found in the index case with MEN 2A. No mutation was detected in the other patients. Three of six evaluated members of the MEN 2A patient had the same mutation. We conclude that routine application of RET proto-oncogene testing should be included in all cases of apparent sporadic MTC.