Endocrinology Question 2

A 34-year-old man is evaluated for episodic palpitations of 8 months' duration. The palpitations last 5 to 10 minutes and then resolve spontaneously. They are usually associated with sweating and anxiety. Medical history is significant for thyroidectomy for medullary thyroid carcinoma diagnosed at 12 years of age. His father has also undergone thyroidectomy for medullary thyroid cancer. His only medication is levothyroxine.

On physical examination, blood pressure is 164/92 mm Hg, pulse rate is 106/min, and respiration rate is 12/min. Auscultation of the heart reveals a regular tachycardia without murmurs. The remainder of his examination is unremarkable.

Laboratory studies show a 24-hour urine excretion of catecholamines of 310 µg/m2/24 h (1832.1 nmol/m2/24 h) and metanephrines of 3400 µg/24 h (17,238 nmol/24 h).

In addition to the presenting diagnosis, which of the following disorders is this patient most likely to develop?

A Insulinoma

B Neurofibroma

C Primary hyperparathyroidism

D Prolactinoma

Choose an Answer Above

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