Multiple endocrine neoplasia type IIb: a description of several patients and review of the literature.

Our experience exemplifies the varied clinical presentations of patients with MEN IIb. This syndrome may be familial or sporadic, and clinical stigmata may be identifiable in infancy, particularly the characteristic facies and the appearance of ganglioneuromas. First-degree relatives of affected propositi and individuals with other stigmata of the syndrome should be screened carefully and repeatedly for both medullary thyroid carcinoma and pheochromocytoma. The availability of sensitive screening tests may permit detection of C-cell hyperplasia of the thyroid and adrenal medullary hyperplasia before the development of malignancy or hemodynamic consequences of pheochromocytoma. Early detection of these thyroid and adrenal disorders will permit early surgical intervention.