Acromegaly can also be associated with hyperparathyroidism, neuroendocrine tumors (e.g. gastrinoma, insulinoma or a non-functional pancreatic tumor), adrenal and other endocrine and non-endocrine tumors in patients with multiple endocrine neoplasia type 1 (MEN1), which is related to a germline mutation of the menin gene in many cases [49,50]. Here, MEN1 is linked to acromegaly.