Table 4. Practice Guidelines for Surveillance of MEN1a

Biochemical Test or ProcedureCondition Screened ForAge Screening Initiated (y) Frequency
Serum prolactin and/or insulin-like growth factor 1Pituitary tumors5Every 1 y
Fasting total serum calcium and/or ionized calcium and PTHParathyroid tumors and PHPT8 Every 1 y
Fasting serum gastrinDuodenopancreatic gastrinoma 20 Every 1 y
Chromogranin A, pancreatic polypeptide, glucagon, and vasointestinal polypeptideDuodenopancreatic NETs<10 Every 1 y
Fasting glucose and insulinInsulinoma5 Every 1 y
Brain MRIcPituitary tumors5 Every 3–5 y based on biochemical results
Abdominal CT or MRIb [4]Duodenopancreatic NETs20Every 3–5 y based on biochemical results
Abdominal CT, MRI, or endoscopic ultrasonographyb [7]Duodenopancreatic NETs<10Every 1 y

CT = computed tomography; MEN1 = multiple endocrine neoplasia type 1; MRI = magnetic resonance imaging; NETs = neuroendocrine tumors; PHPT = primary hyperparathyroidism; PTH = parathyroid hormone.

aAdapted from Brandi et al.[4] and Thakker et al.[7]

bThe recommendations for abdominal imaging differ between two published guidelines for the diagnosis and management of MEN1.[4,7] There is weak evidence at this time to support annual imaging before age 10 years. Imaging before age 10 years does identify disease in a high proportion of patients, but it is not clear whether this impacts prognosis.[19,66]

cThe age to initiate screening and the screening frequency for pituitary tumors may be debatable because the clinical significance of small, nonfunctional tumors is unclear;[67] further study may be warranted.

From: Genetics of Endocrine and Neuroendocrine Neoplasias (PDQ®)

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PDQ Cancer Information Summaries [Internet].
Bethesda (MD): National Cancer Institute (US); 2002-.
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