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Multiple Endocrine Neoplasia (MEN) with Case

by Michael Lazarus

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    00:01 Let's go on to another case.

    00:03 A 21 year old woman is seen in the office following parathyroidectomy for hyperparathyroidism The pathology showed hyperplasia.

    00:12 Her medical history is significant for oligomenorrhea.

    00:16 Her family history is notable for hypercalcemia and kidney stones in her father who died at the age of 49 from pancreatic cancer and a pituitary tumor in her sister at the age of 16.

    00:28 Her vital signs are normal and her skin findings include a dermatofibroma.

    00:34 Her physical examination is normal with no signs of hypercalcemia.

    00:39 What is the most likely diagnosis? With this complex constellation and presentation, this younger patient has hyperparathyroidism, a family history of pancreatic cancer and pituitary tumors coupled with the presence of a dermatofibroma in clinical exam.

    00:57 This should raise the suspicion for multiple endocrine neoplasia.

    01:01 The conclusion here is the patient most likely has the MEN type 1 syndrome Multi-gland hyperplasia causing primary hyperparathyroidism should lead to further investigations with this patient's family history of primary hyperparathyroidism Multiple endocrine neoplasia type 1 is the most common type.

    01:23 In addition to genetic testing, MEN1 can be discriminated from other disorders by personal or family history of recurrent primary hyperparathyroidism and neoplasms in other endocrine tissues.

    01:36 most prominently in your endocrine tumors arising from the pancreas and tumors of the pituitary gland as occurring in this patient's family history.

    01:44 And then finally, the presence of dermatofibromas of the skin is classic for the MEN1 phenotype.


    About the Lecture

    The lecture Multiple Endocrine Neoplasia (MEN) with Case by Michael Lazarus is from the course Metabolic Bone Disorders. It contains the following chapters:

    • Case: 21-year-old Woman with Hyperparathyroidism
    • Multiple Endocrine Neoplasia Type 1 (MEN1)

    Included Quiz Questions

    1. Multiple endocrine neoplasia type 1 (MEN 1)
    2. Multiple endocrine neoplasia type 2 (MEN 2)
    3. von Hippel–Lindau disease
    4. Lynch syndrome

    Author of lecture Multiple Endocrine Neoplasia (MEN) with Case

     Michael Lazarus

    Michael Lazarus


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