Endocrine Abstracts

Multiple endocrine neoplasia type 1 is a rare autosomal-dominant disorder. The most common endocrine tumors are parathyroid tumors, which cause hyperparathyroidism and hypercalcemia. Other tumors of MEN 1 include pituitary tumors for example prolactinomas and enteropancreatic tumors such as gastrinomas, insulinomas, VIPomas, carcinoid tumors. We report a case of a 31 year old male with MEN 1 presenting hypercalcemia with complaints of fatigue and weakness. On further questioning, the patient reported to headache and decreased libido. Laboratory results revealed: serum calcium: 11.27 mg/dl (8.6–110), intact parathormone: 101.1 pg/ml (15–165) phosphor: 2.64 mg/dl (2.6–14.5), prolactin: 1597 ng/ml (4.04–115.2), gastrin 17 pg/ml (13–1115), insulin: 19.79 uU/ml. A cranial MRI revealed 3 cm diameter cystic macroadenoma on the center of pituitary gland. The upper abdominal MRI was scanned for exploratory purpose and did not revealed any tumors. Hyperparathyroidism and pituitary macroadenoma were accepted as MEN 1 components. The patient underwent the operation for resectomy of the pituitary mass. Parathyroidectomy and profilactic thymectomy operations were planned. Although hypercalcemia with hyperprolactinemia is a a rare condition, it should be kept in mind that finding of hyperparathyroidism and hyperprolactinemia togetherness may be the signs of the Men 1 syndrome.

Keywords: MEN 1, hyperparathyroidism, pituitary tumors, pancreatic tumors.