A 35-year-old woman presents with episodic severe headaches and diaphoresis. Vital signs show BP 168/104 mmHg, HR 102 bpm, RR 16, temperature 37.2°C. Physical examination reveals a firm thyroid nodule. Laboratory studies demonstrate elevated plasma free metanephrines (420 pg/mL), serum calcium 11.2 mg/dL with parathyroid hyperplasia on imaging, and calcitonin 285 pg/mL. Fasting glucose is normal. Fine-needle aspiration biopsy confirms medullary thyroid carcinoma. Which syndrome best explains this clinical presentation?
- A)Wermer syndrome unrelated to parathyroid disease
- B)MEN 1
- C)MEN 2B
- D)MEN 2AGABARITO
- E)McCune Albright syndrome
Explicação
MEN 2A consists of medullary thyroid carcinoma, pheochromocytoma, and parathyroid hyperplasia. It is associated with activating mutations of the RET proto oncogene. Hypercalcemia from parathyroid disease helps distinguish MEN 2A from MEN 2B. Ver explicação completa e trilha adaptativa →