Unusual functioning endocrine tumors

Current Treatment Options in Oncology
Chandrajit P Raut, Jeffrey E Lee

Abstract

Endocrine surgeons should maintain a high index of suspicion when patients are diagnosed with clinical signs or symptoms of parathyroid carcinoma. Although rare, the best chance for cure of these patients is at the time of the initial operation. Surgical resection of recurrent disease can provide effective palliation and can sometimes be assisted using gamma-probe directed dissection of sestamibi-labeled tumor tissue. Treatment of hyperparathyroidism in the setting of multiple endocrine neoplasia type 1 (MEN-1), particularly in the reoperative setting, can be aided by using the rapid intraoperative parathyroid hormone assay to judge the adequacy of parathyroid debulking. In addition, in selected cases, the gamma probe can assist in identifying the location of ectopic or autografted sestamibi-labeled parathyroid tissue. Patients with incidental adrenal masses rarely require fine needle aspiration to exclude metastatic cancer. Fine needle aspiration, if performed, should never precede hormone evaluation to exclude pheochromocytoma. Patients who are diagnosed with incidental adrenal masses in the setting of a prior or concurrent cancer diagnosis are equally likely to have a primary adrenal mass as they would be to have metastatic ...Continue Reading

References

Jan 1, 1995·American Journal of Surgery·F G QueL K Kvols
Aug 26, 1999·The New England Journal of Medicine·J A NortonR T Jensen
Feb 7, 2001·The Journal of Clinical Endocrinology and Metabolism·E Shane
May 10, 2002·The New England Journal of Medicine·Hartmut P H NeumannUNKNOWN Freiburg-Warsaw-Columbus Pheochromocytoma Study Group
Jun 7, 2002·Archives of Surgery·Maria A KouvarakiDouglas B Evans
Apr 11, 2003·Archives of Surgery·Linwah YipDouglas B Evans

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Citations

Oct 23, 2008·Endocrine Reviews·Johannes D VeldhuisSteven M Pincus

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