Multiple endocrine neoplasia and primary hyperparathyroidism – practical approach

A rare cause of multiple liver metastases in a 65-year-old man

“…In past medical history, the patient declared a low-energy radius fracture 2 years earlier treated efficiently by an orthopaedist using a plaster cast. Due to the diagnosis of low-energy fracture, primary hyperparathyroidism had been diagnosed at the time [5]. An analysis of hospital medical records from that period revealed values of iPTH 117.5 pg/ml (reference range: 15-65), with normal vitamin D3 (41 ng/ml, reference range: 31-50) and total calcium concentration, i.e.…”

“…Posthumous analysis of medical documentation allows us to presume multiple endocrine neoplasia syndrome type 1 (MEN1). On the example of the described patient, an attempt to link a duodenal NET and primary hyperparathyroidism with MEN1 syndrome was previously undertaken, especially in the context of negligence on the part of the patient causing procrastination in the diagnosis of the disease [5]. Subsequently, the daughter of the deceased patient was repeatedly encouraged to check if she was also burdened by the disease, but she was totally uninterested.…”