Thymic carcinoid tumors are generally a later feature of MEN1 and occur in most series in >90% in males, so that it is important that guidelines for screening/management for these aggressive tumors, that have been proposed in a number of recent papers, be carefully followed.42,111,131,151,196 It has been proposed that the routine use of partial thymectomy (cervical thymectomy) at the time of parathyroidectomy may reduce the occurrence of thymic carcinoids, and at present this is generally recommended; however, cases of thymic carcinoid have still occurred in MEN1 patients who have previously had this surgery, therefore careful regular follow-up is required.45,98,140,151,156,235,412,414,477,479 At present the treatment of advanced metastatic disease in patients with thymic carcinoids is not very effective, therefore the main aim at present is to prevent them if possible (with cervical thymectomy) and for their early diagnosis and aggressive surgical treatment.111,131,151