MeDiCaL ScHoOoL

MeDiCaL ScHoOoL

Monday, January 14, 2008

ATUMOR ATLAS



Endocrine system

Adrenal gland
NEUROBLASTOMA


DATA FORM FOR CANCER CLASSIFICATION - NEUROBLASTOMA

HISTOPATHOLOGIC TYPE



Sympathicoblastoma , Sympathicogonioma , Malignant ganglioneuroma , Gangliosympathicoblastma , Ganglioneuroma



DATA FORM FOR CANCER CLASSIFICATION - THYROID GLAND


HISTOPATHOLOGIC TYPE

Papillary carcinoma (including those with follicular foci) , Follicular carcinoma , Medullary carcinoma , Undifferentiated (anaplastic) carcinoma


RISK FACTORS, ENDOCRINE ORGANS



Exposure to radiation

Multiple endocrine neoplasia
Medullary carcinoma of thyroid
Hyperparathyroidism
Pheochromocytoma






Exposure to radiation

Familial factors

Multiple endocrine neoplasia (MEN) syndrome (type I and type II: Sipple's syndrome) Hyperparathyroidism

Pancreatic islet cell tumor
Pituitary adenoma
Pheochromocytoma
Medullary carcinoma of thyroid


Low serum potassium level
Low serum chloride level
Low total eosinophils
Lymphopenia
Low plasma level of ACTH
Increase plasma cortisol level

Increased urinary free cortisol

Elevated plasma aldosterone level

Low plasma renin level

C.T. scan

M.R.I



MEN type II syndrome ( Sipple's syndrome )

Pheochromocytoma

Hyperparathyroidism

Medullary carcinoma of thyroid
Recklinghausen's neurofibromatosis

Griffith's syndrome

Pheochromocytoma
Neurofibroma
Duodenal somatostatinoma
Von Hippel Lindau's syndrome

Cerebellar, medullary, spinal hemangioblastomas
Pheochromocytoma
Retinal angioma



CLINICAL FEATURES




Early findings:

Hypercalcemia , Polyuria , Polydipsia , Anorexia , Nausea , Vomitting , Constipation , Muscle weakness , Confusion , Depression , Lethargy
Late findings:

Nephrolithiasis , Nephrocalcinosis , Hypertension , Bone pain , Bone cysts , Arthralgias , Osteitis fibrosa cystica , Pathologic fractures , Band keratopathy





Palpable abdominal mass , Abdominal pain , Cushing's syndrome (Increased cortisol secretion) , Cutaneous striae (purple) , Easy bruisability , Deposition of adipose tissue in face (Moon facies) , Deposition of adipose tissue in interscapular area (Buffalo hump) , Deposition of adipose tissue in mesenteric bed (Truncal obesity) , Osteoporosis , Diabetes mellitus , Hypertension , Obesity , Emotional changes , Irritability , Depression , Psychosis , Confusion , Conn's syndrome (Increased aldosterone secretion) , Hypertension , Headaches , Muscle weakness due to hypokalaemia , Easy fatigue , Polyuria , Polydipsia , Increased androgen secretion , Hirsutism , Oligomenorrhea , Virilization




Hypertension , Paroxysms or crises , Headache , Profuse sweating , Palpitations , Apprehension , Pain in the chest or abdomen , Nausea , Vomitting , Flushing , Tachycardia ,Weight loss , Fever , Sipple's syndrome (MEN II syndrome) , Medullary carcinoma of thyroid , Hyperthyroidism


Palpable abdominal mass , Firm to hard , Irregular Non-tender Dumbbell tumors Neuurological signs , Bone pain , Respiratory distress , Massive hepatomegaly


LABORATORY TESTS, THYROID CARCINOMA


Elevated serum calcium level (Sipple's syndrome)
Elevated serum calcitonin level (Medullary carcinoma)

Elevated serum

CEA level Thyroid hormone assays

Ultrasound

Scintigraphy after radioisotope administration (low uptake)

Radioiodine scan (cold lesion)

Fine needle aspiration cytology

Aspiration biopsy

Chest X ray for detection of pulmonary metastases

C.T. scan of neck

Bone scan for detection of bony metastases


LABORATORY TESTS, PARATHYROID CARCINOMA



Elevated serum level of calcium Low serum phosphate level
Elevated serum chloride level
Elevated serum parathyroid hormone (PTH)
Elevated serum alkaline phosphatase
Elevated serum creatinine level Blood urea nitrogen
Serum protein electrophoretic pattern
Bone studies
Radiography of bones (osteopenia)
Osteitis fibrosa cystica found on X rays (rare)
X ray of skull (ground glass appearance)
Ultrasound
C.T. scan of neck
Thallium 201 technetium - 99m subtraction scan
M.R.I.



LABORATORY TESTS, CARCINOMA OF ADRENAL GLAND CORTEX


Low serum potassium level
Low serum chloride level

Low total eosinophils

Lymphopenia

Low plasma level of ACTH

Increase plasma cortisol level

Increased urinary free cortisol

Elevated plasma aldosterone level

Low plasma renin level

C.T. scan

M.R.I




LABORATORY TESTS, PHEOCRHOMOCYTOMA

Elevated blood glucose level
Polycythemia
Elevated plasma epinephrine & nor-epinephrine levels

Elevated urinary catecholamines, metanephrine & vanillyl mandelic acid (VMA)

Plain X ray abdomen

C.T scan

M.R.I .(characteristic bright lesion on T2 weighted imaging)









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