MEN Flashcards
What are the diagnostic criteria conditions for any of the MEN syndromes?
1.) 2+ organs (specific to MEN category) with tumors
Or
2.) 1 organ (specific to MEN category with tumor PLUS positive FHx
Or
3.) Genetic testing
What are the findings in MEN I?
Parathyroid gland tumors
Pancreatic tumors
Pituitary gland tumors
+ facial angiofibromas
What is a common dermatologic finding in MEN I?
Facial angiofibromas
What are the findings in MEN II?
Medullary thyroid carcinoma
Pheochromocytoma
Parathyroid gland tumors
+ cutaneous lichen amyloidosis
What is a common dermatologic finding in MEN II?
Cutaneous lichen amyloidosis
What are the findings in MEN III?
Mucosal neuromas
Medullary thyroid carcinoma
Marfan-like
Pheochromocytoma
How might a parathyroid tumor present?
Frequent kidney stones
Frequent fractures
Test PTH, Ca++, Calcitonin
How might a pancreatic tumor present?
Recurrent peptic ulcers
Hypoglycemia
Necrolytic migratory erythema (lower half of body)
Watery diarrhea, electrolyte imbalance, and weight loss
Gallstones
Signs of malabsorption
Fatty stools
Test: gastrin, somatostatin, C-peptide, glucose
MRI, CT, US as needed
How might a pituitary tumor present?
Headache Vision changes Galactorrhea Acromegaly or gigantism Cushing's syndrome Hyperthyroidism Premature menopause or low testosterone
Test: Prolactin, GH, ACTH, TSH, FSH/LH
How would a medullary thyroid carcinoma present?
Nodules in the neck
What are the timelines for prophylactic thyroidectomy in MEN syndromes?
MEN II: Before 6 YO
MEN III: Before 6 months
How might a pheochromocytoma present?
Refractory HTN (paroxysmal) Anxiety Palpitations HA Sweating
Your patient presents with a confirmed pheochromocytoma. Which MEN syndromes are on the Ddx?
MEN II
MEN III
Your patient has a confirmed medullary thyroid carcinoma. Which MEN syndromes are on the Ddx?
MEN II
MEN III
Your patient has confirmed hyperparathyroidism. Which MEN syndromes are on the Ddx?
MEN I
MEN II
