Management of endocrine neoplasms:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1998
|
| Schriftenreihe: | Surgical oncology clinics of North America
7,4 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XVI S., S. 633 - 925 Ill., graph. Darst. |
Internformat
MARC
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| 245 | 1 | 0 | |a Management of endocrine neoplasms |c Christopher R. McHenry, guest ed. |
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Datensatz im Suchindex
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|---|---|
| adam_text | M/WAC.HMI NTOF ENDOCRINE NEOPLASMS
CONTENTS
Foreword xiii
Blake Cady, MD
Preface xv
Christopher R. McHenry, MD
Papillary Carcinoma of the Thyroid Gland: Treatment Based
on Risk Group Definition 633
Blake Cady
This article outlines the current controversy regarding the extent
of treatment of papillary carcinoma of the thyroid. It emphasizes
that following general principles in surgical oncology, surgeons
doing endocrine cancer management should scale the extensive
ness of their operative procedure to the risk of the cancer. The
majority of patients with papillary carcinoma fall into a low risk
group with a 1% or less risk of death over a period of many years.
It is illogical to treat these patients in the same fashion as patients
who have a 50% risk of death in a shorter period of time. The
various components of the risk assignment systems are outlined
and emphasized to give surgeons the confidence to use risk cate¬
gory in their selection of surgical and adjuvant treatment of pap¬
illary carcinoma of the thyroid.
Papillary Thyroid Carcinoma: Justification for Total
Thyroidectomy and Management of Lymph Node Metastases 645
Herbert Chen and Robert Udelsman
Papillary thyroid carcinoma (PTC) is the most common epithelial
thyroid tumor and comprises approximately 80% of all thyroid
cancers. In this article, the authors discuss the data showing that
total thyroidectomy is the treatment of choice of clinically signifi¬
cant PTC, and review an algorithm for the management of lymph
node metastases. Although the prognosis for patients with PTC is
generally good, appropriate surgical management (total thyroidec
1 SURGICAL ONCOLOGY CLINICS OF NORTH AMERICA
VOLUME 7 • NUMBER 4 • OCTOBER 1998 vii
tomy plus 131I and life long TSH suppression) can further reduce
recurrence and cancer death rates significantly.
Guidelines for the Use of Radio Iodine, Thyroid Hormone,
and Treatment of Metastatic Disease in Patients With
Differentiated Thyroid Cancer 665
Edward Paloyan, Regina Paloyan Walker, and A. M. Lawrence
The treatment of metastatic differentiated thyroid carcinoma is cur¬
rently at a crossroad. The stunning effect of imaging doses of RAI
on subsequent treatment doses is being recognized. Alternatives to
RAI imaging for diagnostic purposes are being tested; these in¬
clude ultrasonography for local and cervical nodal remnants/re¬
currences, Sestamibi and other isotope scanning that do not require
the discontinuation of TSH suppression, and the measurement of
circulating thyroglobulin that is rapidly becoming the cornerstone
of the detection and the treatment follow up of metastatic carci¬
noma.
Medullary Thyroid Carcinoma: Genetic Advances,
Treatment Recommendations, and the Approach to the Patient
With Persistent Hypercalcitoninemia 681
David D. Chi and Jeffrey F. Moley
Medullary thyroid cancer is a tumor of the thyroid C cells that
occurs in sporadic and hereditary clinical settings. Genetic testing
of at risk individuals is available and has been applied to patient
management. Plasma calcitonin levels are a sensitive marker for
the presence of disease. Surgery offers the best hope for cure and
also is an effective modality for managing metastatic and recurrent
disease.
Anaplastic Cancer, Lymphoma, and Metastases
of the Thyroid Gland 707
Janice L. Pasieka
Not all thyroid carcinomas behave in an indolent fashion. There is
a rare group of thyroid neoplasms that is biologically aggressive
and carries a poor prognosis. These tumors include poorly differ¬
entiated tumors, anaplastic, and thyroid lymphomas. Poorly dif¬
ferentiated tumors are important tumors to recognize because ag¬
gressive surgical intervention appears to offer the best chance for
long term survival. Until recently, anaplastic carcinoma was uni¬
versally fatal. Preoperative chemotherapy and hyperfractionated
radiation has led to better local control and a few long term sur¬
vivors. The role of the surgeon in the treatment of the thyroid lym¬
phomas remains controversial, however, most would agree that the
surgeons role is limited, because these tumors are radiosensitive
and chemosensitive.
Viii CONTENTS
Parathyroid Adenoma, Hyperplasia, and Carcinoma:
Localization, Technical Details of Primary Neck Exploration,
j and Treatment of Hypercalcemic Crisis 721
Electron Kebebew and Orlo H. Clark
The pathologic characteristics and clinical presentation of patients
with primary hyperparathyroidism are discussed including the
treatment of hypercalcemic crisis. Surgical issues, including the use
of localizing studies, and the surgical treatment of primary hyper¬
parathyroidism are reviewed.
The Adrenal Incidentaloma: Guidelines for Evaluation
and Recommendations for Management 749
Debra J. Graham and Christopher R. McHenry
Adrenal masses are identified incidentally on up to 1.5% of all ab¬
dominal CT scans. The appropriate evaluation and management of
these incidentalomas remains controversial and centers on ques¬
tions of function and potential for malignancy. Functional evalu¬
ation includes consideration of the diagnoses of aldosteronoma,
pheochromocytoma, and corticosteroid producing adenoma. Po¬
tential for malignancy can be evaluated using a number of imaging
modalities, although none is diagnostic. Size remains one of the
best criteria for assessing potential for malignancy.
Benign and Malignant Pheochromocytoma: Diagnosis,
Treatment, and Follow Up 765
Electron Kebebew and Quan Yang Duh
The clinical manifestation of pheochromocytoma is presented with
specific emphasis on accurate diagnostic approach. The sensitivity,
specificity, and indication of localizing studies of pheochromocy
tomas are reviewed. Management of benign and malignant pheo
chromocytomas are discussed with follow up recommendations.
Functioning and Nonfunctioning Adrenocortical Carcinoma:
Clinical Presentation and Therapeutic Strategies 791
Michael J. Demeure and Lewis B. Somberg
Adrenocortical cancers are relatively rare endocrine tumors that
usually present when hormonally active or after they have become
large and metastasis has occurred. Consequently, the 5 year sur¬
vival rate is 20% to 35%. Surgical removal remains the only form
of therapy proven to prolong survival. Mitotane is the most ac¬
cepted form of chemotherapy. For the approximately 20% to 25%
of patients whose tumors respond to mitotane, survival is pro¬
longed.
CONTENTS IX
Surgical Approach to Adrenal Neoplasms: Laparoscopic
Versus Open Adrenalectomy 807
Constantine V. Godellas and Richard A. Prinz
There are a number of different approaches available to surgically
remove the adrenal gland. These can be broadly classified into two
general categories, open and laparoscopic. There is no one best
method for all patients. Surgeons, skilled in all aspects of adrenal
surgery, should choose an approach for adrenalectomy based on
patient and tumor related factors. Once advantages and disadvan¬
tages of a specific procedure, with these factors in mind, are
weighed, the best approach for the individual patient should be
chosen.
Insulinoma 819
Clive S. Grant
Symptoms most characteristically diagnostic of insulinoma are
those of neuroglycopenia. The combination of hypoglycemia and
endogenous hyperinsulinemia are pathognomonic of insulinoma.
Several localization techniques are available, the choice of which
best depends on the best expertise at individual institutions. Intra
operative ultrasonography is helpful in localization and denning
related anatomy. Enucleation of these intrapancreatic tumors is
preferred, but for body and tail lesions, distal pancreatic resection
may be required. Because at least 90% are benign, long term cure
with complete resolution of preoperative symptoms is expected.
Gastrinoma: Advances in Localization and Treatment 845
Jeffrey A. Norton
Gastrinomas secrete gastrin and cause symptoms related to gastric
acid hypersecretion that can be controlled by antisecretory medi¬
cations. Primary tumors are located within the pancreas or duo¬
denum and 60% metastasize. Liver metastases are associated with
decreased survival. Localization studies especially somatostatin re¬
ceptor scintigraphy are indicated to image the extent of disease.
Surgery is indicated to potentially cure the patient, or control the
malignant tumoral process and prolong survival.
Therapeutic Alternatives in Metastatic
Neuroendocrine Tumors 863
Craig A. Miller and E. Christopher Ellison
In the treatment of neuroendocrine tumors that cannot be resected
for cure two goals must be addressed: (1) the control of symptoms
X CONTENTS
related to hormonal hypersecretion and (2) the prolongation of sur¬
vival by destruction of tumor of the limitation of its growth. Clini¬
cal approaches, medical and surgical, have been developed in re¬
cent years to meet these goals. Surgical options in the face of
metastatic disease include resection of hepatic metastases, cryoab
lation, and liver transplantation. Medical therapy includes treat¬
ment of symptomatic hypersecretory states and systemic chemo
therapeutic and immunomodulatory regimes. Hepatic artery
chemoembolization has also been used successfully in the treat¬
ment of hepatic metastases of neuroendocrine tumors.
Management of Pancreatic Endocrine Tumors in Patients
With Multiple Endocrine Neoplasia Type 1 881
Norman W. Thompson
The rationale for a multifaceted operative procedure in all MEN 1
patients with pancreaticoduodenal neuroendocrine disease who
present without liver metastases is presented. The results in 36
patients with MEN 1 ZES are encouraging in that more than two
thirds are eugastrinemic and none have liver metastases after fol¬
low up as long as 20 years.
Management of Follicular and Hiirthle Cell Neoplasms
of the Thyroid Gland 893
Christopher R. McHenry and Bernardo A. Sandoval
Management of follicular and Hiirthle cell neoplasms of the thy¬
roid gland is a common clinical problem. A diagnosis of follicular
or Hiirthle cell carcinoma cannot be made from a fine needle as¬
piration biopsy alone because it requires histologic demonstration
of capsular or vascular invasion. Thyroid lobectomy and isthmu
sectomy is adequate treatment of benign follicular or Hiirthle cell
adenoma and minimally invasive follicular carcinoma. Total thy
roidectomy, radioiodine ablation, and thyrotropin suppressive
doses of thyroid hormone is advocated for the invasive subtype of
follicular carcinoma and all Hiirthle cell carcinomas. Monitoring of
serum thyroglobulin levels postoperatively is important for detec¬
tion of recurrent disease.
Cumulative Index 1998 911
Subscription Information Inside back cover
CONTENTS X*
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| series | Surgical oncology clinics of North America |
| series2 | Surgical oncology clinics of North America |
| spelling | Management of endocrine neoplasms Christopher R. McHenry, guest ed. Philadelphia [u.a.] Saunders 1998 XVI S., S. 633 - 925 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Surgical oncology clinics of North America 7,4 Hormonaktiver Tumor (DE-588)4160657-7 gnd rswk-swf Chirurgie (DE-588)4009987-8 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Hormonaktiver Tumor (DE-588)4160657-7 s Chirurgie (DE-588)4009987-8 s DE-604 MacHenry, Christopher R. Sonstige oth Surgical oncology clinics of North America 7,4 (DE-604)BV007071205 7,4 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008283888&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Management of endocrine neoplasms Surgical oncology clinics of North America Hormonaktiver Tumor (DE-588)4160657-7 gnd Chirurgie (DE-588)4009987-8 gnd |
| subject_GND | (DE-588)4160657-7 (DE-588)4009987-8 (DE-588)4143413-4 |
| title | Management of endocrine neoplasms |
| title_auth | Management of endocrine neoplasms |
| title_exact_search | Management of endocrine neoplasms |
| title_full | Management of endocrine neoplasms Christopher R. McHenry, guest ed. |
| title_fullStr | Management of endocrine neoplasms Christopher R. McHenry, guest ed. |
| title_full_unstemmed | Management of endocrine neoplasms Christopher R. McHenry, guest ed. |
| title_short | Management of endocrine neoplasms |
| title_sort | management of endocrine neoplasms |
| topic | Hormonaktiver Tumor (DE-588)4160657-7 gnd Chirurgie (DE-588)4009987-8 gnd |
| topic_facet | Hormonaktiver Tumor Chirurgie Aufsatzsammlung |
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