Features of multiple endocrine neoplasia type 1 the patient 48 years (MEN-1 in a patient of 48)

Given the unique observation of atypical MEN­1 (mixed version) of a man 48 years old, due to the presence 9 of multiple tumors and hyperplasia in 8 different organs (parathyroid glands, pancreatic and thyroid glands, duodenum, lung, stomach, skin and adrenal glands). The peculiarity of this case is medullary carcinoma of the thyroid gland that is usually associated with the syndrome of MEN­2. The patient had typical clinical hypoglycemic syndrome, however, among all the investigated neuroendocrine tumors of the insulin­producing cells were not available, that doesn’t mean there are not revealed (possibly very small) tumors of the pancreas. At the same time, it is known that clinical manifestations of MEN­1 may be due to the cumulative effect of all complex of the hormones produced simultaneously by several multiple tumors