多内分泌腺腫症の2例(1型と2b型)

Abstract

Multiple endocrine neoplasia (MEN) is rare. We report two cases of type I and type IIb MEN. A 41-year-old female visited our clinic with a complaint of spontaneous discharge of urinary stones. Right lobe of the thyroid had been resected in previous operation for cancer. She was diagnosed to have hyperparathyroidism from hypercalcemia, hypophosphatemia and a small tumor in the neck. Left upper parathyroid and a lymphnode beside the left lower part of the thyroid were extirpated. Pathological examination revealed the former as adenoma and the later as metastasis of thyroid cancer. Since multiple pancreatic tumors and pituitary tumor were later detected, she was diagnosed to have type I MEN. Recently, her serum calcium level again elevated. A 27-year-old male visited our clinic with complaints of multiple tongue tumors, malfanoid habitus and characteristic facies, such as lip hypertrophy, everted eyelids and prognathism. This characteristic subjective picture made type IIb MEN doubtful. Medullary thyroid cancer was discovered, but pheochromocytomas could not be found.