Brian Wosnitzer: gro. WosnitzerContact Dr. Wosnitzer gro. Copyright © The Authors. Abstract Multiple endocrine neoplasia 1 MEN 1 is a rare genetic disorder classically characterized by a predisposition to tumors of the parathyroid glands, anterior pituitary gland, and adenoma hypophysis mri islet cells 1.
In addition to exhibiting these characteristic tumors, MEN 1 patients also have an increased propensity for other tumors such as carcinoids, adrenal adenomas, angiofibromas, and lipomas 123.
Although MEN 1 is rare, with a prevalence of approximately 2 perpeople, recognition of this syndrome is extremely important for both patient treatment and evaluation of family members 14.
The tumors of MEN 1 are usually benign; however, malignancy of some carcinoid, islet cell, and gastrointestinal tract tumors can cause mortality 5678. Diagnosis of MEN 1 is usually made by a combination of history and physical examination, biochemical serum testing, and various imaging modalities 9 We present a classic case of MEN 1 with unique presentation and diagnosis using predominantly nuclear imaging in order to emphasize the role of nuclear imaging in diagnosing and treating MEN 1.
Abbreviations: CT, computed tomography; MRI, magnetic resonance imaging; MEN 1, multiple endocrine neoplasia 1; EGD, esophagogastroduodenoscopy Case report The patient, a year-old male with a history of peptic ulcer disease, presented to the emergency department after syncope. EGD revealed no gross lesions in the esophagus; however, enlarged gastric folds, duodenal erosion, and two umbilicated nodules were found in the duodenum with no evidence of active bleeding.
After receiving four units of packed red blood cells and not responding appropriately, the patient underwent a nuclear medicine gastrointestinal bleeding scan for evaluation of a bleeding source.
Images show bleeding in the distribution of the small bowel Fig.