All of these individuals should also undergo clinical screening for other tumors of MEN 1, including evaluation for the following: Symptoms of peptic ulcer disease, diarrhea, nephrolithiasis, hypoglycemia, and hypopituitarism Visual field defects, galactorrhea, and features of acromegaly and subcutaneous lipomas Abnormal levels of serum calcium, intact PTH, gastrin, and prolactin Additional laboratory or radiologic tests should be done if these screening tests suggest an endocrine abnormality related to MEN 1.