What are ways to remember the associations with Multiple Endocrine Neoplasia (MEN) 1, 2A, and 2B?

From the Guidelines

To remember the associations with Multiple Endocrine Neoplasia (MEN) syndromes, use these memory aids: For MEN1, remember "3 P's" - Parathyroid hyperplasia, Pituitary adenomas, and Pancreatic tumors, as described in the study by 1. For MEN2A, use "2 P's and M" - Pheochromocytoma, Parathyroid hyperplasia, and Medullary thyroid carcinoma, as outlined in the study by 1. For MEN2B, think "2B is the Most Bumpy" - it includes Medullary thyroid carcinoma, Pheochromocytoma, Mucosal neuromas, and Marfanoid habitus (but no parathyroid involvement), as explained in the study by 1. Another approach is to remember that MEN1 affects organs above the diaphragm plus pancreas, while MEN2 syndromes primarily affect neural crest-derived tissues. The RET proto-oncogene mutation in MEN2 explains why it affects neural crest derivatives like thyroid C-cells and adrenal medulla, as discussed in the study by 1. MEN1 involves mutation of the menin tumor suppressor gene, explaining its broader range of affected organs, as described in the study by 1. These memory devices connect the pathophysiology with the clinical manifestations, making the syndromes easier to distinguish during exams or clinical practice. Some key points to consider when remembering these associations include:

• The high prevalence of Parathyroid hyperplasia, Pituitary adenomas, and Pancreatic tumors in MEN1, as reported in the study by 1
• The presence of Pheochromocytoma, Parathyroid hyperplasia, and Medullary thyroid carcinoma in MEN2A, as outlined in the study by 1
• The characteristic features of MEN2B, including Medullary thyroid carcinoma, Pheochromocytoma, Mucosal neuromas, and Marfanoid habitus, as explained in the study by 1
• The importance of genetic testing for RET proto-oncogene mutations in patients with MEN2, as recommended in the study by 1
• The need for preoperative workup, including measurement of serum markers and screening for pheochromocytoma and hyperparathyroidism, as discussed in the study by 1.

From the Research

Associations with MEN 1, 2A, and 2B

To remember the associations with Multiple Endocrine Neoplasia (MEN) 1, 2A, and 2B, consider the following:

• MEN 1 is characterized by:
  • Parathyroid hyperplasia
  • Pancreatic islet cell tumors
  • Pituitary tumors as noted in 2, 3, 4, 5
• MEN 2A is characterized by:
  • Medullary thyroid carcinoma
  • Pheochromocytoma
  • Parathyroid hyperplasia as mentioned in 2, 3, 6, 4, 5
• MEN 2B is characterized by:
  • Medullary thyroid carcinoma
  • Pheochromocytoma
  • Mucosal neuromas as described in 2, 3, 4

Mnemonics to Remember Associations

Some possible mnemonics to remember these associations include:

• MEN 1: "3 P's" - Parathyroid, Pancreas, Pituitary
• MEN 2A: "3 M's" - Medullary thyroid carcinoma, Pheochromocytoma, Parathyroid hyperplasia (can be modified to "3 P's" - Pheochromocytoma, Parathyroid, Pituitary-like symptoms from medullary thyroid carcinoma)
• MEN 2B: "3 M's" - Medullary thyroid carcinoma, Pheochromocytoma, Mucosal neuromas as inferred from 2, 3, 4

Clinical Features and Treatment

It's essential to understand the clinical features and treatment options for each type of MEN, as discussed in 3, 6, 5