01-23-2009, 05:02 PM
A 52-year-old woman presents to her physician's office complaining of an enlarging nose, thickening of her tongue, and coarsening of her facial features. She had started noticing the gradual change 2-3 years earlier, accompanied by soreness of the hands. No change in shoe size or enlargement of the limbs was reported. The patient denies having headaches. When she was 42 years old, she was diagnosed with chronic bronchitis. At the age of 51, she underwent thyroid surgery for multinodular goiter. On examination, her blood pressure is 140/90 mm Hg and her pulse is 68/min. A chest x-ray film shows a well-demarcated opacity, 5 cm in diameter, located in the posterobasal part of the right pulmonary lobe.
Which of the following is the most likely diagnosis?
A. Gigantism
B. McCune-Albright syndrome
C. NAME syndrome
D. Paraneoplastic syndrome
E. Pituitary adenoma
Which of the following is the most likely diagnosis?
A. Gigantism
B. McCune-Albright syndrome
C. NAME syndrome
D. Paraneoplastic syndrome
E. Pituitary adenoma