Multiple endocrine neoplasia, type IIB (MEN 2b), is omprised of medullary carcinoma of the thyroid, pheohromocytoma, diffuse ganglioneuromatosis of the gasrointestinal tract, and skeletal abnormalities. Alimentary ract manifestations, especially enlargement of the lips and ongue by proliferative neural tissue, are often the earliest lues to the presence of the syndrome. A patient is presented ere who illustrates the chronicity and diversity of symptoms haracteristic of MEN 2b. It is important to recognize the ypical oral manifestations of this syndrome so that the hyroid gland can be evaluated before the development of isseminated medullary carcinoma.