Myocardial Infarction Is Usually Due To Thrombotic Occlusion of a Coronary

Description
Myocardial infarction is usually due to thrombotic occlusion of a coronary vessel caused by rupture of a vulnerable atherosclerosis plaque. There is also the acute myocardial infarction with no evidence of relevant stenosis of the coronary artery, known as myocardial infarction with non-obstructive coronary arteries (MINOCA) such as Takotsubo, myocarditis and catecholamine induced cardiomyopathy. Pheochromocytoma is one of the causes of MINOCA. This association is rare but it may delay diagnosis and must be known in order to provide the best chance at early detection.
Multiple endocrine Neoplasia type 1 (MEN1) is a complex, autosomal dominant inherited syndrome characterized by 3 different tumors (parathyroid, anterior pituitary, and pancreatic islet). The diagnosis is defined clinically by the presence of 2 or more primary tumors. We report the case of a 35 years old patient who presented with recurrent renal stones and imaging findings for MEN1. Computed tomography pancreas revealed a mass in the tail which was confirmed by magnetic resonance imaging. Ultrasound of her neck showed a mass on the left side and MIBI scan diagnosed a parathyroid adenoma which was later pathologically confirmed. Neuroendocrine neoplasms (NENs) are relatively rare neoplasms with 6.4-times increasing age-adjusted annual incidence during the last four decades. NENs arise from neuroendocrine cells, which release hormones in response to neuronal stimuli and they are distributed into organs and tissues. The presentation and biological behaviour of the NENs are highly heterogeneous, depending on the organ. The increased incidence is mainly due to increased awareness and improved detection methods both in the majority of sporadic NENs (non-inherited), but also the inherited groups of neoplasms appearing in at least ten genetic syndromes. The most important one is multiple endocrine Neoplasia type 1 (MEN-1), caused by mutations in the tumour suppressor gene MEN1. MEN-1 has been associated with different tumour manifestations of NENs e.g. pancreas, gastrointestinal tract, lungs, thymus and pituitary. Pancreatic NENs tend to be less aggressive when arising in the setting of MEN-1 compared to sporadic pancreatic NENs. There have been very important improvements over the past years in genotyping, genetic counselling and family screening, introduction and validation of various relevant biomarkers, as well as newer imaging modalities. Alongside this development, both medical, surgical and radionuclide treatments have also advanced and improved morbidity, quality of life and mortality in many of these patients.
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With regards
Michel
Journal Coordinator
Journal of Reproductive Endocrinology & Infertility