{"id":118,"date":"2013-10-21T23:58:10","date_gmt":"2013-10-21T23:58:10","guid":{"rendered":"http:\/\/www.modestosurgery.com\/surgeryblog\/?p=118"},"modified":"2013-11-16T15:40:44","modified_gmt":"2013-11-16T15:40:44","slug":"multiple-endocrine-neoplasias","status":"publish","type":"post","link":"http:\/\/www.modestosurgery.com\/surgeryblog\/multiple-endocrine-neoplasias\/","title":{"rendered":"Multiple Endocrine Neoplasias"},"content":{"rendered":"<h2>MEN syndromes<\/h2>\n<p>Inherited as autosomal dominant<\/p>\n<p>All family members of a patient diagnosed with MEN syndromes should be screened for MEN.<\/p>\n<p>Types: \u00a0MEN I, MEN IIA, MEN IIB<\/p>\n<h3><span style=\"color: #0000ff;\">MEN I<\/span><\/h3>\n<p>Most common tumors: \u00a0mnemonic &#8211; <span style=\"color: #0000ff;\">PPP<\/span> (all the P&#8217;s are followed by a vowel)<\/p>\n<ul>\n<li><strong>Parathyroid<\/strong> <strong>hyperplasia<\/strong> (90% of patients have this)<\/li>\n<li><a href=\"http:\/\/www.modestosurgery.com\/surgeryblog\/somatostatinoma-glucagonoma-insulinoma-vipoma-gastrinoma\/\">Pancreatic islet cell tumors<\/a> (66%): \u00a0<a href=\"http:\/\/www.modestosurgery.com\/surgeryblog\/somatostatinoma-glucagonoma-insulinoma-vipoma-gastrinoma\/\">Gastrinoma <\/a>(ZE syndrome) 50%, <a href=\"http:\/\/www.modestosurgery.com\/surgeryblog\/somatostatinoma-glucagonoma-insulinoma-vipoma-gastrinoma\/\">Insulinoma <\/a>20%<\/li>\n<li>Pituitary tumors (66%)<\/li>\n<\/ul>\n<p>Other tumors associated with MEN I = adenomas of Adrenal 30% and Thyroid 15%<\/p>\n<p><strong><span style=\"font-family: Bitter, Georgia, serif; font-size: 22px; line-height: 1.3;\"><span style=\"color: #99cc00;\">MEN II<\/span>A<\/span><\/strong><\/p>\n<p>Most common tumors: <em>mnemonic MPH &#8211; 2 miles per hour<\/em><\/p>\n<ul>\n<li>Medullary thyroid carcinoma 100%<\/li>\n<li>Pheochromocytoma 33%<\/li>\n<li><strong>Hyperparathyroidism<\/strong> (50%), hypercalcemia<\/li>\n<\/ul>\n<p><strong><em><span style=\"color: #99cc00;\">100% of patients with MEN IIA have medullary carcinoma of the thyroid.<\/span><\/em><\/strong><\/p>\n<h3><span style=\"color: #99cc00;\">MEN II<\/span>B<\/h3>\n<p>Most common abnormalities: <em>mnemonic MMMP &#8211; 3M plastics<\/em><\/p>\n<ul>\n<li>Mucosal neuromas 100%<\/li>\n<li>Medullary thyroid carcinoma 85%<\/li>\n<li>Marfanoid<\/li>\n<li>Pheochromocytoma 50%<\/li>\n<\/ul>\n<p>Physical findings of MEN IIB: \u00a0Mucosal neuromas (mouth, eyes, etc), Marfanoid body shape, abnormal arch of foot, <strong>constipation<\/strong>.<\/p>\n<p>Major difference between MEN IIA and IIB: \u00a0MEN IIA has Hyperparathyroidism &#8211; hyperplasia, MEN IIB does not.<\/p>\n<p><span style=\"color: #0000ff;\">MEN I<\/span> and<span style=\"color: #99cc00;\"> MEN II<\/span>A have hyperplasia of the parathyroid &#8211; treated with removal of all parathyroid tissue with autotransplant of some parathyroid tissue &#8211; perhaps into the forearm.<\/p>\n<p><a href=\"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-content\/uploads\/2013\/10\/Multiple_endocrine_neoplasia.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-124\" alt=\"Multiple_endocrine_neoplasia\" src=\"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-content\/uploads\/2013\/10\/Multiple_endocrine_neoplasia-300x256.png\" width=\"300\" height=\"256\" srcset=\"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-content\/uploads\/2013\/10\/Multiple_endocrine_neoplasia-300x256.png 300w, http:\/\/www.modestosurgery.com\/surgeryblog\/wp-content\/uploads\/2013\/10\/Multiple_endocrine_neoplasia.png 700w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>Picture credit:<\/p>\n<p>http:\/\/commons.wikimedia.org\/wiki\/User:Mikael_H%C3%A4ggstr%C3%B6m<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>MEN syndromes Inherited as autosomal dominant All family members of a patient diagnosed with MEN syndromes should be screened for MEN. Types: \u00a0MEN I, MEN IIA, MEN IIB MEN I Most common tumors: \u00a0mnemonic &#8211; PPP (all the P&#8217;s are followed by a vowel) Parathyroid hyperplasia (90% of patients have this) Pancreatic islet cell tumors &hellip; <a href=\"http:\/\/www.modestosurgery.com\/surgeryblog\/multiple-endocrine-neoplasias\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Multiple Endocrine Neoplasias<\/span> <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[240,239],"tags":[241,244,242,245],"class_list":["post-118","post","type-post","status-publish","format-standard","hentry","category-men","category-multiple-endocrine-neoplasias","tag-autosomal-dominant","tag-medullary-thyroid-carcinoma","tag-parathyroid-hyperplasia","tag-zollenger-ellison"],"_links":{"self":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts\/118","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/comments?post=118"}],"version-history":[{"count":7,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts\/118\/revisions"}],"predecessor-version":[{"id":161,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts\/118\/revisions\/161"}],"wp:attachment":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/media?parent=118"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/categories?post=118"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/tags?post=118"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}