Acromegaly as the Initial Presentation of Multiple Endocrine Neoplasia Type 1: A Case Report.
Hadeel Yousef Hussein Odeh, Mohamed H Ahmed, Nabaa Mustafa Al Munshee et al.
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Case in brief
A 34-year-old woman presented with acromegalic features and hypercalcemia. Testing and MRI showed a recurrent growth hormone–secreting pituitary macroadenoma, while neck imaging identified a parathyroid adenoma. Genetic analysis found a pathogenic MEN1 variant. Following repeat transsphenoidal surgery with complete radiological resection of the pituitary tumor, growth hormone and insulin-like growth factor-1 levels normalized. Parathyroid surgery was planned, and she entered multidisciplinary MEN-1 surveillance.
What made this case unusual
Acromegaly from a growth hormone–secreting pituitary adenoma was the initial clinical manifestation of MEN-1, rather than the more usual early presentation with primary hyperparathyroidism.
Diagnostic / clinical pearl
The combination of a pituitary adenoma and hypercalcemia should prompt evaluation for MEN-1, even without a family history.
Why it matters
Recognizing MEN-1 enables coordinated care and long-term surveillance for additional syndrome-associated tumors.