Management of the Indeterminate Thyroid Nodule

Feb 26, 2017 by in ENDOCRINOLOGY Comments Off on Management of the Indeterminate Thyroid Nodule

Royal College of Pathologists-modified BTA nomenclature US Bethesda System (BSRTC) Risk of malignancy (%) Thy1: Nondiagnostic I: Nondiagnostic 0–10 Virtually acellular specimen Other (blood, clotting artifacts, etc.) Thy1c: Nondiagnostic –…

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Pheochromocytoma and Paraganglioma

Feb 26, 2017 by in ENDOCRINOLOGY Comments Off on Pheochromocytoma and Paraganglioma

Syndrome Gene (chromosome)a,b Clinical manifestations % With PHEO % Bilateral von Hippel-Lindauc VHL (3p25-p26) PHEO, cerebellar hemangioblastoma, retinal angiomas, renal cell carcinoma, pancreatic cysts, pancreatic NETs in 5–10 % 10–20…

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Assessment of Goiter

Feb 26, 2017 by in ENDOCRINOLOGY Comments Off on Assessment of Goiter

Classification Finding 0 No goiter palpable or visible 1a Goiter detected by palpation only 1b Goiter palpable and visible with neck extended 2 Goiter visible with neck in normal position…

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Surgery for Benign Thyroid Disease

Feb 26, 2017 by in ENDOCRINOLOGY Comments Off on Surgery for Benign Thyroid Disease

Simple(nontoxic) goiter Multinodular Solitary thyroid nodule Follicular adenoma Thyroid cyst Toxic goiter Diffuse (Graves’ disease) Toxic multinodular (Plummer’s disease) Solitary toxic adenoma Inflammatory goiter Acute suppurative thyroiditis Subacute (painless) lymphocytic,…

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Minimally Invasive Adrenal Surgery

Feb 26, 2017 by in ENDOCRINOLOGY Comments Off on Minimally Invasive Adrenal Surgery

Fig. 7.1 Patient position for posterior retroperitoneoscopic adrenalectomy The patient is positioned prone with hips and knees flexed, with the side of surgery as near to the side of the…

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Cushing’s Disease and Syndrome

Feb 26, 2017 by in ENDOCRINOLOGY Comments Off on Cushing’s Disease and Syndrome

Fig. 2.1 Contrast-enhanced CT scan in a patient with Cushing’s syndrome demonstrating a left primary adrenal tumor and a synchronous metastasis in the right lobe of the liver Medical Management…

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Adrenal and Paraganglioma: Presentation, Assessment, and Diagnosis

Feb 26, 2017 by in ENDOCRINOLOGY Comments Off on Adrenal and Paraganglioma: Presentation, Assessment, and Diagnosis

Amiloride Estrogen (combined oral contraceptive pill, hormone replacement therapy) Diuretics ACE inhibitors Angiotensin II receptor blockers Dihydropyridine calcium channel blockers Heparin Lithium Nonsteroidal anti-inflammatory drugs (NSAIDs) Plasma renin activity will…

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Management of Conn’s Syndrome

Feb 26, 2017 by in ENDOCRINOLOGY Comments Off on Management of Conn’s Syndrome

Causes of primary hyperaldosteronism Percentage of cases Remarks Aldosterone-producing adenoma (APA) ~35 % Original pathology described by Conn Bilateral idiopathic adrenal hyperplasia (BAH) ~60 % – Primary unilateral adrenal hyperplasia…

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Adrenal Metastasectomy

Feb 26, 2017 by in ENDOCRINOLOGY Comments Off on Adrenal Metastasectomy

Pearls Pitfalls All patients should be discussed in a multidisciplinary team (MDT) meeting Be sure that the imaging is contemporaneous as some adrenal metastases have a rapid doubling time (esp…

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Adrenocortical Carcinoma and Open Adrenalectomy

Feb 26, 2017 by in ENDOCRINOLOGY Comments Off on Adrenocortical Carcinoma and Open Adrenalectomy

Histological criteria assessed for the Weiss score High mitotic rate Atypical mitoses High nuclear grade Low percentage of clear cells Necrosis Diffuse architecture of tumor Capsular invasion Sinusoidal invasion Venous…

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