This would include individuals with: parathyroid adenomas before the age of 30 years or multigland parathyroid disease; gastrinoma or multiple pancreatic islet cell tumors at any age; or individuals who have two or more MEN1-associated tumors, which are not part of the classical triad of parathyroid, pancreatic islet and anterior pituitary tumors (e.g. parathyroid tumor plus adrenal tumor) (Thakker et al., 2012). This evidence concerns the gene MEN1 and gastrin-producing neuroendocrine tumor.