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Multinodular Adrenal Hyperplasia as a Part of Multiple Endocrine Neoplasia Type 1: A Case Report and Literature Review
摘要
Background. Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominantly inherited disease, characterized primarily by parathyroid tumors or hyperplasia, gastroenteropancreatic neuroendocrine tumors (GEP NET), and pituitary adenomas. With the development of imaging techniques, adrenal involvement is detected with increasing frequency in MEN1 and constitutes a significant clinical problem. Methods. We described a case of MEN1 with concomitant multinodular adrenal hyperplasia, in addition to parathyroid adenoma and pituitary prolactinoma. Results. A 46-year-old man was referred to the division of endocrinology with recurrent primary hyperparathyroidism and multinodular adrenal hyperplasia, which was discovered incidentally on abdominal computed tomography (CT) in the year 2015. Further endocrine investigations revealed hyperprolactinemia without any evidence of adrenal hypersecretion. Magnetic resonance imaging (MRI) of sella turcica detected a pituitary microadenoma. The patient was diagnosed to have a prolactinoma. Based on these findings, a diagnosis of MEN1 was made with co-existing parathyroid adenoma, pituitary prolactinoma, and multinodular adrenal hyperplasia. Conclusion. MEN1 patients with adrenal involvement require greater scrutiny due to their increased risk for malignancy. A careful, long-term follow-up is important.