🎧 Podcast Episode: Multiple Endocrine Neoplasia – MSRA Deep DiveWelcome to another high-yield episode of The Deep Dive, where today we unpack one of endocrinology’s most genetically complex topics: Multiple Endocrine Neoplasia (MEN). 🧬💥
Whether you're prepping for the MSRA exam or looking to master rare endocrine syndromes, this episode provides a structured, memorable breakdown of the MEN types, features, investigations, and management — with mnemonics and clarity throughout.
📚 What You’ll Learn in This Episode:
• 📖 Definition: MEN is a group of rare autosomal dominant genetic syndromes that cause tumours in multiple hormone-producing glands• 🧬 Genetics:
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MEN1 = MEN1 gene, chromosome 11
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MEN2A/2B = RET proto-oncogene, chromosome 10
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MEN4 = CDKN1B gene
• 🧠 Pathophysiology:Mutations cause unchecked cell growth → hormone-secreting tumors in parathyroid, pancreas, pituitary, thyroid, adrenal, and more
🔢 Types of MEN and Mnemonics:
🧩 MEN1 – “3 Ps”
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Parathyroid (hyperparathyroidism – most common)
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Pancreatic/Gastro tumors (e.g. gastrinoma, insulinoma)
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Pituitary tumors (e.g. prolactinoma, acromegaly)
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Skin clues: angiofibromas, lipomas, collagenomas
🧬 MEN2A – “2 Ps + MTC”
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Parathyroid (hyperparathyroidism)
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Pheochromocytoma
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Medullary Thyroid Carcinoma (MTC) – early and common
🧬 MEN2B – “1 P + MTC + Physical Features”
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Pheochromocytoma
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MTC – aggressive and earlier onset
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Marfanoid habitus
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Mucosal neuromas (e.g. lips, tongue)
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GI neuromas and delayed puberty also possible
🧪 MEN4 – Very rare, overlaps with MEN1 but caused by CDKN1B mutations
🩺 Clinical Features:
• Hormonal syndromes:
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Hypercalcemia from parathyroid tumors
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Zollinger-Ellison syndrome (gastrinomas)
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Hypoglycemia (insulinomas)
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Acromegaly, amenorrhea, Cushing’s (pituitary tumors)• MTC: neck lump, flushing, diarrhoea, itch• Pheochromocytoma: episodic hypertension, sweating, tachycardia• Distinct physical signs in MEN2B: tall stature, mucosal neuromas
🧪 Investigations:
• Genetic testing is key
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MEN1 gene testing RET proto-oncogene testing (MEN2)
• Hormone markers:
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Calcium, PTH, gastrin, prolactin, insulin
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Catecholamines/VMA (pheochromocytoma)
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Calcitonin & CEA (for MTC)
• Imaging: CT, MRI, US, MIBG scan as appropriate
• Skin signs: helpful early clues in MEN1
⚕️ Management Overview:
• 🧬 Multidisciplinary: endocrinology, surgery, genetics• Surgical treatment:
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Parathyroidectomy, thyroidectomy, adrenalectomy
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Prophylactic thyroidectomy for RET mutations (MEN2)
• Medical therapy:
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PPI for gastrinomas
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Diazoxide for insulinomas
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Hormone replacement as needed
• Lifelong surveillance:
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Annual screening from age 10+ for at-risk individuals
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Monitor calcitonin, CEA, calcium, PTH, catecholamines
🚨 Complications & Prognosis:
• Tumor-related: MTC metastases, severe hypercalcemia, insulinoma-induced hypoglycemia• Surgical: nerve damage, hypoparathyroidism
• MEN1: higher risk of malignant pancreatic tumors
• MEN2B: often poorer prognosis due to early aggressive MTC• Early diagnosis + regular monitoring improves survival and quality of life
🧠 High-Yield Mnemonics Recap:
• MEN1 – “3 Ps” = Parathyroid, Pancreas, Pituitary
• MEN2A – “2 Ps + MTC”
• MEN2B – “1 P + MTC + Physical Features”
📚 MSRA Learning Resources:
🗂️ Revision Notes
https://www.passthemsra.com/topic/mul...
🧠 Flashcards
https://www.passthemsra.com/topic/mul...
❓ Accordion Q&A
https://www.passthemsra.com/topic/mul...
🔥 Rapid Quiz
https://www.passthemsra.com/topic/mul...
🎯 Final Takeaway:
MEN syndromes are rare but crucial to know – especially if you encounter unusual endocrine tumors or strong family history. Early screening, genetic testing, and multidisciplinary care save lives. 🔍🧬
#MSRA #Endocrinology #MENsyndromes #MEN1 #MEN2A #MEN2B #RETgene #MSRARevision #MSRAFlashcards #MedicalPodcast #GeneticDisorders #MultipleEndocrineNeoplasia
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