WHEN EVEN THE CLASSICS REQUIRE CLOSE SURVEILLANCE – A TYPICAL CASE OF MEN SYNDROME

  • Irina Zaharia “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
  • R. M. Mirică “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; Department of General Surgery, “St. John” Emergency Clinical Hospital, Bucharest, Romania
  • R. Iosifescu “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; Department of General Surgery, “St. John” Emergency Clinical Hospital, Bucharest, Romania
  • T. N. Dumitrașcu “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; Department of General Surgery, Fundeni Clinical Institute, Bucharest, Romania
  • Ioana Michaela Stănel “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; Department of Gastroenterology, Fundeni Clinical Institute, Bucharest, Romania
  • Mara Mardare Department of General Surgery, “St. John” Emergency Clinical Hospital, Bucharest, Romania
  • Andrada Spânu Department of General Surgery, “St. John” Emergency Clinical Hospital, Bucharest, Romania
  • N. Iordache “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; Department of General Surgery, “St. John” Emergency Clinical Hospital, Bucharest, Romania
  • O. Ginghină “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; Department of General Surgery, “St. John” Emergency Clinical Hospital, Bucharest, Romania
Keywords: MEN syndrome, parathyroid adenomas, corporeal-caudal pancreatectomy

Abstract

The genetic syndrome known in literature as the Multiple Endocrine Neoplasia type 1 (MEN 1) is
transmitted in a dominant manner. The primary discovery of more than two endocrine tumor
formations representative for MEN 1 should guide the doctor to the suspicion and subsequent
confirmation of the diagnosis. Statistics state a long association of the MEN 1 syndrome with the
tumors discovered in the small intestine and the pancreas with the adenomas encountered in the
parathyroid and pituitary glandular tissueWhile in postmenopausal women, the primary
hyperparathyroidism is diagnosed mostly with abnormal levels of parathyroid hormone and serum
calcium specifically. The most useful preoperative imaging tools are neck ultrasound scanning and
technetium-99m sestamibi scintigraphy. Using bilateral neck exploration, subtotal, and
parathyroidectomy are proposed. Our case consists of a 54 years old female, diagnosed with right
inferior parathyroid adenoma. With three first degree relatives operated for neuroendocrine
pancreatic tumors, her medical history includes distal corporeal-caudal pancreatectomy for a
neuroendocrine tumor four years ago. Laboratory tests unveil increased calcium (12, 41 mg/dl) and
glucose (150 mg/dl) levels. During hospitalization, the patient’s representative parameters for
monitoring hyperparathyroidism maintained at high levels. Parathyroid ultrasound and the 99mTctetrofosmin/99mTc-pertechnetate parathyroid scintigraphy sustained the diagnosis. Consequently,
the patient was proposed for a subtotal parathyroidectomy with a pathology examination. It is highly
recommended the interdisciplinary cooperation for the monitoring and management of patients with
suspicion of MEN 1. The annual assessment of serum calcium level, together with the parathyroid
hormones, is proposed as a screening tool in early diagnosis.

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Published
2020-09-01
How to Cite
[1]
I. Zaharia, “WHEN EVEN THE CLASSICS REQUIRE CLOSE SURVEILLANCE – A TYPICAL CASE OF MEN SYNDROME”, JSS, vol. 7, no. 2, pp. 69-73, Sep. 2020.
Section
Articles