Table 6.

Recommended Evaluations Following Initial Diagnosis in Individuals with MEN1

System/ConcernEvaluationComment
Multiglandular
parathyroid
disease
  • Fasting total serum calcium concentration (corrected for albumin) &/or ionized-serum calcium concentration
  • Consider fasting serum concentration of intact (full-length) PTH.
In those age ≥5 yrs
Anterior pituitary
tumors
  • Serum concentration of prolactin, IGF-1, fasting glucose, & insulin
  • Head MRI
In those age ≥5 yrs
Well-differentiated
endocrine tumors
of the GEP tract 		Chromogranin-A, pancreatic polypeptide, glucagon, vasoactive intestinal peptide for other pancreatic NETIn those age ≥8 yrs
  • Fasting serum gastrin concentration
  • Consider abdominal CT, MRI, or EUS exam.
In those age ≥20 yrs
Carcinoid tumors Consider: 1
  • Chest CT;
  • Chest MRI;
  • SRS octreotide scan.
In those age ≥15 yrs
Non-endocrine
tumors 		Skin exam
Genetic
counseling 		By genetics professionals 2To inform affected persons & their families re nature, MOI, & implications of MEN1 to facilitate early diagnostic, medical, therapeutic & personal decision making

EUS = endoscopic ultrasound; GEP = gastroenteropancreatic; MOI = mode of inheritance; PTH = parathyroid hormone; SRS = somatostatin receptor scintigraphy

1.

Chest CT and MRI have better sesitivity than either chest x-ray or somatostatin receptor scintigraphy (SRS) scan in detecting either primary or recurrent thymic carcinoid [Gibril et al 2003, Scarsbrook et al 2007, Goudet et al 2009].

2.

Medical geneticist, certified genetic counselor, certified advanced genetic nurse

From: Multiple Endocrine Neoplasia Type 1

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