A 20 year old male presented with chronic constipation, headache and palpitations. On examination he had marfanoid habitus, neuromas of tongue, medullated corneal nerve fibers and nodule of 2x2 cm size in the left lobe of thyroid gland. This patient is a case of :
Answer is D (MEN IIB); The association of medullary carcinoma thyroid & pheochromocytoma, with mucosa' neuromas and marlinoid hahitus is designated 'MEN IIB' - Mucosal neuromas and marlinoid habitus are the most distinctive features of MEN 11B and are recognized in childhood. - Harrison True Neuromas are present on the tip of tongue, under the eyelids and throughout the gastrointestinal tract and are tree neuromas distinct from neurolibromas. MEN I (Wermer's syndrome) MEN II MEN II A (Sipple syndrome) MEN II B Characteristic Manifestations * MTC * MTC * Parathyroid hyperplasia or adenoma * Pheochromocytoma * Pheochromocytoma * Pancreatic tumors (Islet cell hyperplasia, adenoma, or carcinoma) * Parathyroid hyperplasia or adenoma * Mucosal and gastrointestinal neuromas * Marfanoid features * Pituitary hyperplasia or adenoma * Cutaneous lichen amyloidosis Other less common manifestations * Hischsprung disease * Foregut carcinoid * FMTC * Subcutaneous or visceral lipomas * Dermal angiofibromas or collagenomas
Sporadic medullary carcinoma of thyroid
Familial medullary carcinoma of thyroid
MEN IIA
MEN IIB