Multiple endocrine neoplasia

Question 1

Multiple endocrine neoplasia?

Answer 1

Question 2

What is MEN type I?

Answer 2

3 P’s

• Parathyroid (95%): hyperparathyroidism due to parathyroid hyperplasia
• Pituitary (70%)
• Pancreas (50%): e.g. insulinoma, gastrinoma (leading to recurrent peptic ulceration)

Also: adrenal and thyroid

MEN1 gene

Most common presentation = hypercalcaemia

Question 3

MEN type IIa?

Answer 3

Medullary thyroid cancer (70%):

2 P’s

• Parathyroid (60%)
• Phaeochromocytoma
• RET oncogene

Question 4

MEN type IIb?

Answer 4

Medullary thyroid cancer:

1 P:

• Phaeochromocytoma
• Marfanoid body habitus
• Neuromas

RET oncogene

Question 5

Answer 5