From the Research
For a patient with neck pressure and a family history of acromegaly, thyroid tumors, and parathyroid cancer, I recommend ordering comprehensive blood work including thyroid function tests (TSH, free T3, free T4), parathyroid hormone (PTH), serum calcium, phosphorus, growth hormone (GH), and insulin-like growth factor-1 (IGF-1). This recommendation is based on the most recent and highest quality study available, which emphasizes the importance of early diagnosis and treatment of acromegaly and other endocrine disorders 1. The following tests are essential:
- Thyroid function tests (TSH, free T3, free T4) to evaluate thyroid function
- Parathyroid hormone (PTH) and serum calcium and phosphorus to assess parathyroid activity
- Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) to screen for acromegaly
- Calcitonin to screen for medullary thyroid cancer
- Complete blood count (CBC) and comprehensive metabolic panel (CMP) for baseline assessment The family history of acromegaly, thyroid tumors, and parathyroid cancer suggests possible Multiple Endocrine Neoplasia (MEN) syndrome, which can affect multiple endocrine glands 2, 3. Neck pressure could indicate thyroid enlargement, nodules, or parathyroid abnormalities, and imaging studies like neck ultrasound would be appropriate to visualize any structural abnormalities after blood work 1, 4. Early detection is crucial as these conditions can have significant health implications if left untreated, and the strong family history increases the patient's risk for these endocrine disorders 5.