Table 5.

Multiple Endocrine Neoplasia Type 4: Treatment of Manifestations

Manifestation/ConcernTreatmentConsiderations/Other
PHPT Parathyroidectomy 1Medical therapy (cinacalcet) can be considered in those w/symptomatic hypercalcemia who are not surgical candidates.
Pituitary adenoma
  • Pituitary surgery for ACTH- or GH-secreting tumors
  • Cabergoline for PRL-secreting tumors
Pituitary surgery should be carried out by surgeon w/pituitary expertise.
Neuroendocrine tumors & carcinoids
  • Surgical resection if possible
  • Consider referral to medical oncologist.
  • Some persons may be treated w/somatostatin analogs.
  • Persons w/gastrin-secreting tumors can be treated w/proton pump inhibitors.

ACTH = adrenocorticotrophic hormone; GH = growth hormone; PHPT = primary hyperparathyroidism; PRL = prolactin

1.

For further treatment details see Multiple Endocrine Neoplasia Type 1, Treatment of Manifestations, PHPT.

From: Multiple Endocrine Neoplasia Type 4

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