Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for follow-up of MEN1-associated non-functioning pancreatic neuroendocrine tumor (pNET). Patient denies symptoms of hormonal hypersecretion (no hypoglycemia, flushing, or diarrhea). Review of systems negative for abdominal pain, weight loss, or jaundice. Known history of MEN1 syndrome with prior surveillance imaging confirming stable/progressive pancreatic lesion.
Clinical Examination Findings
General: Patient appears well-nourished, in no acute distress. Abdomen: Soft, non-tender, non-distended. No palpable masses or organomegaly. Bowel sounds present and normoactive. Skin: No evidence of neurofibromas, angiofibromas, or collagenomas (stigmata of MEN1). Cardiovascular: Regular rate and rhythm, no murmurs.
Treatment Protocol
Plan: 1. Continue biochemical surveillance (Chromogranin A, Pancreatic Polypeptide). 2. Serial cross-sectional imaging (MRI abdomen or EUS) per NCCN guidelines for MEN1-associated pNET. 3. Multidisciplinary tumor board review for surgical candidacy vs. active surveillance. 4. Maintain close monitoring of calcium and PTH levels due to underlying MEN1.