American Board of Surgery Qualifying Exam (ABS QE) Practice Test

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Which syndromes are associated with multiple endocrine neoplasia (MEN) type 1?

Thyroid carcinoma, adrenal tumor
Pituitary adenoma, parathyroid hyperplasia
Pheochromocytoma, pancreatic tumor
Adrenal cortex carcinoma, pituitary neoplasm

The correct answer is: Pituitary adenoma, parathyroid hyperplasia

Multiple endocrine neoplasia type 1 (MEN type 1), also known as Wermer's syndrome, is characterized by the triad of pituitary adenomas, hyperparathyroidism due to parathyroid hyperplasia, and pancreatic endocrine tumors. The association with pituitary adenomas explains the presence of these tumors in patients with MEN type 1, which can include prolactinomas, growth hormone-secreting adenomas, and others. Parathyroid hyperplasia leads to elevated parathyroid hormone levels, resulting in hypercalcemia and its related complications. The involvement of pancreatic tumors can vary, but is also a hallmark of MEN type 1, where patients may develop gastrin-secreting tumors (gastrinomas) or insulinomas. Given the key features of MEN type 1, the correct answer highlights the most relevant syndromic associations with this condition. This knowledge is crucial for understanding the pathophysiology and clinical management of patients with MEN type 1.