Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Multiple Endocrine Neoplasia type 1 is an autonomic dominant disease with a high degree of penetrance. It is characterized by combinations of over 20 different endocrine and nonendocrine tumors. A 25-year-old woman was referred for 1 year-evolution amenorrhea and bilateral galactorrhea. She also had fasting hypoglycaemia and hypercalcemia, and she was diagnosed of Multiple Endocrine Neoplasia type 1A. Resection of three parathyroid glands was performed showing hyperplasia of principal cells. Post-parathyroidectomy serum levels of calcium and intact PTH were normal but 3 years later serum calcium levels rose again. A 99mTc-sestamibi scan showed increased uptake in the low right area compatible with adenoma. After biochemical test showing probable insulinoma, somatostatin receptor scintigraphy showed a focal captation in head and body of pancreas. MRI found two nodules in the same localization. An antral gastrectomy, total pancreatoduodenectomy, colecistectomy and truncal vagotomy was performed and histopathologic examination revealed a combination of neuroendocrine tumors: gastrinomas, somastotinomas, glucagonomas and insulinomas. After surgery she started with tingling in fingers, toes and lips, and calcium levels was 5.9 mg/dl and PTH intact 3 pg/ml. A new 99m Tc-sestamibi scan showed no captation and cervical ultrasonography was normal. Now, 2 years later, she continues with normal calcium and i-PTH levels. This report represents an unusual case of MEN 1A with association of insulinomas, gastrinomas glucagonomas and somatostatinomas in the same patient.
 ...
PMID:An unusual association of neuroendocrine tumors in MEN 1A. 2181 87

The standard of care for primary hyperparathyroidism is minimally invasive surgical removal of hyperfunctional parathyroid tissue. Abroad, this minimally invasive approach is often performed in the ambulatory setting. Patients with primary hyperparathyroidism are eligible for outpatient surgery if the risk of conducting the operation is low and various imaging techniques have confirmed the location of the parathyroid adenoma. Of 20 patients with primary hyperparathyroidism who had been treated at our hospital's day surgery department, 5 visited the emergency department the next day because of a tingling sensation; however, minor hypocalcaemia was observed in only 1 of these patients. This relatively high number of emergency-department visits may have been the result of the strict instructions given to the patients or a rapid fall in their serum calcium levels, even without this having resulted in hypocalcaemia. Calcium supplementation is affordable and safe and could reduce the number of visits to the emergency ward after outpatient treatment of hyperparathyroidism.
 ...
PMID:[Outpatient surgical treatment of primary hyperparathyroidism]. 2272 28