Multiple Endocrine Neoplasia (MEN) Endocrinology

Multiple Endicrine neoplasia: A group of heritable syndromes characterized by abherant growth of benign or malignant tumors in a subset of endocrine tissues.

• Types

o MEN I: tumors involving the parathyroid glands; endocrine pacreas; and the pituitary

o MEN IIA: medullary carcinoma of the thyroid gland; pheochromocytoma; and hyperparathyroidism

o MEN 2B: medullary carinoma of the thyroid; multiple neuromas; and pheochromocytoma

MEN I (Wermer’s syndrome)

• Autosomal dominant

• 2-20/100,000

• features:

o hyperparathyroidism*

o enteropancreatic tumors (gastrinomas/Zollinger-Ellison syndrome; VIPomas; glucagonomas; insuilinomas)**

o pituitary adenomas (prolactinomas)***

o adrenal adenomas

o carcinoid tumors

o facial angiofibromas

*Note: Predator attacking victim’s parathyroid (hyperparathyroidism)gland by grasping either side of the victim’s neck

**Note: Predator attacking the victim by kicking him to the abdomen inducing tumors.

***Note: Predator attacking the victim’s pituitary gland by poking the victim between his eyes inducing pituitary adenoma.





• Symptoms are related to the respective tumors

• Treatment

o Hyperparathyroidism

• Partial or total resection of parathyroid glands

• Prophylactic thymectomy

o Gastrinomas

• Proton pump inhibitors

• Correction of hypercalcemia

MEN II

• Autosominal dominant

• 1-10/100,00

MEN IIA (Sipple’s syndrome)-like sheep

• features

o medullary carcinoma of the thyroid (80-100%)*

• calcitonin producing parafollicular cells

o hyperparathyroidism**

o pheochromocytoma (50%)

• Hypertension; headache; palpitations; diaphoresis

• Super-strength demonstrated by the sheep after conquering the victim indicates the elevated catacholamines ***

o Hirschsprung’s disease







*Note: Sheep attacking victim’s thyroid resulting in medullary thyroid carcinoma

**Note: Sheep attacks parathyroid gland resulting in hyperparathyroidism

***Note: Sheep has power after eating the very nutritional thyroid and parathyroid organs and develops pheochromocytoma

MEN IIB (MEN III)

• Features

o Medullary carcinoma of the thyroid*

o Pheochromocytoma**

o Marfanoid body habitus

o Multiple neuromas of the conjunctiva; lips; labia; tongue; mucosa; larynx***







*Note: Werewolf attacking victim’s thyroid resulting in medullary thyroid carcinoma.

**Note: Werewolf now becomes very powerfull immediatelly, and develops pheochromocytoma after eating the thyroid gland.

***Note: Werewolf develops neuromas from all the energy produced from the pheochromocytoma.



