A woman in her 20s presented to the dermatology clinic for evaluation of lesions on her tongue that had been present since infancy. They were asymptomatic; however, they were occasionally painful when the patient bit on them during eating. Physical examination revealed multiple soft yellow papules on the tongue and buccal mucosa (Figure), as well as enlargement of the upper lip. She had a history of medullary thyroid carcinoma, pheochromocytoma resulting in a right-sided adrenalectomy, and positive genetic testing results for a pathogenic variant in the rearranged during transfection (RET) protooncogenic gene, which were all consistent with multiple endocrine neoplasia syndrome (MEN) type 2B (MEN2B). Her oral lesions were consistent with mucosal neuroma, which is present in all patients with MEN2B within the first few months of life.1,2