Coexistence of pituitary incidentaloma and primary hyperparathyroidism mimicking multiple endocrine neoplasia Type 1: A case report
Coexistence of pituitary incidentaloma and primary hyperparathyroidism mimicking multiple endocrine neoplasia Type 1: A case report
The widespread use of imaging procedures has led to an increased discovery of incidental masses in the pituitary gland. Although the majority of pituitary incidentalomas are non-functioning benign adenomas but their increased prevalence poses a diagnostic and therapeutic challenge. These masses may cause various hormonal disturbances as well as they might also be a component of multiple endocrine neoplasia syndromes type 1 (MEN-1) or type 4 (MEN-4). In both syndromes, primary hyperparathyroidism frequently accompanies with pituitary adenomas. Herein we present a 56-year-old man with pituitary incidentaloma who is also detected primary hyperparathyroidism. Contrary to our expectations, any gene defects could be found related with neither MEN-1 nor MEN-4 in the genetic examinatio
___
- 1. Vasilev V, Rostomyan L, Daly AF, et al. Management of Endocrine Disease: Pituitary ‘incidentaloma’: neuroradiological assessment and differential diagnosis. Eur J Endocrinol 2016;175:171-84.
- 2. Freda PU, Beckers AM, Katznelson L, et al. Pituitary incidentaloma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2011;96:894-904.
- 3. Molitch ME. Pituitary tumours: pituitary incidentalomas. Best Practice & Research: Clinical Endocrinology & Metabolism 2009;23:667-75.
- 4. Yue NC, Longstreth WT Jr, Elster AD, et al. Clinically serious abnormalities found incidentally at MR imaging of the brain: data from the Cardiovascular Health Study. Radiology 1997;202:41-6.
- 5. Vernooij MW, Ikram MA, Tanghe HL, et al. Incidental findings on brain MRI in the general population. N Engl J Med 2007;357:1821-8.
- 6. Tichomirowa MA, Daly AF, Beckers A. Familial pituitary adenomas. J Intern Med 2009;266:5-18.
- 7. Pellegata NS, Quintanilla-Martinez L, Siggelkow H, et al. Germ-line mutations in p27Kip1 cause a multiple endocrine neoplasia syndrome in rats and humans. Proc Natl Acad Sci 2006;103:15558-63.
- 8. Anagnostis P, Adamidou F, Polyzos SA, et al. Pituitary incidentalomas: a single-centre experience. Int J Clin Pract Suppl 2011;65:172-7.
- 9. Thakker RV, Newey PJ, Walls GV, et al. Clinical practice guidelines for multiple endocrine neoplasia type 1 (MEN1). J Clin Endocrinol Metab 2012;97:2990-3011.
- 10. Hai N, Aoki N, Shlmatsu A, Mod T, et al. Clinical features of multiple endocrine neoplasia type 1 (MEN1) phenocopy without germline MEN1 gene mutations: analysis of 20 Japanese sporadic cases with MEN1. Clin Endocrinol 2000;52:509-18.
- 11. Burgess JR, Nord B, David R, et al. Phenotype and phenocopy: the relationship between genotype and clinical phenotype in a single large family with multiple endocrine neoplasia type 1 (MEN 1). Clin Endocrinol 2000;53:205-11.
- 12. Kövesdi A, Tóth M, Butz H, et al. True MEN1 or phenocopy?Evidencefor geno-phenotypiccorrelations in MEN1 syndrome. Endocrine 2019;65:451-9.
- 13. De Laat JM, Van Leeuwaarde RS, Valk GD. The Importance of an Early and Accurate MEN1 Diagnosis. Front. Endocrino 2018;533:1-8.
- 14. Yeh MW, Ituarte PHG, Zhou HC, et al. Incidence and prevalence of primary hyperparathyroidism in a racially mixed population. J Clin Endocrinol Metab 2013;98:1122-9.
- 15. Agarwal SK, Mateo CM, Marx SJ. Rare germline mutations in cyclin-dependent kinase inhibitor genes in multiple endocrine neoplasia type 1 and related states. J Clin Endocrinol Metab 2009;94:1826-34.