[A family with multiple endocrine adenomatosis (MEA Type I) and some additional peculiarities alpha-1-antitrypsin deficiency (twice), polyp of small intestine with heterotopic gastric mucosa (once), medullary thyroid carcinoma (once) (author's transl)]

Medullary carcinoma of the thyroid with metastasis to the pituitary gland

A case of metastatic medullary thyroid carcinoma presenting with anterior pituitary dysfunction is reported. Initial evaluation revealed an intrasellar mass at a time when serum calcitonin and carcinoembryonic antigen levels were elevated, and histological analysis of resected tissue demonstrated the presence of metastatic medullary carcinoma of the thyroid. Immunohis-tochemical analysis confirmed the presence of calcitonin in the tumor cells. Like other malignant processes, metastatic medullary carcinoma of the thyroid may involve the pituitary gland and should be included in the differential diagnosis in the appropriate clinical setting.

Multiple endocrine neoplasia: how many syndromes?

The phrase multiple endocrine neoplasia (MEN) generally denotes an association of tumors so specific as to constitute a syndrome. Three well-recognized such syndromes exist. All are autosomal dominant traits and all have been tentatively mapped to specific chromosomes. Other purported endocrine tumor syndromes have been suggested either as new entities or as subtypes of the existing MEN syndromes. The evidence in favor of these contentions is examined critically. Only one "new" association, that of pheochromocytomas and islet cell tumors, seems reasonable, and even in this setting, some relatives have had manifestations of von Hippel-Lindau syndrome. There is no compelling reason why such conditions as von Hippel-Lindau syndrome, peripheral neurofibromatosis, McCune-Albright syndrome, and others should be reclassified as MEN syndromes, although awareness of their collective endocrine abnormalities is clinically important.