Multiple Endocrine Neoplasia (MEN) Overview

Tampa General Hospital’s Pituitary Tumor Center proudly offers treatment for multiple endocrine neoplasia (MEN), a group of genetic disorders that affect various glands and tissues within the endocrine system. The endocrine system produces and releases certain hormones that help regulate numerous bodily functions, and MEN can disrupt normal endocrine function. MEN is relatively rare, with the National Library of Medicine (NIH) estimating that the most common type (type 1) affects only one in 35,000 people.

Multiple Endocrine Neoplasia Types

The medical community generally classifies multiple endocrine neoplasia into the following three types:

  • Multiple endocrine neoplasia type 1 (MEN-1) – Also referred to as multiple endocrine adenomatosis or Wermer’s syndrome, MEN-1 is a genetic condition that causes tumors to develop in multiple endocrine glands and tissues, including the pancreas, parathyroid glands and pituitary gland. This usually causes the affected glands to release excess hormones into the bloodstream, leading to various issues. While the tumors caused by MEN-1 are typically benign (noncancerous), they can sometimes be malignant (cancerous). This is the most common type of MEN.
  • Multiple endocrine neoplasia type 2 (MEN-2) – Commonly known as Sipple syndrome, MEN-2 is a genetic polyglandular cancer syndrome that leads to medullary thyroid cancer and increases the risk of developing tumors affecting other endocrine glands. Individuals with MEN-2 also develop hyperparathyroidism (an overactive parathyroid gland) and/or pheochromocytoma (a tumor located in the center of one or both adrenal glands).
  • Multiple endocrine neoplasia type 4 (MEN-4) – MEN-4 produces many of the same symptoms as MEN-1 but is caused by different genetic mutations. This is the least common type of MEN.

Causes and Risk Factors of Multiple Endocrine Neoplasia

Since multiple endocrine neoplasia is a genetic condition, it’s caused by certain genetic mutations. For example, MEN-1 is caused by mutations of the MEN1 gene, and MEN-2 is caused by mutations of the RET gene. These genetic mutations can either be inherited or occur randomly before birth. Unfortunately, there’s nothing you can do to prevent MEN.

Because the genetic mutations that lead to MEN can be inherited, having a family member who has MEN (especially a biological parent or sibling) can increase your risk of developing the condition. If that’s the case for you, you may want to consider speaking to a medical provider about undergoing screening—even if you’re not experiencing any symptoms—since genetic testing could help detect any tumors while they’re still in their early stages.

Signs and Symptoms of Multiple Endocrine Neoplasia

Symptoms vary from one person to another depending on factors such as the type of multiple endocrine neoplasia present and the glands and tissues being affected. For example:

  • Gastrinomas (tumors that produce gastrin) can cause abdominal pain, acid reflux, diarrhea and peptic ulcers.
  • Hyperparathyroidism can cause bone and joint pain, muscle weakness, increased thirst, more frequent urination, reduced appetite, constipation, nausea, vomiting, fatigue, depression, difficulty concentrating, confusion and memory problems.
  • Insulinomas (tumors that produce insulin) can cause heart palpitations, shakiness, sweating, hunger, anxiety, confusion and temporary vision changes.
  • Medullary thyroid cancer can cause a lump at the front of the neck, pain in the front of the neck, hoarseness, difficulty swallowing, coughing and shortness of breath.
  • Pheochromocytomas can cause headaches, hypertension (high blood pressure), an irregular heartbeat, shakiness and sweating.
  • Prolactinomas (tumors that produce prolactin) can cause headaches, vision changes, nausea, vomiting, infertility and reduced interest in sex. For men, they can also cause erectile dysfunction, and for women, they can also cause galactorrhea (milky nipple discharge) and menstrual changes (e.g., amenorrhea or irregular periods).

Diagnosing Multiple Endocrine Neoplasia

If a medical provider suspects that you have multiple endocrine neoplasia, they’ll likely order one or more of the following tests to confirm your diagnosis:

Multiple Endocrine Neoplasia Treatment

Researchers are still working to identify a cure for multiple endocrine neoplasia, but certain treatments can help manage the condition. The recommended approach will depend on a variety of factors, including the MEN type present, the glands and tissues being affected, the symptoms being produced and the patient’s age and overall health. With that said, MEN treatment may include:

TGH’s Approach to Treating Multiple Endocrine Neoplasia

If you’re experiencing the multiple endocrine neoplasia symptoms listed above, turn to Tampa General Hospital’s Pituitary Tumor Center for diagnosis and treatment. We take a multidisciplinary approach to patient care, holding dedicated monthly pituitary conferences and using state-of-the-art technology. Plus, we’re part of Tampa General Hospital’s Neuroscience Institute, which U.S. News & World Report named as one of the nation’s top 10% of hospitals for Neurology & Neurosurgery for 2023-24. Contact us at (800) 822-3627 to learn more and schedule a consultation at our Tampa, FL, treatment center.