Multiple endocrine neoplasia type 1 medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [3]
Overview
Pharmacologic medical therapies for multiple endocrine neoplasia type 1 include cabergoline, somatostatin analogues, and H2- receptor blockers.
Medical Therapy
- Medical therapy of MEN-1 includes[1][2][3][4][5][6]
- Because the type of pancreatic endocrine cancer associated with multiple endocrine neoplasia type 1 can be difficult to recognize, difficult to treat, and slow to progress, there are different views about the value of surgery in managing these tumors.
- One approach is to "watch and wait," using medical, or nonsurgical, treatments. According to this school of thought, pancreatic surgery has serious complications, so it should not be attempted unless it will cure a tumor or cure a hormone excess state.
- Excessive release of certain hormones mainly gastrin from pancreatic endocrine cancer in multiple endocrine neoplasia type 1 needs to be treated, and medications are often effective in blocking the effects of these hormones.
- Cabergoline is the treatment of choice for prolactinomas.
- Somatostatin analogues such as octreotide or lanreotide are used for the treatment of growth hormone secreting tumors.
- H2-receptor antagonists and proton pump inhibitors are used to reduce the gastric output in gastrinomas.
References
- ↑ Moyes VJ, Monson JP, Chew SL, Akker SA (2010). "Clinical Use of Cinacalcet in MEN1 Hyperparathyroidism". Int J Endocrinol. 2010: 906163. doi:10.1155/2010/906163. PMC 2877200. PMID 20585352.
- ↑ [1] Multiple Endocrine Neoplasia Type 1
- ↑ Sheppard BC, Norton JA, Doppman JL, Maton PN, Gardner JD, Jensen RT (1989). "Management of islet cell tumors in patients with multiple endocrine neoplasia: a prospective study". Surgery. 106 (6): 1108–17, discussion 1117–8. PMID 2573957.
- ↑ Metz DC, Strader DB, Orbuch M, Koviack PD, Feigenbaum KM, Jensen RT (1993). "Use of omeprazole in Zollinger-Ellison syndrome: a prospective nine-year study of efficacy and safety". Aliment. Pharmacol. Ther. 7 (6): 597–610. PMID 8161665.
- ↑ Sadowski SM, Triponez F (2015). "Management of pancreatic neuroendocrine tumors in patients with MEN 1". Gland Surg. 4 (1): 63–8. doi:10.3978/j.issn.2227-684X.2014.12.01. PMC 4321051. PMID 25713781.
- ↑ Demeure MJ, Klonoff DC, Karam JH, Duh QY, Clark OH (1991). "Insulinomas associated with multiple endocrine neoplasia type I: the need for a different surgical approach". Surgery. 110 (6): 998–1004, discussion 1004–5. PMID 1684067.