Multiple endocrine neoplasia type 1 secondary prevention: Difference between revisions
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==Overview== | ==Overview== | ||
According to the National | According to the National Cancer Institute, surveillance for multiple endocrine neoplasia type-1 by imaging studies such as brain [[MRI]], abdominal [[CT]], and abdominal [[MRI]] is recommended every 3-5 year among patients with [[pituitary tumor]]s and [[pancreatic neuroendocrine tumor]]s respectively. Biochemical tests such as serum [[prolactin]], [[insulin-like growth factor]] 1, fasting total serum [[calcium]], ionized [[calcium]], [[parathyroid hormone]], fasting serum [[gastrin]], [[chromogranin A]], pancreatic polypeptide, [[glucagon]] and vasoactive intestinal polypeptide are recommended every year for patients with [[pituitary tumor]]s, [[pancreatic neuroendocrine tumor]]s, and [[primary hyperparathyroidism]]. | ||
==Secondary Prevention== | ==Secondary Prevention== | ||
Surveillance for multiple endocrine neoplasia type 1 may employ a combination of biochemical tests and imaging. Available recommendations are summarized in the following table.<ref name=NCI>{{cite web | title = National Caner Institute Multiple endocrine neoplasia type 1 Surveillance| url =http://www.cancer.gov/types/thyroid/hp/medullary-thyroid-genetics-pdq#link/_775_toc }}</ref><ref name="urlMultiple endocrine neoplasia type 1 - Doherty - 2005 - Journal of Surgical Oncology - Wiley Online Library">{{cite web |url=http://onlinelibrary.wiley.com/doi/10.1002/jso.20181/full |title=Multiple endocrine neoplasia type 1 - Doherty - 2005 - Journal of Surgical Oncology - Wiley Online Library |format= |work= |accessdate=}}</ref> | Surveillance for multiple endocrine neoplasia type 1 may employ a combination of biochemical tests and imaging. Available recommendations are summarized in the following table.<ref name="NCI">{{cite web | title = National Caner Institute Multiple endocrine neoplasia type 1 Surveillance| url =http://www.cancer.gov/types/thyroid/hp/medullary-thyroid-genetics-pdq#link/_775_toc }}</ref><ref name="urlMultiple endocrine neoplasia type 1 - Doherty - 2005 - Journal of Surgical Oncology - Wiley Online Library">{{cite web |url=http://onlinelibrary.wiley.com/doi/10.1002/jso.20181/full |title=Multiple endocrine neoplasia type 1 - Doherty - 2005 - Journal of Surgical Oncology - Wiley Online Library |format= |work= |accessdate=}}</ref><ref name="urlIs Total Parathyroidectomy the Treatment of Choice for Hyper... : Annals of Surgery">{{cite web |url=http://journals.lww.com/annalsofsurgery/Abstract/2007/12000/Is_Total_Parathyroidectomy_the_Treatment_of_Choice.23.aspx |title=Is Total Parathyroidectomy the Treatment of Choice for Hyper... : Annals of Surgery |format= |work= |accessdate=}}</ref> | ||
{|style="border: 0px; font-size: 90%; margin: 3px; width: 700px;" align=center | {| style="border: 0px; font-size: 90%; margin: 3px; width: 700px;" align="center" | ||
! style="background:#4479BA; width: 400px" align=center|{{fontcolor|#FFF| Biochemical Test or Procedure}} | ! style="background:#4479BA; width: 400px" align="center" |{{fontcolor|#FFF| Biochemical Test or Procedure}} | ||
! style="background:#4479BA; width: 400px" align=center|{{fontcolor|#FFF| Condition Screened For}} | ! style="background:#4479BA; width: 400px" align="center" |{{fontcolor|#FFF| Condition Screened For}} | ||
! style="background:#4479BA; width: 400px" align=center|{{fontcolor|#FFF| Age Screening Initiated (y)}} | ! style="background:#4479BA; width: 400px" align="center" |{{fontcolor|#FFF| Age Screening Initiated (y)}} | ||
! style="background:#4479BA; width: 400px" align=center|{{fontcolor|#FFF| Frequency}} | ! style="background:#4479BA; width: 400px" align="center" |{{fontcolor|#FFF| Frequency}} | ||
|- | |- | ||
! style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''Serum prolactin''' and/or insulin-like growth factor 1 | ! style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''Serum prolactin''' and/or insulin-like growth factor 1 | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|[[Pituitary tumor]]s | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |[[Pituitary tumor]]s | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''5''' | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''5''' | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''Every 1 year''' | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''Every 1 year''' | ||
|- | |- | ||
! style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''Fasting total serum calcium and/or ionized calcium and parathyroid hormone''' | ! style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''Fasting total serum calcium and/or ionized calcium and parathyroid hormone''' | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|[[Parathyroid]][[tumor]]s and [[primary hyperparathyroidism]] | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |[[Parathyroid]][[tumor]]s and [[primary hyperparathyroidism]] | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''8''' | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''8''' | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''Every 1 year''' | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''Every 1 year''' | ||
|- | |- | ||
! style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''Fasting serum gastrin''' | ! style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''Fasting serum gastrin''' | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|Duodenopancreatic [[gastrinoma]] | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |Duodenopancreatic [[gastrinoma]] | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''20''' | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''20''' | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''Every 1 year''' | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''Every 1 year''' | ||
|- | |- | ||
! style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''Chromogranin A, pancreatic polypeptide, glucagon, and vasointestinal polypeptide''' | ! style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''Chromogranin A, pancreatic polypeptide, glucagon, and vasointestinal polypeptide''' | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|[[Pancreatic neuroendocrine tumor]]s | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |[[Pancreatic neuroendocrine tumor]]s | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''<10years''' | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''<10years''' | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''Every 1 year''' | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''Every 1 year''' | ||
|- | |- | ||
! style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''Fasting glucose and insulin''' | ! style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''Fasting glucose and insulin''' | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|[[Insulinoma]] | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |[[Insulinoma]] | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''5''' | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''5''' | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''Every 1 year''' | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''Every 1 year''' | ||
|- | |- | ||
! style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''Brain MRI''' | ! style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''Brain MRI''' | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|[[Pituitary tumor]]s | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |[[Pituitary tumor]]s | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left| '''5''' | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" | '''5''' | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''Every 3–5 year based on biochemical results''' | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''Every 3–5 year based on biochemical results''' | ||
|- | |- | ||
! style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''Abdominal CT or MRI''' | ! style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''Abdominal CT or MRI''' | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|[[Pancreatic neuroendocrine tumor]]s | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |[[Pancreatic neuroendocrine tumor]]s | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''20''' | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''20''' | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''Every 3–5 year based on biochemical results''' | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''Every 3–5 year based on biochemical results''' | ||
|- | |- | ||
! style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''Abdominal CT, MRI, or endoscopic US''' | ! style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''Abdominal CT, MRI, or endoscopic US''' | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|[[Pancreatic neuroendocrine tumor]]s | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |[[Pancreatic neuroendocrine tumor]]s | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''<10''' | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''<10''' | ||
| style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align=left|'''Every 1 year''' | | style="padding: 0 5px; font-size: 100%; background: #f0f0f0" align="left" |'''Every 1 year''' | ||
|} | |} | ||
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{{WS}} | {{WS}} | ||
{{WH}} | {{WH}} | ||
[[Category:Up-To-Date]] | |||
[[Category:Oncology]] | |||
[[Category:Medicine]] | |||
[[Category:Endocrinology]] | |||
[[Category:Surgery]] |
Latest revision as of 02:46, 27 November 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]
Overview
According to the National Cancer Institute, surveillance for multiple endocrine neoplasia type-1 by imaging studies such as brain MRI, abdominal CT, and abdominal MRI is recommended every 3-5 year among patients with pituitary tumors and pancreatic neuroendocrine tumors respectively. Biochemical tests such as serum prolactin, insulin-like growth factor 1, fasting total serum calcium, ionized calcium, parathyroid hormone, fasting serum gastrin, chromogranin A, pancreatic polypeptide, glucagon and vasoactive intestinal polypeptide are recommended every year for patients with pituitary tumors, pancreatic neuroendocrine tumors, and primary hyperparathyroidism.
Secondary Prevention
Surveillance for multiple endocrine neoplasia type 1 may employ a combination of biochemical tests and imaging. Available recommendations are summarized in the following table.[1][2][3]
Biochemical Test or Procedure | Condition Screened For | Age Screening Initiated (y) | Frequency |
---|---|---|---|
Serum prolactin and/or insulin-like growth factor 1 | Pituitary tumors | 5 | Every 1 year |
Fasting total serum calcium and/or ionized calcium and parathyroid hormone | Parathyroidtumors and primary hyperparathyroidism | 8 | Every 1 year |
Fasting serum gastrin | Duodenopancreatic gastrinoma | 20 | Every 1 year |
Chromogranin A, pancreatic polypeptide, glucagon, and vasointestinal polypeptide | Pancreatic neuroendocrine tumors | <10years | Every 1 year |
Fasting glucose and insulin | Insulinoma | 5 | Every 1 year |
Brain MRI | Pituitary tumors | 5 | Every 3–5 year based on biochemical results |
Abdominal CT or MRI | Pancreatic neuroendocrine tumors | 20 | Every 3–5 year based on biochemical results |
Abdominal CT, MRI, or endoscopic US | Pancreatic neuroendocrine tumors | <10 | Every 1 year |