Cancer is a multistep phenomenon, and multiple cellular genetic lesion
s are involved in the emergence of the malignant neoplasm. Several ear
ly events, including ras mutations in follicular thyroid carcinoma and
RET gene rearrangement in papillary tumors, have been implicated in t
he neoplastic transformation of thyrocytes. The stepwise array of muta
tions or deletions described to date in candidate oncogenes and tumor
suppressor genes that are necessary for the advance to malignancy and
for tumor progression await further investigation. The identification
of additional, thyroid-cancer-specific lesions in these pathways is be
ing further studied also.