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…
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…
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)…
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…
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…
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…
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…
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…
Adrenocortical adenoma Micronodular disease Macronodular disease MAS PPNAD/iMAD/CNC BMAH A. Genetic alterations 1. cAMP/PKA signaling pathway – – MC2R a (missense) – GNAS a – GNAS a GNAS a…
Fig. 1 Pre-receptor regulation of glucocorticoid availability governs access to bind and activate the glucocorticoid receptor Circulating GC levels are tightly controlled by the hypothalamo–pituitary–adrenal (HPA) axis , which regulates…
