Jaruratanasirikul S, Patarakijvanich N, Patrapinyokul S, Saetung P
Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
J Med Assoc Thai. 1993 Jun;76(6):334-8.
We reported a 14-year-old boy who had had multiple thyroid nodules for 4 yrs. Physical examination revealed marfanoid habitus, coarse facies with thick lips and prominent jaw. Mucosal neuromas were present on the buccal mucosa, tongue and upper eyelids. Thyroid scan demonstrated multiple, cold nodules and medullary thyroid carcinoma was confirmed by pathological examination. He was normotensive and his 24 hrs urinary vanillyl mandelic acid was in the normal range. Computerized tomography demonstrated normal adrenal glands. Multiple endocrine neoplasia type IIb (MEN IIb) was diagnosed by the appearance of typical phenotypic features, multiple mucosal neuromas and medullary thyroid carcinoma. The scarcity of such reports in children and the importance of early recognition of this disorder prompted us to describe this patient.
我们报告了一名14岁男孩,他有多个甲状腺结节已4年。体格检查发现其具有马方综合征体型,面容粗糙,嘴唇增厚,下颌突出。颊黏膜、舌头和上眼睑有黏膜神经瘤。甲状腺扫描显示多个冷结节,病理检查证实为甲状腺髓样癌。他血压正常,24小时尿香草扁桃酸在正常范围内。计算机断层扫描显示肾上腺正常。根据典型的表型特征、多个黏膜神经瘤和甲状腺髓样癌的出现,诊断为IIb型多发性内分泌肿瘤(MEN IIb)。儿童中此类报告较少,且早期识别这种疾病很重要,这促使我们描述该患者。