title: Multiple endocrine neoplasia 2B: delayed presentation, rapid diagnosis.
abstract: Multiple endocrine neoplasia (MEN) refers to the synchronous or metachronous development of tumours in two or more endocrine organs. MEN 2B is associated with medullary thyroid carcinoma and phaeochromocytoma along with classic morphological features such as marfanoid habitus and mucosal neuromas. Dominantly inherited germline mutations involving the REarranged during Transfection (RET) proto-oncogene are responsible. Affected patients usually present in childhood with thyroid mass or gastrointestinal symptoms. We describe the case of a 28-year-old man who presented to us with metastatic medullary thyroid carcinoma. He lacked the classic marfanoid habitus, but had mucosal neuromas and thickened corneal nerves. Whole-body metaiodobenzyl guanidine scan (MIBG) showed tracer uptake in adrenal and thyroid-confirming phaeochromocytoma and medullary thyroid carcinoma. This case exemplifies the late presentation of multiple endocrine neoplasia 2B and emphasises the need to screen all cases of medullary thyroid carcinoma for phaeochromocytoma.
authors: Department of Endocrinology, Jawaharlal Institute of Post Graduate Medical Education & Research, Puducherry, India.
authors: Karthik
authors: K
authors: Balachandran
authors: Sadishkumar
authors: S
authors: Kamalanathan
authors: S
authors: S
authors: Gopalakrishnan
authors: K
authors: K
authors: Murugananadham
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000473:pathology; D000311:Adrenal Glands / Q000473:pathology*; D000328:Adult; D018276:Carcinoma, Medullary / Q000151:congenital* / Q000175:diagnosis / Q000473:pathology; D003316:Corneal Diseases / Q000175:diagnosis; D018095:Germ-Line Mutation; D006801:Humans; D008297:Male; D018813:Multiple Endocrine Neoplasia Type 2a / Q000175:diagnosis* / Q000473:pathology; D018814:Multiple Endocrine Neoplasia Type 2b / Q000175:diagnosis* / Q000473:pathology; D009463:Neuroma / Q000175:diagnosis; D010673:Pheochromocytoma / Q000175:diagnosis* / Q000473:pathology; D000090063:Proto-Oncogene Mas; D051096:Proto-Oncogene Proteins c-ret / Q000235:genetics; D013961:Thyroid Gland / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology
chemical_list: C000715470:MAS1 protein, human; D000090063:Proto-Oncogene Mas; D051096:Proto-Oncogene Proteins c-ret
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