A patient with MEN-1 syndrome undergoes surveillance. Which of the following combinations is the HALLMARK triad of MEN-1?
- A Parathyroid adenoma, pituitary adenoma, pancreatic neuroendocrine tumor ✓
- B Medullary thyroid carcinoma, pheochromocytoma, parathyroid hyperplasia
- C Parathyroid adenoma, pheochromocytoma, mucosal neuromas
- D Pituitary adenoma, adrenal adenoma, pancreatic ductal carcinoma
Correct answer: A. Parathyroid adenoma, pituitary adenoma, pancreatic neuroendocrine tumor
Explanation
MEN-1 (Wermer syndrome) is characterized by the triad of primary hyperparathyroidism (parathyroid adenoma/hyperplasia, 95%), pituitary adenoma (prolactinoma most common, 30–40%), and pancreatic/duodenal neuroendocrine tumors (gastrinoma most common, Zollinger-Ellison syndrome). MEN-2A features medullary thyroid carcinoma, pheochromocytoma, and parathyroid hyperplasia. MEN-2B features MTC, pheochromocytoma, and mucosal neuromas.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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