WHEN EVEN THE CLASSICS REQUIRE CLOSE SURVEILLANCE – A TYPICAL CASE OF MEN SYNDROME
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 diag...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Editura Universitara Carol Davila
2020-09-01
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| Series: | Journal of Surgical Sciences |
| Subjects: | |
| Online Access: | http://journalofsurgicalsciences.com/index.php/jss/article/view/354 |
| _version_ | 1818286341793775616 |
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| author | Irina Zaharia R. M. Mirică R. Iosifescu T. N. Dumitrașcu Ioana Michaela Stănel Mara Mardare Andrada Spânu N. Iordache O. Ginghină |
| author_facet | Irina Zaharia R. M. Mirică R. Iosifescu T. N. Dumitrașcu Ioana Michaela Stănel Mara Mardare Andrada Spânu N. Iordache O. Ginghină |
| author_sort | Irina Zaharia |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-13T01:23:04Z |
| format | Article |
| id | doaj.art-2aecd1a9864449f7bf75ac02f26384af |
| institution | Directory Open Access Journal |
| issn | 2360-3038 2457-5364 |
| language | English |
| last_indexed | 2024-12-13T01:23:04Z |
| publishDate | 2020-09-01 |
| publisher | Editura Universitara Carol Davila |
| record_format | Article |
| series | Journal of Surgical Sciences |
| spelling | doaj.art-2aecd1a9864449f7bf75ac02f26384af2022-12-22T00:04:11ZengEditura Universitara Carol DavilaJournal of Surgical Sciences2360-30382457-53642020-09-0172697310.33695/jss.v7i2.354354WHEN EVEN THE CLASSICS REQUIRE CLOSE SURVEILLANCE – A TYPICAL CASE OF MEN SYNDROMEIrina Zaharia0R. M. Mirică1R. Iosifescu2T. N. Dumitrașcu3Ioana Michaela Stănel4Mara Mardare5Andrada Spânu6N. Iordache7O. Ginghină8“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; Department of General Surgery, “St. John” Emergency Clinical Hospital, Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; Department of General Surgery, “St. John” Emergency Clinical Hospital, Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; Department of General Surgery, Fundeni Clinical Institute, Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; Department of Gastroenterology, Fundeni Clinical Institute, Bucharest, RomaniaDepartment of General Surgery, “St. John” Emergency Clinical Hospital, Bucharest, RomaniaDepartment of General Surgery, “St. John” Emergency Clinical Hospital, Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; Department of General Surgery, “St. John” Emergency Clinical Hospital, Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; Department of General Surgery, “St. John” Emergency Clinical Hospital, Bucharest, RomaniaThe 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.http://journalofsurgicalsciences.com/index.php/jss/article/view/354men syndromeparathyroid adenomascorporeal-caudal pancreatectomy |
| spellingShingle | Irina Zaharia R. M. Mirică R. Iosifescu T. N. Dumitrașcu Ioana Michaela Stănel Mara Mardare Andrada Spânu N. Iordache O. Ginghină WHEN EVEN THE CLASSICS REQUIRE CLOSE SURVEILLANCE – A TYPICAL CASE OF MEN SYNDROME Journal of Surgical Sciences men syndrome parathyroid adenomas corporeal-caudal pancreatectomy |
| title | WHEN EVEN THE CLASSICS REQUIRE CLOSE SURVEILLANCE – A TYPICAL CASE OF MEN SYNDROME |
| title_full | WHEN EVEN THE CLASSICS REQUIRE CLOSE SURVEILLANCE – A TYPICAL CASE OF MEN SYNDROME |
| title_fullStr | WHEN EVEN THE CLASSICS REQUIRE CLOSE SURVEILLANCE – A TYPICAL CASE OF MEN SYNDROME |
| title_full_unstemmed | WHEN EVEN THE CLASSICS REQUIRE CLOSE SURVEILLANCE – A TYPICAL CASE OF MEN SYNDROME |
| title_short | WHEN EVEN THE CLASSICS REQUIRE CLOSE SURVEILLANCE – A TYPICAL CASE OF MEN SYNDROME |
| title_sort | when even the classics require close surveillance a typical case of men syndrome |
| topic | men syndrome parathyroid adenomas corporeal-caudal pancreatectomy |
| url | http://journalofsurgicalsciences.com/index.php/jss/article/view/354 |
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