Endocrinology Onco

Q)  MEN 2A also known as
A. sipple syndrome

B. Wermer syndrome

C) Werner syndrome


Ans a

Sipple and Steiner described the association of thyroid cancer with pheochromocytoma and hyperparathyroidism, respectively

Bailey says MTC combined with phaeochromocytoma alone is called Sipple’s syndrome (page 856)

MEN2A is characterized by MTC,  pheochromocytoma (50%) and hyperparathyroidism (25%).

Associated with mutations in codon 634 in the RET proto-oncogene.

Wermer-  MEN 1 is characterised by the triad of tumours in the anterior pituitary gland, mostly presenting as prolactinomas
or non-functioning tumours, hyperplasia of the parathyroids causing primary hyperparathyroidism (pHPT) and pancreaticoduodenal endocrine tumours (PETs)

Patients with MEN 2B do not develop pHPT


Q2.) Male patient comes with Gynecomastia, Blindness and nipple discharge? Which hormone level will you do

a) Testosterone

b) Estrogen

c)  Prolactin

d)  BHCG

Ans 2)  c  HIgh Prolactin due to Prolactinoma

Women with prolactinomas may present with amenorrhea and/or galactorrhea, whereas men with prolactinomas may present with sexual
dysfunction and/or gynecomastia. A serum prolactin level >200 ng/mL and an associated adenoma on MRI confirm the diagnosis of prolactinoma.

symptoms of local compression such as headache, visual field deficits, hypopituitarism,
temporal lobe epilepsy, mild hyperprolactinemia from stalk compression,
and cranial nerve III or VI dysfunction

Q3) Which of the following is not true for Pheochromocytoma

a)  10% bilateral

b) Extra adrenal cases are more malignant

c) Arises from adrenal cortex

d) Patient  may be normotensive

Ans c 

Neuroendocrine tumour of the chromaffin cells of the adrenal medulla.

Hypertension and hyperglycaemia are often found

10% of cases are bilateral. 10% occur in children. 11% are malignant (higher when tumour is located outside the

10% will not be hypertensive.