title: Adrenal involvement in MEN1. Analysis of 715 cases from the Groupe d'etude des Tumeurs Endocrines database.
abstract: OBJECTIVE
  Limited data regarding adrenal involvement in multiple endocrine neoplasia type 1 (MEN1) is available. We describe the characteristics of MEN1-associated adrenal lesions in a large cohort to provide a rationale for their management.
  
  
  METHODS
  Analysis of records from 715 MEN1 patients from a multicentre database between 1956 and 2008. Adrenal lesions were compared with those from a multicentre cohort of 144 patients with adrenal sporadic incidentalomas.
  
  
  RESULTS
  Adrenal enlargement was reported in 20.4% (146/715) of patients. Adrenal tumours (>10 mm in size) accounted for 58.1% of these cases (10.1% of the whole patient cohort). Tumours were bilateral and >40 mm in size in 12.5 and 19.4% of cases respectively. Hormonal hypersecretion was restricted to patients with tumours and occurred in 15.3% of them. Compared with incidentalomas, MEN1-related tumours exhibited more cases of primary hyperaldosteronism, fewer pheochromocytomas and more adrenocortical carcinomas (ACCs; 13.8 vs 1.3%). Ten ACCs occurred in eight patients. Interestingly, ACCs occurred after several years of follow-up of small adrenal tumours in two of the eight affected patients. Nine of the ten ACCs were classified as stage I or II according to the European Network for the Study of Adrenal Tumors. No evident genotype/phenotype correlation was found for the occurrence of adrenal lesions, endocrine hypersecretion or ACC.
  
  
  CONCLUSIONS
  Adrenal pathology in MEN1 differs from that observed in sporadic incidentalomas. In the absence of relevant symptoms, endocrine biology can be restricted to patients with adrenal tumours and should focus on steroid secretion including the aldosterone-renin system. MEN1 is a high-risk condition for the occurrence of ACCs. It should be considered regardless of the size of the tumour.
authors.affiliation: Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, Hôpital Haut Lévêque, Centre Hospitalier Universitaire de Bordeaux, Avenue de Magellan, 33600 Pessac, France.
authors.forename: B
authors.initials: B
authors.lastname: Gatta-Cherifi
authors.forename: O
authors.initials: O
authors.lastname: Chabre
authors.forename: A
authors.initials: A
authors.lastname: Murat
authors.forename: P
authors.initials: P
authors.lastname: Niccoli
authors.forename: C
authors.initials: C
authors.lastname: Cardot-Bauters
authors.forename: V
authors.initials: V
authors.lastname: Rohmer
authors.forename: J
authors.initials: J
authors.lastname: Young
authors.forename: B
authors.initials: B
authors.lastname: Delemer
authors.forename: H
authors.initials: H
authors.lastname: Du Boullay
authors.forename: M F
authors.initials: MF
authors.lastname: Verger
authors.forename: J M
authors.initials: JM
authors.lastname: Kuhn
authors.forename: J L
authors.initials: JL
authors.lastname: Sadoul
authors.forename: Ph
authors.initials: P
authors.lastname: Ruszniewski
authors.forename: A
authors.initials: A
authors.lastname: Beckers
authors.forename: M
authors.initials: M
authors.lastname: Monsaingeon
authors.forename: E
authors.initials: E
authors.lastname: Baudin
authors.forename: P
authors.initials: P
authors.lastname: Goudet
authors.forename: A
authors.initials: A
authors.lastname: Tabarin
mesh_terms: D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D000328:Adult; D000368:Aged; D001530:Belgium / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004252:DNA Mutational Analysis; D019992:Databases as Topic / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D018761:Multiple Endocrine Neoplasia Type 1 / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D010673:Pheochromocytoma / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D011518:Proto-Oncogene Proteins / Q000235:genetics; D047368:Tumor Burden; D055815:Young Adult
chemical_list: C105373:MEN1 protein, human; D011518:Proto-Oncogene Proteins