Which glands are usually involved?

• Parathyroid glands – control calcium

• Pituitary gland – controls many hormones

• Pancreas (endocrine part) – insulin, gastrin, etc.

• Thyroid gland

• Adrenal glands

Q3. Are there different types of MEN?

Yes. Mainly MEN 1 and MEN 2.

MEN TYPE 1 (MEN 1)

Q4. What is MEN 1 also called?

“3 P Syndrome” because it affects:

• Parathyroid

• Pancreatic endocrine tumors

• Pituitary

Q5. What symptoms occur in MEN 1?

1. Parathyroid Tumors (Most Common)

• High calcium

• Kidney stones

• Bone pain

• Constipation

• Weakness

• Depression

2. Pancreatic Endocrine Tumors

Depends on hormone:

Tumor                                         Symptoms

Insulinoma                        Low sugar, sweating, fainting

Gastrinoma                      Severe ulcers, acidity

Glucagonoma                 Weight loss, rash, diabetes

3. Pituitary Tumors

• Headache

• Vision problems

• Irregular periods

• Milk discharge

• Infertility

Q6. What is the genetic cause of MEN 1?

• MEN1 gene mutation

• Autosomal Dominant → 50% chance to children

• Family screening is very important

MEN TYPE 2 (MEN 2)

Q7. What glands are involved in MEN 2?

• Thyroid (Medullary Thyroid Cancer)

• Adrenal (Pheochromocytoma)

• Parathyroid (sometimes)

Q8. Types of MEN 2?

• MEN 2A

• MEN 2B

• Familial Medullary Thyroid Cancer (FMTC)

Q9. Symptoms of MEN 2

Medullary Thyroid Cancer

• Neck swelling

• Difficulty swallowing

• Hoarseness

• Lymph node enlargement

Pheochromocytoma

• Headache

• Sweating

• Palpitations

• High BP

MEN 2B Additional Features

• Thick lips

• Tongue nodules

• Tall thin body

• Intestinal problems

Q10. Genetic Cause of MEN 2

• RET gene mutation

• Autosomal Dominant inheritance

• Genetic testing is crucial

DIAGNOSIS OF MEN SYNDROME

Q11. How is MEN diagnosed?

1. Blood Tests

• Calcium

• Hormone levels

• Calcitonin

• Insulin, Gastrin, Prolactin

2. Imaging

• Ultrasound

• CT / MRI

• Nuclear scans

3. Genetic Testing

• Very important

• Tests family members

• Detects disease early

ROLE OF SURGERY IN MEN

Surgery is often the main treatment.

MEN 1 – Surgery

Parathyroid

• Subtotal or Total Parathyroidectomy

• Most common surgery

Pancreatic Tumors

• Tumor removal

• Sometimes partial pancreas removal

Pituitary

• Brain surgery through nose (Transsphenoidal)

MEN 2 – Surgery

Thyroid (Very Important)

• Total Thyroidectomy

• Often done preventively in children with RET mutation

Adrenal (Pheochromocytoma)

• Adrenalectomy

• Must control BP before surgery

FOLLOW-UP IN MEN SYNDROME

Q12. Why is follow-up important?

Because tumors can:

• Recur

• Appear in new glands

• Become cancerous

Q13. What follow-up is needed?

Life-long monitoring:

• Blood tests yearly

• Hormone levels

• Imaging scans

• Genetic counseling

• Family screening

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Final Take-Home Message

• MEN is genetic and lifelong.

• Early diagnosis + genetic testing saves lives.

• Surgery plays a major role, especially thyroid and parathyroid surgery.

• Regular follow-up and family screening are essential.