Benjamín Zúñiga, Nicolás Carpo, Salvador Madrid, Néstor Soto
{"title":"[1型多发性内分泌瘤的临床分析]。","authors":"Benjamín Zúñiga, Nicolás Carpo, Salvador Madrid, Néstor Soto","doi":"10.4067/s0034-98872024000600724","DOIUrl":null,"url":null,"abstract":"<p><p>Multiple endocrine neoplasia type 1 (MEN1) is a rare autosomal dominant disease with an estimated prevalence of 2 per 100,000. This disease is caused by a mutation in the tumor suppressor gene MEN1, which is located on chromosome 11 and codifies the menin protein. It is characterized by a predisposition of parathyroids, enteropancreatic, and anterior pituitary tumors, affecting the quality of life and lifespan of those who have the disease. Clinical case: We present a case of a 24-year-old woman with recurrent episodes of symptomatic hypoglycemia and first-degree relatives who were diagnosed with insulinoma. Initial studies showed endogenous hyperinsulinism secondary to two pancreatic tumors, the main one measured 8.2 × 4.2 cm, and PTH-dependent hypercalcemia secondary to a parathyroid adenoma. Further studies, based on magnetic resonance imaging of the pituitary, showed a macroadenoma. Additionally, we performed a genetic study that evidenced a deletion in the IAT gene, which is compatible with MEN1 syndrome. Pancreatic and parathyroid surgery were performed, and function substitution therapies were initiated. Discussion: The diagnosis is established in the presence of two or more defining NEM1 tumors or at least one associated with compatible genetic testing or a first-degree relative with a history of MEN1. Screening and surveillance in patients with confirmed MEN1 diagnosis would enable the reduction of the disease burden, with a nonclear impact on lifespan.</p>","PeriodicalId":101370,"journal":{"name":"Revista medica de Chile","volume":"152 6","pages":"724-729"},"PeriodicalIF":0.0000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Review of Multiple Endocrine Neoplasia Type 1 Based on a Clinical Case].\",\"authors\":\"Benjamín Zúñiga, Nicolás Carpo, Salvador Madrid, Néstor Soto\",\"doi\":\"10.4067/s0034-98872024000600724\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Multiple endocrine neoplasia type 1 (MEN1) is a rare autosomal dominant disease with an estimated prevalence of 2 per 100,000. This disease is caused by a mutation in the tumor suppressor gene MEN1, which is located on chromosome 11 and codifies the menin protein. It is characterized by a predisposition of parathyroids, enteropancreatic, and anterior pituitary tumors, affecting the quality of life and lifespan of those who have the disease. Clinical case: We present a case of a 24-year-old woman with recurrent episodes of symptomatic hypoglycemia and first-degree relatives who were diagnosed with insulinoma. Initial studies showed endogenous hyperinsulinism secondary to two pancreatic tumors, the main one measured 8.2 × 4.2 cm, and PTH-dependent hypercalcemia secondary to a parathyroid adenoma. Further studies, based on magnetic resonance imaging of the pituitary, showed a macroadenoma. Additionally, we performed a genetic study that evidenced a deletion in the IAT gene, which is compatible with MEN1 syndrome. Pancreatic and parathyroid surgery were performed, and function substitution therapies were initiated. Discussion: The diagnosis is established in the presence of two or more defining NEM1 tumors or at least one associated with compatible genetic testing or a first-degree relative with a history of MEN1. Screening and surveillance in patients with confirmed MEN1 diagnosis would enable the reduction of the disease burden, with a nonclear impact on lifespan.</p>\",\"PeriodicalId\":101370,\"journal\":{\"name\":\"Revista medica de Chile\",\"volume\":\"152 6\",\"pages\":\"724-729\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista medica de Chile\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4067/s0034-98872024000600724\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista medica de Chile","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4067/s0034-98872024000600724","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
[Review of Multiple Endocrine Neoplasia Type 1 Based on a Clinical Case].
Multiple endocrine neoplasia type 1 (MEN1) is a rare autosomal dominant disease with an estimated prevalence of 2 per 100,000. This disease is caused by a mutation in the tumor suppressor gene MEN1, which is located on chromosome 11 and codifies the menin protein. It is characterized by a predisposition of parathyroids, enteropancreatic, and anterior pituitary tumors, affecting the quality of life and lifespan of those who have the disease. Clinical case: We present a case of a 24-year-old woman with recurrent episodes of symptomatic hypoglycemia and first-degree relatives who were diagnosed with insulinoma. Initial studies showed endogenous hyperinsulinism secondary to two pancreatic tumors, the main one measured 8.2 × 4.2 cm, and PTH-dependent hypercalcemia secondary to a parathyroid adenoma. Further studies, based on magnetic resonance imaging of the pituitary, showed a macroadenoma. Additionally, we performed a genetic study that evidenced a deletion in the IAT gene, which is compatible with MEN1 syndrome. Pancreatic and parathyroid surgery were performed, and function substitution therapies were initiated. Discussion: The diagnosis is established in the presence of two or more defining NEM1 tumors or at least one associated with compatible genetic testing or a first-degree relative with a history of MEN1. Screening and surveillance in patients with confirmed MEN1 diagnosis would enable the reduction of the disease burden, with a nonclear impact on lifespan.