2009 Volume 23 Issue 6 Pages 821-825
The case was a 32-year-old female. A chest CT, obtained while the patient visited our hospital for the treatment of urolithiasis, revealed an opacity in the right lung. Thoracoscopic partial resection of the lung was performed, and the postoperative examination of permanent sections revealed an atypical carcinoid. After about 2 weeks, right middle lobectomy, ND2a, was performed. The pathological staging was pT1N2M0 stage IIIA. The postoperative course was uneventful. However, hypercalcemia, an elevated level of intact PTH, and swelling of three parathyroid glands were noted, suggestive of primary hyperparathyroidism, and surgery was performed. The pathological diagnosis was parathyroid hyperplasia. Multiple endocrine neoplasia type 1 was suspected, and gene screening was carried out. As a result, a mutation in exon 4 of the MEN1 gene was identified, allowing a definitive diagnosis. It is relatively rare for multiple endocrine neoplasia type 1 to be associated with pulmonary carcinoid, and so this case is reported with a review of the literature.