Department of Medical Oncology, Jinhua Hospital, Zhejiang University School of Medicine, 351 Mingyue Road, Jinhua, 321000, Zhejiang Province, China.
Department of Medical Oncology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310000, China.
BMC Neurol. 2020 Mar 4;20(1):76. doi: 10.1186/s12883-020-01659-7.
Multiple endocrine neoplasia type 1 (MEN1) is a rare autosomal dominant disorder arising from mutations of the MEN1 tumor suppressor gene on chromosome 11q13; MEN1 is characterized by the development of neuroendocrine tumors, including those of the parathyroid, gastrointestinal endocrine tissue and anterior pituitary. Additionally, thymic neuroendocrine tumors in MEN1 are also rarely reported.
This case report observed a family that presented with MEN1 p.L105Vfs mutation, and two of the family members had been diagnosed with thymic neuroendocrine tumor combined with MEN1. To the best of our knowledge, this is the first time such a mutation in the MEN1 gene has been reported. The proband presented with thymic neuroendocrine tumor, parathyroid adenoma and rectum adenocarcinoma. The son of the proband presented with thymic neuroendocrine tumor, gastrinoma, hypophysoma and parathyroid adenoma. Genetic testing revealed the frameshift mutation p.L105Vfs, leading to the identification of one carrier in the pedigree (the patient's younger sister). The proband then underwent parathyroidectomy at the age of 26 years (in 1980) for a parathyroid adenoma. Subsequently, the patient underwent thymectomy, radiotherapy and chemotherapy. The patient is now 64 years old, still alive and still undergoing Lanreotide therapy.
Thymic neuroendocrine MEN1 is rare, but it accounts for almost 20% of MEN1-associated mortality. Consequently, we should focus on regular clinical screening of the thymus in MEN1 patients.
多发性内分泌腺瘤病 1 型(MEN1)是一种罕见的常染色体显性遗传疾病,由 11q13 染色体上的 MEN1 肿瘤抑制基因的突变引起;MEN1 的特征是神经内分泌肿瘤的发展,包括甲状旁腺、胃肠道内分泌组织和垂体前叶的肿瘤。此外,MEN1 中的胸腺神经内分泌肿瘤也很少报道。
本病例报告观察了一个家族,该家族存在 MEN1 p.L105Vfs 突变,其中两名家族成员被诊断为合并 MEN1 的胸腺神经内分泌肿瘤。据我们所知,这是首次报道这种 MEN1 基因突变。先证者表现为胸腺神经内分泌肿瘤、甲状旁腺腺瘤和直肠腺癌。先证者的儿子表现为胸腺神经内分泌肿瘤、胃泌素瘤、垂体瘤和甲状旁腺腺瘤。基因检测显示移码突变 p.L105Vfs,导致家系中发现 1 名携带者(患者的妹妹)。先证者于 26 岁(1980 年)时因甲状旁腺腺瘤行甲状旁腺切除术。随后,患者接受了胸腺切除术、放疗和化疗。患者目前 64 岁,仍存活,并仍在接受兰瑞肽治疗。
胸腺神经内分泌性 MEN1 罕见,但占 MEN1 相关死亡的近 20%。因此,我们应该关注 MEN1 患者的胸腺定期临床筛查。