Abraham Lincoln

Multiple Endocrine Neoplasia (MEN) Syndromes – Mnemonic

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This will help you keep the multiple endocrine neoplasia syndromes straight in your head:

  • MEN1: the number “1” in MEN1 should remind you of primary or prime number. MEN1 involves things that start with the letter P:
    • Pituitary adenoma
    • Parathyroid hyperplasia
    • Pancreatic islet cell tumors (gastrinoma, insulinoma, glucagonoma)
  • MEN2A: happens to involve the letter C (This is MEN2A, so there are two C’s in each item!):
    • Calcitonin (medullary carcinoma of the thyroid with elevated calcitonin level)
    • Calcium (parathyroid hyperplasia, which causes elevated calcium levels)
    • Catecholamines which are made in the chromocytes (as in pheochromocytoma)
  • Men 2B: B is for big (marfanoid habitus) and for belly problems (mucosal neuromas)

Here is a table to help drive home the key features of the multiple endocrine neoplasia syndromes:

Multiple Endocrine Neoplasia Syndromes

Clinical presentation

  • MEN1
    • Hypercalcemia: brittle bones (fractures, due to osteoporosis), kidney stones, abdominal moans (abdominal pain), and psychiatric overtones (confusion).
    • Treatment-resistant peptic ulcer disease (gastrinoma) or hypoglycemia (insulinoma).
  • MEN2A
    • Hypercalcemia: brittle bones (fractures, due to osteoporosis), kidney stones, abdominal moans (abdominal pain), and psychiatric overtones (confusion).
    • Elevated catecholamines: severe, treatment-resistent hypertension (particularly paroxysmal in nature, with headaches, palpitations, and diaphoresis).
  • MEN2B
    • Marfanoid habitus
    • Mucosal neuromas on lips, tongue and eyelids.
    • Note that Abraham Lincoln was said (apocryphally?) to have been marfanoid, and he clearly was one of the great “men to be” (MEN2B)!
Abraham Lincoln
Abraham Lincoln

References

  • Board Basics (2012, reviewed here)
  • The Merck Manual for Health Care Professionals (accessed 6/9/2013)
  • John G. Sotos MD (2008), The Physical Lincoln

27 thoughts on “Multiple Endocrine Neoplasia (MEN) Syndromes – Mnemonic”

    • I am glad that you found it helpful.

      I think I made it up while in medical school. I then forgot the mnemonic, and somehow recalled it after a few months of intermittent effort. :-).

      Reply

  2. I’ve always gotten these confused and other mnemonics have always been too complicated. Thanks so much for your simple mnemonic! It’s so helpful.

    Reply

    • I am glad it helped you!

      I try to avoid memorizing complicated mnemonics. My philosophy is, if you end up needing to remember more as a consequence of the mnemonic, then you are doing it wrong!

      Reply

  10. Great mnemonic! Thanks! Just want to point out there’s a typo in your table for MEN2B. It says “MEN2A” in that third column.

    Reply

  12. Multiple endocrine neoplasia was one of the very important topics in recent advance Pathology in 1985 when we were pg examinees . Thanks for reminding this interesting subject with the updates.

    Reply

  14. Mnemonics like this are underrated as teaching tools. The traditional way of keeping the syndromes straight — three P’s for MEN1, two P’s for MEN2A, one P for MEN2B — works, but students still trip over which endocrine slots belong where, and a table that lines the key features up side by side is exactly what makes the pattern stick. I’ve noticed learners remember the exceptions better when the mnemonic itself encodes the countdown, since recalling ‘one P’ forces you to ask which P survived and why. Do you also cover why medullary thyroid carcinoma appears in both MEN2 variants while parathyroid drops out in MEN2B? That contrast is usually the exam trap. Saving this table for the endocrine block.

    Reply

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