A 19-year old man presented with acute onset of intractable hypertension with associated dizziness and nausea. Abdominal computed tomography revealed a 7.0cm x 6.27cm x 6.0cm suprarenal mass on the right. The patient was diagnosed to have pheochromocytoma and successfully underwent retroperitoneal laparoscopic adrenalectomy.

Human ; Male ; Young Adult ; Adrenalectomy ; Surgical Procedures, Operative ; Endocrine Surgical Procedures ; Laparoscopy ; Adrenal Gland Neoplasms ; Neoplasms ; Endocrine Gland Neoplasms

BACKGROUND: Thyroid cancer is the most common tumor with a endocrine gland origin, and it has a gradually increasing incidence rate. An operative procedure is useful to obtain good results for this disease. Howevers, the selection of operation method remains controversial. Thus, we reviewed the variable prognostic factors which influence thyroid cancer recurrence in order to determine the treatment methods which reduce the recurrence rate. METHODS: We retrospectively reviewed the cases of 383 thyroid cancer patients who had received operations from January 1988 to December 1993. The review looked at age, sex, operation methods, lymph-node metastasis, histologic types, mass size and capsular invasions, and the correlations between these factors and recurrence were analyzed by using Chi-square and SAS trend tests. Complications which developed after various operation methods were also reviewed. RESULTS: Thyroid cancer recurred in 33 (8.6%) patients. Age, sex, lymph-node metastasis, histologic types and capsular invasions did not influence the cancer recurrence rate significantly. However, mass size and operation method were potential factors for recurrence. CONCLUSIONS: If thyroid cancer is diagnosed, a total thyroidectomy with lymph-node dissection is the best method for reducing the cancer recurrence rate. By careful management, complications can be prevented after a total thyroidectomy.
Endocrine Glands ; Humans ; Incidence ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Surgical Procedures, Operative ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

It is well known that olfactory dysfunction relates to many etiologies such as obstructive nasal and sinus diseases, upper respiratory tract infections, head trauma, aging, congenital anomalies, endocrine diseases, drugs and so forth. Chronic paranasal sinusitis is the most common etiology of olfactory dysfunction. So, We studied the effect of the surgery on olfaction in patients with chronic paranasal sinusitis. A preoperative and postoperative evaluation of the olfactory function was carried out in 80 patients using the T and T olfactometer. All patients were divided into two groups-chronic paranasal sinusitis and chronic paranasal sinusitis with polyposis. According to the preoperative recognition threshold, olfactory function of all patients were divided into five groups. The group 1 was normal, group 2 was mild decreased, group 3 was moderate decreased, group 4 was severe decreased and group 5 was anosmia. Almost patients were improved on olfaction in the postoperative state. The olfactory fissure was usually closed in patients with nasal polyp. In the patients with closed olfactory fissure, recognition threshold was 4.9+/-1.5 and in opened olfactory fissure, 1.9+/-1.8. Therefore the olfactory fissure was the one of the most important factors on olfaction.
Aging ; Craniocerebral Trauma ; Endocrine System Diseases ; Humans ; Nasal Polyps ; Nasal Surgical Procedures* ; Olfaction Disorders ; Respiratory Tract Infections ; Sinusitis* ; Smell*

Adolescent ; Adult ; Aged ; Endocrine Surgical Procedures ; methods ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Parathyroid Neoplasms ; surgery ; Thyroid Neoplasms ; surgery ; Young Adult

PURPOSE: The increased detection of hypercalcemia during health screening has been increased the diagnosis of hyperparathyroidism. The surgical treatment of primary hyperparathyroidism has been changing from standard exploration for all 4 parathyroid glands to minimally invasive surgery focused to abnormal gland. For the latter, exact preoperative localization is necessary. The aims of this study were to evaluate clinical features of patients with primary hyperparathyroidism and the preoperative localization methods. METHODS: A retrospective study was performed for 61 patients with primary hyperparathyroidism in Samsung Medical Center. RESULTS: There were 19 males and 42 females whose ages ranged from 12 to 76 years. Among 61 patients with primary hyperparathyroidism, there were 51 adenomas, 7 hyperplasias and 3 adenocarcinomas. Preoperative parathyroid hormone (PTH) level was increased in all patients except in a MEN IIA associated patient. Among the methods for preoperative localization, ultrasonography detected 47 of 55 cases (85.5%), (99m)Tc-sestamibi scan 40 of 49 cases (81.6%), MRI 3 of 5 cases (60.0%), CT 9 of 18 cases (50.0%) and Tl-Tc subtraction scan 6 of 9 cases (66.7%). In 26 patients who have been diagnosed as single nodular lesion in the same area by the parathyroid scan and ultrasonography, we could find a single parathyroid adenoma in that area during exploration. Postoperative PTH level of all patients but one were normalized. CONCLUSION: Single gland disease detected by both parathyroid scan and ultrasonography was mostly due to adenoma which can be treated safely by unilateral exploration or minimally invasive surgery.
Adenocarcinoma ; Adenoma ; Diagnosis ; Female ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary* ; Hyperplasia ; Magnetic Resonance Imaging ; Male ; Mass Screening ; Minimally Invasive Surgical Procedures ; Multiple Endocrine Neoplasia Type 2a ; Parathyroid Glands ; Parathyroid Hormone ; Parathyroid Neoplasms ; Retrospective Studies ; Ultrasonography

The thyroid nodules are the most frequent encountered disorders of the endocrine system. A clinical study of 34 cases with thyroid nodules, which were treated by surgical excision and confirmed pathologically at the department of otolaryngology-head and neck surgery, Kon-Kuk University hospital, from January 1990 to July 1995, was conducted. This study was designed for early diagnosis and proper treatment of thyroid nodules through clinical analysis. The clinical analysis results were obtained as follows: 1) The sexual distribution showed the preponderance of female with 1:5.8. 2) The most prominent sign was palpable nodule on anterior neck. 3) The duration of illness within 3 months was most common(51.5%), and the size of thyroid nodules was parallel to the duration of illness. 4) Most nodules were unilateral in 29/34(85.2%), among them, right lobe in 47%, lower lobe in 38.2%. 5) The consistency of nodules was soft in 12 cases(31.5%) and most nodules were single in 26 cases(76.4%). 6) Fine needle aspiration biopsy showed consistent with surgical result in 13/19 cases(70%) at benign nodules and in 3/4 cases(75%) at malignant nodules. 7) The histopathologic classification of benign diseases in decreasing order of the frequency were adenomatous goiter, 17.28 cases(60.7%); follicular adenoma, 7/28 cases(25%); Graves' disease, 0 cases. The malignant diseases were papillary carcinoma, 6/6 cases(100%). 8) The frequent performed operative procedure was unilateral lobectomy 28/34(82.3%) in both benign and malignant disease. 9) The postoperative complication occured in 12/34 cases(35.2%) including 5 cases of mild dysphagia(14.7%) and 2 cases of transient hoarseness(5.8%) and 1 case of hypocalcemia(2.9%) and 1 case of ecchymosis(2.9%) in wound and were related to the extent of the surgical procedure.
Adenoma ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Classification ; Early Diagnosis ; Endocrine System ; Female ; Goiter ; Graves Disease ; Humans ; Neck ; Postoperative Complications ; Surgical Procedures, Operative ; Thyroid Gland* ; Thyroid Nodule* ; Wounds and Injuries

A multiple endocrine neoplasia type 2B(MEN2B) is the most distinct and aggressive form of the MEN type 2 variants. We report a case of a 24-years-old woman with MEN2B. The patient had previously undergone a Duhamel's operation due to a megacolon at 6 years old, minor surgery to remove small tumors on the lip at 8 years old, and a bilateral osteotomy of the femur, due to coxa valga, at 15 years old. She underwent a total thyroidectomy and neck dissection, due to a growing thyroid nodule, despite thyroxine treatment, at 19 years old. The pathology revealed a medullary thyroid carcinoma. There was no history of MEN 2B in her family. She had prominent lips, multiple oral mucosal masses, and marfanoid habitus. During the subsequent follow-up, a positron emission tomogram was taken due to a persistently high level of serum calcitonin, despite repeated neck dissections, which revealed a mass in the right adrenal gland. Adrenomedullary function tests showed high levels of urinary catecholamine metabolites, and a genetic analysis of the peripheral leukocyte showed a codon 918 mutation (Met918Thr) at exon 16 of the RET proto-oncogene. The patient underwent a right adrenalectomy and the pathology revealed a pheoch-romocytoma.
Adolescent ; Adrenal Glands ; Adrenalectomy ; Calcitonin ; Child ; Codon ; Coxa Valga ; Electrons ; Exons ; Female ; Femur ; Follow-Up Studies ; Humans ; Leukocytes ; Lip ; Male ; Megacolon ; Multiple Endocrine Neoplasia Type 2b* ; Multiple Endocrine Neoplasia* ; Neck Dissection ; Osteotomy ; Pathology ; Pheochromocytoma ; Proto-Oncogenes* ; Surgical Procedures, Minor ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy ; Thyroxine ; Young Adult