Which condition classically presents with episodic hypertension or headache, particularly in MEN 2A and 2B?

The condition that classically presents with episodic hypertension or headache, particularly in MEN 2A and 2B, is pheochromocytoma. This tumor arises from the adrenal medulla and secretes catecholamines, such as epinephrine and norepinephrine, which can lead to episodes of increased blood pressure, palpitations, and headaches.

In the context of Multiple Endocrine Neoplasia (MEN) syndromes type 2A and 2B, pheochromocytoma is known to be associated, making it a significant concern for patients with these genetic conditions. The episodic nature of the symptoms is characteristic of the paroxysmal release of catecholamines triggered by various stimuli.

Insulinoma primarily leads to hypoglycemia, and its symptoms include shakiness and confusion rather than hypertension. Adenomas can refer to a variety of benign tumors and are not specifically associated with the classic symptoms described. Carcinoid syndrome, which can cause flushing and diarrhea, is linked more to serotonin secretion rather than the hypertension and headache seen in patients with pheochromocytoma.