A 35-year-old man comes to the physician because of a painless lump on his neck. Physical examination shows a firm, irregular swelling on the right side of the neck. Ultrasonography of the thyroid gland shows a 2-cm nodule with irregular margins and microcalcifications in the right thyroid lobe. There are multiple 4- to 8-mm soft papules on the lips and tongue. The arm span exceeds his height and the patient has long fingers. Serum calcitonin levels are elevated. Which of the following is most likely to develop in this patient?

Question

A 35-year-old man comes to the physician because of a painless lump on his neck. Physical examination shows a firm, irregular swelling on the right side of the neck. Ultrasonography of the thyroid gland shows a 2-cm nodule with irregular margins and microcalcifications in the right thyroid lobe. There are multiple 4- to 8-mm soft papules on the lips and tongue.  The arm span exceeds his height and the patient has long fingers.  Serum calcitonin levels are elevated.  Which of the following is most likely to develop in this patient?

Quizplus · Accepted Answer

Eductional Objective: Multiple endocrine neoplasia type 2B is characterized by medullary thyroid cancer, pheochromocytomas, mucosal neuromas, and marfanoid habitus.  Hyperparathyroidism is not a feature of this syndrome.

A 35-Year-Old Man Comes to the Physician Because of a Painless