Multiple Endocrine Neoplasia (MEN) Type 1 Screening Guidelines and Diagnostic Services

MEN Type 1 Screening Guidelines

If a family member has a history of MEN1, the Scott & White Genetics Clinic and your Integrated Care Team encourage careful watching over the course of your lifetime.

Here are our management and early screening recommendations for MEN1:

  • Annual Biochemical Screening
    • Total calcium and/or ionized calcium: at age 8
    • Gastrin: at age 20
    • Prolactin: at age 5
    • Pancreatic polypeptide: determined by your physician
  • Imaging, Every 1 to 3 Years or as Determined by Your Physician
    • Head MRI: at age 5
    • Abdominal CT or MRI: at age 15-20
    • Possible:
      • Annual chest CT*
      • Somatostatin receptor scintigraphy (OctreoTide scan)*
      *The testing interval depends on biochemical evidence of neoplasia and/or signs of symptoms of MEN1-related tumors
  • Surgery
    • Prophylactic thymectomy (males) — surgical removal of the thymus, which manufactures T-lymphocytes (key cells in your immune system), before tumor cells develop

MEN1 is suspected when you have tumors in at least two of the following glands:

  • Parathyroid gland
  • Pancreatic gland
  • Pituitary gland

Generally, your Integrated Care Team may use the following to make a diagnosis of MEN1:

  • Your family history
  • Genetic testing for the MEN1 gene
  • A series of imaging and laboratory tests to determine which hormones are being overproduced

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MEN Type 1 Diagnostic Services

If you have symptoms that suggest you may have MEN1, your physician may order one or more of the following tests to confirm that you have MEN1.

Imaging Tests

Laboratory Tests

Blood Tests

Your physician may order the following blood tests:

  • Gastrin. Elevated levels may indicate tumors in the islet cells of the pancreas or duodenum
  • Prolactin. Elevated levels may indicate tumors in the pituitary gland
  • Pancreatic polypeptide (PP). Elevated levels may indicate tumors in the pancreas
  • Fasting VIP. Elevated levels may indicate tumors in the pancreas
  • Glucagon. Elevated levels may indicate tumors in the pancreas

Total Calcium or Ionized-Calcium Level Test

Tumors in parathyroid gland in some cases will cause an overproduction of the parathyroid hormone (PTH), increasing the levels of calcium in your blood. Your physician may order a total-calcium or ionized-calcium level test to check for elevated levels of calcium in your blood.

Somatostatin Receptor Scintigraphy (OctreoTide Scan)

Your physician may order somatostatin receptor scintigraphy if he or she suspects you may have endocrine tumors of the pancreas or GI tract.

In this scan, the radioactive octreotide  (similar to your body’s somatostatin) will be injected into your bloodstream; it attaches to tumor cells that have receptors for somatostatin. A special radiation-detecting device placed in front of your neck measures radiation in your neck. The octreotide will reveal the presence of any tumor cells.

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Scott & White Cancer Genetics Services

If you have a family member with MEN1 or were diagnosed with two or more endocrine tumors, your physician will recommend that you have genetic counseling to determine whether you are a good candidate for MEN1 genetic testing.

Genetic counseling is available here at the Scott & White Cancer Genetics Clinic to help identify individuals and families who carry the MEN1 gene and are at an increased risk to develop MEN1.

The Scott & White Cancer Genetics Clinic is located at 3 South, Brindley Circles, Rooms 341 and 342. For more information, please call 254-724-3379.

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