Cia peb kawm txog qee qhov teeb meem nrog koj lub cev lub cev glandular? - Multiple Endocrine Neoplasia (MEN)

Peb lub cev zoo li lub tshuab zoo kawg nkaus, puas yog? Yuav kom lub tshuab no ua haujlwm tau zoo, txhua qhov yuav tsum ua haujlwm ua ke thiab sib koom tes kom zoo. Muaj ib lub cev tseem ceeb heev hauv peb lub cev, uas hu ua lub cev endocrine . Cov qog hauv lub cev no tsim cov tshuaj hormones uas tswj ntau yam haujlwm hauv peb lub cev. Txawm li cas los xij, qee zaum lub cev no tuaj yeem ua tsis tau zoo. Hnub no peb yuav tham txog ib qho mob tsis tshua muaj tab sis tseem ceeb heev uas yuav tsum paub txog. Ntawd yog Multiple Endocrine Neoplasia , tseem hu ua '(MEN)' luv.

Yog li ntawd, qhov endocrine system no yog dab tsi?

Hais yooj yim xwb, peb lub cev endocrine yog ib lub network ntawm cov qog thiab cov kab mob hauv peb lub cev. Cov no yog cov uas tsim cov tshuaj hu ua cov tshuaj hormones thiab tso lawv mus rau hauv cov ntshav. Xav txog cov tshuaj hormones no ua cov tub xa xov me me uas nqa cov lus hauv peb lub cev. Cov lus no qhia peb cov kab mob, daim tawv nqaij, thiab cov leeg nqaij yuav ua li cas thiab thaum twg yuav ua.

Muaj ntau lub qog thiab cov kabmob tseem ceeb uas koom nrog peb lub cev endocrine:

• Hypothalamus: Qhov no nyob rau hauv qab ntawm peb lub hlwb. Nws tswj ntau yam hauv lub endocrine system.
• Pituitary gland: Lub qog me me no, txuas nrog hypothalamus, tsim cov tshuaj hormones uas tswj ntau lwm cov qog, suav nrog cov thyroid gland, adrenal gland, ovaries, thiab noob qes.
• Thyroid: Lub qog no zoo li npauj npaim nyob rau pem hauv ntej ntawm lub caj dab tswj peb lub cev metabolism, uas yog li cas peb siv lub zog los ntawm cov khoom noj uas peb noj.
• Cov qog Parathyroid: Cov qog me me plaub no, feem ntau nyob ze ntawm cov qog thyroid, tswj cov calcium thiab phosphorus hauv peb lub cev.
• Cov qog adrenal: Ob lub qog no, nyob saum lub raum, tswj cov metabolism, ntshav siab, kev loj hlob ntawm kev sib deev, thiab kev teb rau kev ntxhov siab.
• Qog Pineal: Cov qog no tsim cov tshuaj hormone melatonin thiab tswj peb lub voj voog pw tsaug zog.
• Pancreas: Qhov no yog qhov chaw uas insulin raug tsim tawm. Nws tseem ceeb heev rau kev zom zaub mov thiab kev tswj cov piam thaj hauv cov ntshav. Nws kuj yog ib feem ntawm peb lub cev zom zaub mov.
• Zes qe menyuam: Cov no yog qhov chaw uas cov tshuaj hormones poj niam estrogen, progesterone, thiab testosterone raug tsim tawm.
• Cov noob qes: Thaum tsim cov phev hauv cov txiv neej, cov tshuaj hormone testosterone kuj tseem tsim tawm ntawm no.

Yog li ntawd, Multiple Endocrine Neoplasia (MEN) yog dab tsi?

Multiple Endocrine Neoplasia (MEN) yog ib qho mob caj ces tsis tshua muaj uas cov qog tsim ntau dua ib qho ntawm cov qog thiab cov nqaij ntawm lub endocrine system, uas peb tau tham ua ntej. Qee zaum cov qog no tuaj yeem dhau los ua mob qog noj ntshav.

Muaj ob hom mob '(MEN)' no:

1. Mob qog nqaij hlav ntau hom 1 (MEN hom 1): Qhov no yog ib qho mob uas muaj ntau hom qog nqaij hlav hauv ntau lub qog ntawm lub cev endocrine. Qhov no kuj hu ua MEN-1 thiab Wermer's syndrome.

2. Mob qog nqaij hlav ntau hom 2 (MEN hom 2): Qhov no yog ib yam mob qog nqaij hlav uas cuam tshuam rau ntau lub qog. Cov neeg uas muaj MEN2 yuav mob qog nqaij hlav thyroid hu ua mob qog nqaij hlav medullary thyroid (MTC) . Lawv kuj muaj feem yuav mob qog nqaij hlav hauv lwm cov qog ntawm lub cev endocrine. Qhov no kuj hu ua MEN-2 thiab Sipple syndrome.

Vim li cas qhov xwm txheej '(MEN)' no thiaj tshwm sim?

Ob hom '(MEN)' no yog tshwm sim los ntawm kev hloov pauv hauv peb cov noob caj noob ces , uas yog, kev hloov pauv . Xav txog tias peb lub cev muaj ib yam dab tsi zoo li phau ntawv qhia, uas yog, noob caj noob ces. Yog tias txawm tias ib tsab ntawv hauv phau ntawv qhia no tsis raug, uas yog, yog tias ib qho noob caj noob ces hloov pauv, qee qhov kev ua haujlwm ntawm lub cev tuaj yeem raug cuam tshuam.

• (MEN hom 1) yog tshwm sim los ntawm kev hloov pauv hauv cov noob 'MEN1' . Cov noob 'MEN1' no yog cov noob tiv thaiv qog . Uas yog, cov noob uas pab tswj kev faib cell thiab tiv thaiv cov qog los ntawm kev tsim. Yog tias cov noob no tsis ua haujlwm zoo, qee cov cell tuaj yeem loj hlob tawm ntawm kev tswj hwm thiab tsim cov qog.
• (MEN hom 2) yog tshwm sim los ntawm kev hloov pauv hauv cov noob 'RET' . Cov noob 'RET' no yog ib qho noob uas cuam tshuam nrog kev loj hlob ntawm mob qog noj ntshav. Thaum cov noob no hloov pauv, cov cell hauv qee lub cev thiab cov qog loj hlob tsis tuaj yeem tswj tau thiab tsim cov qog.

Cov kev hloov pauv caj ces no tuaj yeem tau txais los ntawm niam txiv lossis tuaj yeem tshwm sim yam tsis tau npaj tseg thaum lub sijhawm cev xeeb tub. Yog tias ib tug niam txiv muaj MEN, muaj li ntawm 50% txoj hmoo uas tus menyuam yuav muaj nws.

Cia peb kawm ntxiv me ntsis txog `(MEN)` hom 1 (`MEN hom 1`)

Cov neeg uas muaj tus kab mob MEN hom 1 yuav muaj qog nqaij hlav hauv ntau lub qog ntawm lub cev endocrine. Cov cheeb tsam uas feem ntau raug kev txom nyem yog:

• Cov qog Parathyroid: Qhov no yog qhov feem ntau.
• Kab mob Gastroenteropancreatic: Qhov no txhais tau tias cov qog nqaij hlav tuaj yeem tsim nyob rau hauv lub txiav, lub plab, thiab lwm qhov ntawm lub cev zom zaub mov, xws li duodenum.
• Cov qog pituitary.

Feem ntau, cov qog uas tshwm sim nrog MEN hom 1 tsis yog mob qog noj ntshav (benign) . Txawm li cas los xij, qee cov qog tuaj yeem yog mob qog noj ntshav (malignant).Nws kuj tseem tuaj yeem kis mus rau lwm qhov ntawm lub cev. Cov qog uas muaj qog feem ntau tso cov tshuaj hormones ntau dhau rau hauv cov ntshav. Qhov no yog qhov ua rau muaj ntau yam tsos mob thiab teeb meem kev noj qab haus huv.

Cov kws kho mob tau txheeb xyuas ntau dua 20 hom qog endocrine thiab tsis yog endocrine rau cov neeg uas muaj MEN hom 1. Muaj lwm hom qog uas tsis tshua muaj, xws li:

• Cov qog nqaij hlav neuroendocrine uas tshwm sim hauv thymus (lub qog ntshav hauv lub hauv siab) thiab bronchi (txoj hlab pa hauv lub ntsws).
• Cov qog adrenal tsim nyob rau hauv txheej sab nraud ntawm cov qog adrenal.
• Cov pob rog (Lipomas) uas tsim nyob rau hauv qab daim tawv nqaij.
• Mob qog nqaij hlav mis.
• Cov qog nqaij hlav xws li meningiomas thiab ependymomas uas tuaj yeem tshwm sim hauv lub hlwb lossis tus txha caj qaum.

Cov tsos mob ntawm tus kab mob "(MEN hom 1)" yog dab tsi?

Cov tsos mob ntawm MEN hom 1 tuaj yeem sib txawv ntawm ib tus neeg mus rau ib tus neeg. Nws nyob ntawm seb cov qog twg raug cuam tshuam thiab lawv tsim cov tshuaj hormones ntau npaum li cas. Ib txhia neeg yuav tsis muaj tsos mob li, lwm tus yuav muaj tsos mob me me, thiab ib txhia yuav muaj tsos mob hnyav, txawm tias muaj kev phom sij rau lub neej. Cov tsos mob tuaj yeem sib txawv ntawm ib tus neeg mus rau ib tus neeg, txawm tias nyob hauv tib tsev neeg, txawm tias ntawm cov menyuam ntxaib.

Cia peb saib qee hom pob loj thiab lawv cov tsos mob cuam tshuam:

• Vim muaj teeb meem nrog cov qog parathyroid (hyperparathyroidism):

90% ntawm cov neeg uas muaj tus mob "MEN type 1" yuav muaj tus mob no thaum lawv muaj hnub nyoog 50 xyoo. Hauv qhov no, cov qog parathyroid ua haujlwm ntau dhau.

• Cov tsos mob me me: mob pob qij txha, cov leeg tsis muaj zog, qaug zog, nyuaj siab, nyuaj rau tsom ntsoov, tsis xav noj mov.
• Cov tsos mob hnyav: xeev siab, ntuav, tsis meej pem, tsis nco qab, nqhis dej ntau dhau thiab tso zis ntau zaus, cem quav, mob pob txha.

• Vim yog cov qog nqaij hlav hauv lub txiav thiab thawj feem ntawm txoj hnyuv me (Gastrinomas):

Kwv yees li ntawm 40% ntawm cov neeg laus uas muaj MEN hom 1 muaj cov qog hu ua gastrinomas. Cov no tsim cov tshuaj hormones hu ua gastrin, uas ua rau lub plab tsim cov kua qaub ntau dhau.

• Cov tsos mob: Mob plab, raws plab, kub siab (acid reflux), mob plab (mob plab hnyuv).
• Lwm yam qog uas pom hauv pawg no yog insulinoma . Qhov no tsim cov insulin, uas tuaj yeem ua rau cov ntshav qab zib qis (hypoglycemia).
• Cov tsos mob: tsis meej pem, tshee hnyo, tawm hws, tshaib plab heev, tsis so, lub plawv dhia ceev ceev, pom kev tsis meej ib ntus.

• Vim yog cov qog pituitary (prolactinomas):

Kwv yees li ntawm 25% ntawm cov neeg uas muaj MEN hom 1 muaj cov qog pituitary. Cov qog prolactinomas uas pom ntau tshaj plaws yog cov uas tsim cov tshuaj hormone prolactin .

• Cov tsos mob ntawm cov poj niam: kev coj khaub ncaws tsis xwm yeem lossis tsis coj khaub ncaws tas (amenorrhea), nyuaj rau xeeb tub, cov kua mis tawm ntawm lub txiv mis thaum tsis cev xeeb tub lossis pub niam mis (galactorrhea), txo qis kev xav sib deev.
• Cov tsos mob ntawm cov txiv neej: Kev ntshaw kev sib deev tsawg dua vim yog cov testosterone tsawg dua, kev ua haujlwm tsis zoo ntawm erectile (ED), thiab nyuaj rau xeeb tub.
• Yog tias lub pob loj: mob taub hau, xeev siab/ntuav, pom kev hloov (pom ob sab, pom tsis meej ntawm sab).

Tseem Ceeb: Tsis yog txhua tus neeg yuav muaj cov tsos mob zoo ib yam. Daim ntawv teev npe no tsis yog tag nrho. Muaj ntau hom qog uas tuaj yeem tshwm sim hauv MEN hom 1.

Cia peb kawm txog `(MEN)` hom 2 (`MEN hom 2`)

Txhua tus neeg uas muaj MEN hom 2 yuav muaj ib hom mob qog noj ntshav hu ua mob qog noj ntshav medullary thyroid (MTC) . Hom mob qog noj ntshav no yuav tshwm sim hauv ib hom cell tshwj xeeb hauv cov qog thyroid hu ua C cells. Cov cell no tsim cov tshuaj hormones hu ua calcitonin. MTC tuaj yeem kis mus rau cov qog ntshav thiab lwm yam kabmob. Kev kho mob tseem ceeb yog phais tshem tawm cov qog thyroid (thyroidectomy).

Tsis tas li ntawd xwb, cov neeg uas muaj '(MEN hom 2)' yuav muaj ib lossis ob qho tib si ntawm cov mob hauv qab no:

• Pheochromocytoma: Qhov no yog ib qho mob qog nqaij hlav uas tsis tshua muaj uas tshwm sim hauv nruab nrab ntawm ib lossis ob qho qog adrenal (adrenal medulla). Feem ntau, cov no tsis yog mob qog noj ntshav. Kwv yees li 10% -15% ntawm cov neeg mob tuaj yeem dhau los ua mob qog noj ntshav thiab kis mus rau lwm qhov.
• Hyperparathyroidism: Cov calcium hauv cov ntshav nce ntxiv vim yog kev tsim cov tshuaj parathyroid hormone (PTH) ntau dhau los ntawm cov qog parathyroid.

Cov tsos mob ntawm tus kab mob "(MEN hom 2)" yog dab tsi?

Cov tsos mob ntawm no kuj txawv. Cov tsos mob feem ntau yog tshwm sim los ntawm cov tshuaj hormones ntau uas tsim los ntawm mob qog noj ntshav (MTC) thiab qee cov qog nqaij hlav.

• Cov tsos mob ntawm mob qog nqaij hlav medullary thyroid (MTC):
• Muaj ib lub pob nyob rau pem hauv ntej ntawm lub caj dab, mob caj dab, lub suab hloov pauv (qaug zog), hnoos, nqos nyuaj, ua pa nyuaj.

• Cov tsos mob tshwm sim los ntawm Pheochromocytoma: (tshwm sim hauv kwv yees li 50% ntawm cov neeg mob)
• Cov tsos mob tsuas yog tshwm sim thaum cov qog no tsim cov tshuaj hormones ntau dhau, xws li adrenaline. Qee cov qog tsis tsim cov tshuaj hormones thiab tej zaum yuav tsis qhia cov tsos mob dab tsi.
• Cov tsos mob uas tshwm sim ntau zaus (feem ntau tuaj thiab mus ua ntej): ntshav siab (ntshav siab), mob taub hau, tawm hws ntau dhau yam tsis muaj laj thawj, lub plawv dhia ceev lossis tsis xwm yeem, tshee hnyo.

• Cov tsos mob tshwm sim los ntawm hyperparathyroidism:
• Ib yam li hauv '(MEN hom 1', cov tsos mob xws li mob pob qij txha, cov leeg tsis muaj zog, qaug zog, nyuaj siab, nyuaj rau tsom ntsoov, tsis xav noj mov, xeev siab, ntuav, nqhis dej ntau dhau thiab tso zis ntau zaus, cem quav, thiab mob pob txha yuav tshwm sim.

Leej twg thiaj muaj tau tus mob '(MEN)' no? Nws tshwm sim ntau npaum li cas?

Tus mob '(MEN)' tuaj yeem cuam tshuam rau txiv neej thiab poj niam sib npaug. Lub hnub nyoog uas tus mob '(MEN hom 1)' tshwm sim sib txawv heev. Nws tau kuaj pom tias muaj rau cov menyuam yaus hnub nyoog li 8 xyoos thiab cov neeg laus hnub nyoog li 80 xyoo.

`(MEN)` yog ib qho mob tsis tshua muaj .

• `(MEN hom 1)` cuam tshuam kwv yees li ib ntawm 30,000 tus neeg.
• `(MEN hom 2)` cuam tshuam kwv yees li ib ntawm 35,000 tus neeg.

Qee cov kws tshawb nrhiav ntseeg tias tus lej tiag tiag ntawm cov neeg uas muaj cov mob no yuav siab dua vim yog tsis tau kuaj mob txaus lossis kuaj mob tsis raug.

Cov kws kho mob kuaj mob li cas '(MEN)'? (Kev kuaj mob)

Kev kuaj mob '(MEN)' tuaj yeem nyuaj me ntsis, vim nws cuam tshuam rau ntau yam qog.

• Kev txheeb xyuas ntawm `(MEN hom 1)`:

Feem ntau ib tug neeg raug kuaj pom tias muaj MEN hom 1 yog tias lawv muaj tsawg kawg yog ob ntawm peb qhov mob qog nqaij hlav loj hauv endocrine uas tau hais los saum toj no (cov qog nqaij hlav parathyroid, cov qog nqaij hlav pituitary, thiab/lossis cov qog nqaij hlav ntawm txoj hnyuv plab), lossis yog tias lawv muaj ib qho ntawm cov qog nqaij hlav ntawd thiab ib tug neeg hauv tsev neeg muaj MEN hom 1.

• Kev Ntsuas:
• Kev kuaj ntshav: Xyuas seb puas muaj cov tshuaj hormones ntau (piv txwv li, parathyroid hormone (PTH), calcium).
• Kev kuaj duab: Cov no tuaj yeem pab nrhiav cov cheeb tsam ntawm cov pob, xws li CT scan (computed tomography scan) lossis MRI (magnetic resonance imaging scan).
• Kev kuaj noob caj noob ces: Tshawb xyuas seb puas muaj kev hloov pauv hauv cov noob 'MEN1'.

• Kev txheeb xyuas ntawm `(MEN hom 2)`:

Ib tug neeg raug kuaj pom tias muaj MEN hom 2 yog tias lawv muaj mob qog nqaij hlav medullary thyroid (MTC) nrog rau pheochromocytoma thiab/lossis hyperplasia lossis adenoma ntawm cov qog parathyroid.

• Kev Ntsuas:
• Kev kuaj ntshav: Xyuas cov theem ntawm cov tshuaj hormones xws li calcitonin (rau MTC), parathyroid hormone (PTH), thiab catecholamines (rau pheochromocytoma).
• Kev kuaj duab: Siv 'CT scan' lossis 'MRI scan'.
• Kev kuaj noob caj noob ces: Tshawb xyuas seb puas muaj kev hloov pauv hauv cov noob 'RET'.

Cov kev kho mob rau '(MEN)' yog dab tsi?

Kev kho mob rau MEN nyob ntawm seb cov qog endocrine thiab cov kab mob twg raug cuam tshuam. Feem ntau nws yuav muaj ib pab pawg kws kho mob ntau yam, suav nrog cov kws kho mob endocrinologist , cov kws phais , thiab cov kws kho mob oncologist .

Tej zaum yuav muaj ntau txoj kev xaiv kho mob:

• Tshuaj: Tswj cov tsos mob thiab txo cov teebmeem ntawm cov tshuaj hormones ntau dhau.
• Phais Mob: Tshem tawm lub qog lossis tag nrho cov qog uas raug mob (piv txwv li, cov qog thyroid).
• Kev kho mob hloov tshuaj hormones: Yog tias ib lub qog endocrine raug phais tshem tawm, cov tshuaj hormones uas nws tsim tawm yuav raug muab rau sab nraud.
• Kev kho mob qog noj ntshav: Yog tias qog noj ntshav tau kis mus rau lwm qhov chaw (metastasized), kev kho mob xws li chemotherapy thiab kev kho mob hluav taws xob .

Vim tias txhua tus neeg mob '(MEN)' yog tus kheej, txoj kev npaj kho mob uas ua haujlwm rau txhua tus neeg yog txawv. Tsis txhob ntshai tham nrog koj tus kws kho mob txog cov kev xaiv kho mob uas zoo tshaj plaws rau koj.

Puas kho tau '(MEN)' kom zoo tag nrho? Puas tiv thaiv tau?

Tu siab kawg li, tam sim no tsis muaj tshuaj kho tau tus mob "(MEN)". Txawm li cas los xij, nws tuaj yeem tswj tau . Cov kws kho mob kho cov kev hloov pauv hauv txhua lub qog nrog kev phais lossis tshuaj raws li tsim nyog rau lub sijhawm.

Nws tsis muaj peev xwm tiv thaiv kev loj hlob ntawm '(MEN)', vim nws yog los ntawm kev hloov pauv caj ces. Cov kev hloov pauv caj ces no tuaj yeem tau txais los ntawm niam txiv lossis tshwm sim tsis raws cai thaum lub sijhawm embryonic.

Txawm li cas los xij, yog tias ib tug neeg hauv tsev neeg (niam txiv, kwv tij neej tsa) tau kuaj pom tias muaj MEN, nws yog ib qho tseem ceeb uas yuav tsum tham nrog koj tus kws kho mob txog kev kuaj noob caj noob ces rau MEN. Ua li ntawd tuaj yeem pab nrhiav pom cov qog nqaij hlav thaum ntxov yog tias koj muaj tus mob no.

Yuav muaj dab tsi tshwm sim thaum koj nyob nrog '(MEN)'? (Kev kwv yees)

Qhov kev kwv yees rau MEN nyob ntawm ntau yam:

• Tau txheeb xyuas '(MEN)' sai npaum li cas.
• Cov qog endocrine twg raug cuam tshuam?
• Seb lub qog puas yog mob qog noj ntshav los tsis yog.
• Hom kev kho mob siv.
• Seb qhov mob qog nqaij hlav puas tau kis mus rau lwm qhov ntawm lub cev (metastasized) hu ua.

Yog tias koj tau kuaj pom tias muaj MEN, koj tus kws kho mob tuaj yeem muab lub tswv yim zoo tshaj plaws rau koj txog koj txoj kev kho mob thiab txoj hauv kev rau pem hauv ntej.

Thaum twg yuav tsum mus ntsib kws kho mob thiab cov lus nug tseem ceeb uas yuav tsum nug

Yog tias koj tau kuaj pom tias muaj MEN, koj yuav tsum mus ntsib koj tus kws kho mob tsis tu ncua kom saib xyuas koj tus mob thiab xyuas kom tseeb tias koj txoj kev kho mob ua haujlwm zoo.

Thiab, yog tias ib tug neeg hauv koj tsev neeg muaj '(MEN)', nrog koj tus kws kho mob tham txog kev kuaj noob caj noob ces, raws li tau hais ua ntej.

Yog koj muaj tus mob "MEN" (MEN), tej zaum yuav pab tau yog koj nug koj tus kws kho mob cov lus nug zoo li no:

• Kuv muaj hom '(MEN)' twg?
• Cov tshuaj (MEN) cuam tshuam li cas rau kuv lub cev?
• Kuv yuav tsum saib xyuas cov tsos mob twg?
• Kuv muaj cov kev kho mob twg?
• Cov txiaj ntsig thiab qhov tsis zoo ntawm ntau txoj kev kho mob yog dab tsi?
• Yuav siv sijhawm ntev npaum li cas rau kev kho mob kom ua tiav?
• Puas yuav tsum kuaj kuv tsev neeg rau (MEN)?

Thaum kawg, tej yam yuav tsum nco ntsoov (Cov Lus Coj Mus Tsev)

Kab mob qog nqaij hlav ntau yam (MEN) yog ib yam mob tsis tshua muaj. Tsis tas li ntawd, vim tias MEN tuaj yeem ua rau muaj ntau yam tsos mob thiab tsis yog txhua tus neeg mob zoo ib yam, qee zaum nws yuav nyuaj rau paub seb koj puas muaj nws.

Yog tias koj muaj cov tsos mob tshiab uas ua rau koj txhawj, lossis yog tias koj pom muaj kev hloov pauv hauv koj lub cev, qhov zoo tshaj plaws ua yog mus ntsib kws kho mob.

Txawm hais tias qee kis ntawm '(MEN)' tshwm sim tsis raws sijhawm, nws kuj tuaj yeem khiav hauv tsev neeg. Yog tias ib tug ntawm koj cov txheeb ze muaj '(MEN)', nws yog ib qho tseem ceeb heev uas yuav tsum tau kuaj noob caj noob ces kom paub seb koj puas muaj feem yuav muaj tus kab mob. Tham nrog koj tus kws kho mob txog txhua lo lus nug uas koj muaj txog koj qhov kev pheej hmoo ntawm kev muaj '(MEN)'. Lawv nyob ntawd los pab koj. Tsis txhob ntshai, tsis txhob ntshai, thiab tsis txhob ntshai nug cov lus nug.

` Multiple endocrine neoplasia, MEN, endocrine system, cov tshuaj hormones, qog nqaij hlav, mob qog noj ntshav, MEN hom 1, MEN hom 2, parathyroid, pituitary, pancreas, thyroid, MTC, pheochromocytoma, mob caj ces, cov tsos mob, kev kuaj mob, kev kho mob