Thereafter, He had no hypoglycemia however, he developed hypoparathyroidism. Histopathology confirmed a well-differentiated pancreatic neuroendocrine tumor, and a 9 mm Papillary Thyroid Cancer (PTC) (pT1aN0).
#Insulinoma on mri sag localizer plus
The multidisciplinary team recommended cabergoline, insulinoma surgery, and total thyroidectomy plus total parathyroidectomy with autoimplantation of the parathyroid. Thyroid nodules FNA showed follicular neoplasm. MEN1 was clinically diagnosed and confirmed by genetic testing. He had prolactin > 100000 (85-323 mIU/L), IGF-1 456 (96-228 ug/L), secondary hypogonadism and secondary hypothyroidism. MRI abdomen showed a pancreatic lesion suggestive of insulinoma. Sestamibi scan revealed parathyroid gland hyperplasia. During hospitalization, he developed hypoglycemia 1.6 mmol/L with C-peptide 5.48 (1.10-4.4 ng/mL), and insulin 22.8 (2.6-24.9 mcunit/mL). He received intravenous saline, calcitonin, and zoledronate. He was vitally stable, dehydrated with coarse facial features, nodular goiter, and trunk neurofibroma-like lesions. A 30- year-old man presented with abdominal pain. We report a patient with MEN1 and present a comprehensive literature review. Multiple endocrine neoplasia type 1 (MEN1) is rare and characterized by 3 main endocrine tumors (parathyroid, enteropancreatic, and pituitary).
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