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endo pr

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by

heather watson

on 19 June 2016

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Transcript of endo pr

EXCESS growth most common most dangerous complications complications investigations Tx Tx pituitary adenoma 99% <<1% ectopic GHRH somatic
metabolic
organomegaly Aggressive lung/GI
carcinoma --> mets surgery
radiation Primary:
surgery
Mets:
somatostatin
analogue IGF-1 Echo OGTT MRI apnea study + visual fields usually macro Incr soft tissue, cartilage, sweat, oil, arthralgias, carpal tunnels insulin resist, lipolysis, HTn, calculi, GI carcinomas heart, liver, thyroid debulking & pre-op somatostatin the more normal GH before surgery
the more likely cure hormone profile TSH, PRL, FSH, LH SS may be required
long term to mng GH hypopituitary 47% mets at time of
acromegalic symptom
presentation pituitary
adenoma hypothalamic
tumour ectopic
GHRH Thyroid nodule most common most dangerous complications complications investigations Tx Tx benign adenoma 25% pediatric malignant anaplastic carcinoma somatic
metabolic
organomegaly survival = months surgery
radiation Primary:
surgery
Mets:
somatostatin
analogue FNAB Frozen sxn RAI scan colloid, follicular Hurthle debulking & pre-op somatostatin the more normal GH before surgery
the more likely cure SS may be required
long term to mng GH mass fx can prohibit
DA flow into pit
incr PRL (galacto) thyroid cyst Benign cysts can be evacuated successfully by aspiration, usually with no recurrence simple MALIGNANT Papillary 75% Follicular 15% MEDULLARY ANAPLASTIC LYMPHOMA 1/3 MEN II a/b
1/3 FMTC
1/3 isolated years MEN ii +pheo polygonal
spindle cells surgical
candidates c-cells calcitonin - > granules ground glass
psammoma bodies indolent
late-stage lung mets can be active
hyperthyroid voice fx swallowing stridor BENIGN cold < 20 or > 70 > hyperthyroid HOT f/u TSH f/u U/S 15% unsatisfactory collxn
benign = follow warm/cold = surgery intraoperative COLLOID FOLLICULAR COMPLEX
CYST HASHIMOTOS FOCAL ASYMMETRIC ENLARGEMENT some follicles
small, empty
filled w colloid honeycomb ENCAPSULATED TSH, T4 always follow
min 1 year
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