Modified Neck Dissection for Differentiated Thyroid Cancer
Figure 9.1 Levels of the central (a) and lateral (b) neck Figure 9.2 Rates of metastasis are highest to levels IIa to Vb, with disease less common at levels I,…
ENDOCRINOLOGY
Surgery for Duodenal and Gastric Neuroendocrine Tumors
Figure 14.1 Duodenal NET identified incidentally during endoscopy. Note the tumor originates in the submucosa and is seen as a small mass within the duodenal wall 14.1.2 Surgery Patients who…
Mediastinal/Thoracoscopic Parathyroidectomy
Figure 5.1 Sestamibi scan showing persistent uptake of the radionuclide by an intrathoracic parathyroid adenoma (arrow) Figure 5.2 CT scan confirming the presence of a parathyroid adenoma in the mediastinum…
Thyroid Lobectomy and Total Thyroidectomy
Figure 6.1 The incision may be placed just below the cricoid cartilage, conforming to the skin crease. If the patient is likely to require neck dissection, a higher incision on…
Substernal Goiter
Figure 8.1 The upper pole is prepared and resected with ligation of the superior thyroid artery and vein Figure 8.2 The superior parathyroid gland and the recurrent laryngeal nerve (RLN)…
Minimally Invasive Parathyroidectomy with Intraoperative PTH Testing
Figure 2.1 Preoperative imaging in a patient with primary hyperparathyroidism. (a) High-resolution ultrasound identified a likely parathyroid adenoma between the left thyroid lobe and the left carotid artery. (b) Planar…
Parathyroid Transplantation
Figure 4.1 The parathyroid gland is grasped along its long axis (shown here with DeBakey forceps) and, using a scalpel with a #10 Bard Parker blade, whole tissue discs approximately…
and Metabolic Syndrome: A Phenotype of Mild Long-Term Hypercortisolism?
Fig. 1 Overlap between Cushing’s syndrome and metabolic syndrome Although the example of Cushing’s syndrome makes a link between cortisol and obesity in the general population theoretically plausible, it represents…
Effects of Prior Cushing’s Syndrome
Fig. 1 Main clinical manifestations after remission of Cushing’s syndrome This chapter addresses current information on the main long-term/persistent effects of prior Cushing’s disease/glucocorticoid exposure. Cardiovascular and Metabolic Comorbidities Hypercortisolism…
Generalized Glucocorticoid Resistance or Chrousos Syndrome: Allostasis Through a Mutated Glucocorticoid Receptor
Target tissue Glucocorticoid hypersensitivity = Glucocorticoid excess Glucocorticoid resistance = Glucocorticoid deficiency Central nervous system Insomnia, anxiety, depression, defective cognition Fatigue, somnolence, malaise, defective cognition Liver + Gluconeogenesis, + lipogenesis…
