№ 19Endocrinology13 min read
Multiple endocrine neoplasia (MEN) syndromes
1. Big picture
Multiple endocrine neoplasia (MEN) syndromes are inherited tumor-predisposition syndromes in which a patient develops tumors in several endocrine organs. The exam task is not to memorize every rare tumor, but to recognize the classic combinations:
| Syndrome | Classic exam triad |
|---|---|
| MEN1 | Parathyroid + pancreatic/duodenal neuroendocrine tumors + pituitary adenoma |
| MEN2A | Medullary thyroid carcinoma + pheochromocytoma + hyperparathyroidism |
| MEN2B | Medullary thyroid carcinoma + pheochromocytoma + mucosal neuromas + marfanoid habitus |
| MEN4 | MEN1-like syndrome, usually parathyroid/pituitary tumors, due to CDKN1B |
The most dangerous immediate rule:
In MEN2, always exclude or treat pheochromocytoma before thyroid/parathyroid surgery. Otherwise anesthesia or manipulation can trigger a hypertensive crisis.
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