The scores of each item in the scoring system were defined as 2 points for recurrent or multigland parathyroid disease, 1 for presence of dpNET, 1 for age at presentation with first MEN1-related primary manifestation ≤ 39, and 1 for presence of angiofibroma or collagenoma (Table 3). Here, MEN1 is linked to parathyroid gland disorder.