Multiple Endocrine Neoplasia Type 1 (MEN1) Syndrome Clinical Presentation and the Role of Newer Functional Imaging in the Diagnosis and Management: A Case Report.

Multiple endocrine neoplasia type 1 (MEN1) is a rare genetic disorder characterized by the development of both benign and malignant tumors in the pituitary, parathyroid, and pancreatic glands. These tumors cause hormonal imbalances that lead to various clinical manifestations, including hyperparathyroidism, abdominal pain, and mental disturbances. The management of MEN1 requires accurate detection and localization of these tumors, making imaging a critical tool. In the management of MEN1, various imaging modalities are employed to detect, monitor, and assess tumor progression. Imaging techniques include conventional imaging such as computed tomography (CT) and magnetic resonance imaging (MRI). However, functional imaging, particularly 68Ga-DOTATATE PET/CT, has emerged as a highly effective approach for detecting neuroendocrine tumors associated with MEN1 and providing crucial data for long-term surveillance. We present a case of a patient with MEN1 who presented with clinical symptoms of hyperparathyroidism. The patient was found to have adenomas in the pituitary, parathyroid, and pancreatic glands, consistent with the manifestations of MEN1. A combination of imaging techniques, including CT, MRI, and 68Ga-DOTATATE PET/CT scans, was utilized to detect and localize the tumors, guiding further clinical management. This case highlights the increased importance of functional imaging, particularly 68Ga-DOTATATE PET/CT, in the diagnosis and management of MEN1. The ability to detect and monitor tumors in multiple endocrine glands plays a crucial role in improving patient outcomes through more targeted treatment strategies and long-term surveillance.