title: MEN 2 syndrome masquerading as MEN 1.
abstract: Patients with multiple endocrine neoplasia (MEN) type 2A develop medullary thyroid cancer, which is associated with poor prognosis in its metastatic stage. Hyperparathyroidism is a common finding in both MEN 1 and 2. We report a 68-year-old patient diagnosed clinically with MEN 1 based  on the presence of hyperparathyroidism and pituitary Cushing's disease with no supporting genetic evidence. The hyperparathyroidism was later found to be part of MEN 2A with underlying metastatic medullary thyroid cancer. We highlight the importance of genetic confirmation before a diagnosis  of MEN 1 is made as other more serious pathologies might be overlooked.
authors.affiliation: Department of Endocrine Surgery, John Radcliffe Hospital, Oxford, UK.
authors.forename: Tarek
authors.initials: T
authors.lastname: Ezzat
authors.forename: Rajeev
authors.initials: R
authors.lastname: Paramesawaran
authors.forename: Ben
authors.initials: B
authors.lastname: Phillips
authors.forename: Greg
authors.initials: G
authors.lastname: Sadler
mesh_terms: D000236:Adenoma / Q000150:complications* / Q000175:diagnosis; D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000175:diagnosis; D000368:Aged; D003937:Diagnosis, Differential; D055088:Early Detection of Cancer; D006801:Humans; D008297:Male; D018761:Multiple Endocrine Neoplasia Type 1 / Q000175:diagnosis*; D018813:Multiple Endocrine Neoplasia Type 2a / Q000175:diagnosis*; D010282:Parathyroid Neoplasms / Q000150:complications* / Q000175:diagnosis; D010673:Pheochromocytoma / Q000150:complications* / Q000175:diagnosis