In Multiple endocrine neoplasia type 2B (MEN2B), when regional or distant spread limits what conventional surgery can safely achieve, the management approach shifts toward preserving function while still pursuing disease control.
When MEN2B presents with extensive regional or metastatic disease, the priority is balancing oncologic control against preservation of critical structures — including voice, swallowing, parathyroid function, and shoulder mobility.
In the presence of extensive regional or metastatic disease less aggressive surgery in the central and lateral neck may be appropriate to preserve speech, swallowing, parathyroid function, and shoulder mobility.
External beam radiotherapy (EBRT), systemic medical therapy, and other nonsurgical therapies should be considered to achieve local tumor control.
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