BACKGROUND: Adrenal  nodules  can  either  be  non  functioning or hormone secreting. Once proven functional,
adrenalectomy is warranted. Laparoscopic adrenalectomy has been the popular intervention for these nodules. There is no local literature citing the clinical outcomes, particularly on  symptom  and  medication  reduction.  Considering  that  these tumors present with hypertension, such condition may be  under  diagnosed  in  a  population  with  a  hypertension  prevalence  of  22.3%.  This  study  reviewed  the  outcomes 
of the procedure particularly on the improvement of signs and  symptoms  and  medication  use.

METHODOLOGY: This  is  a  retrospective  review  describing  the  post-operative  outcomes  of  patients  who  underwent  laparoscopic  adrenalectomy  conducted  in  a  tertiary 
medical  center  from  2010  -  2015. 

RESULTS: Twenty-three  (23)  patients  were  categorized  according  to  pathology  -  primary  hyperaldosteronism 
-(17),   pheochromocytoma   -   four  (4)  and  Cushing's  syndrome - two (2). Post-operatively, there was a reduction in  the  systolic  blood  pressure  of  patients  with  primary  hyperaldosteronism  (p  =  0.156).  A  mean  reduction  of  20-30  mmHg  in  the  blood  pressure  was  documented  in patients  who  had  pheochromocytoma  (p  =  0.625).  There  was  a  reduction  in  the  number  and  dosages  of  anti-hypertensive  medications  (primary  hyperaldosteronism  p=
Human ; Male ; Female ; Aged 80 And Over ; Aged (a Person 65 Through 79 Years Of Age) ; Middle Aged (a Person 45-64 Years Of Age) ; Adult (a Perso ; Adrenalectomy ; Antihypertensive Agents ; Pheochromocytoma ; Hydrocortisone ; Hyperaldosteronism ; Hypertension ; Cushing Syndrome ; Blood Pressure Determination

BACKGROUNDb>: Various studies have shown that papillary thyroid microcarcinoma (PTMC) has a favorable prognosis but has the capacity to be aggressive; thereby, requiring effective treatment.

OBJECTIVESb>: To determine the clinical characteristics and outcomes of PTMC in Filipino patients diagnosed and treated at Makati Medical Center.

STUDY DESIGN:b> This is a retrospective, descriptive study.

SUBJECTS AND METHODSb>: Medical and clinical records of twenty two patients diagnosed and treated for papillary thyroid microcarcinoma from 1993-2004 were reviewed. Statistical means and percentages were used.

RESULTSb>: The patients' age ranged from 19-73 years old with a mean of 46years. There was a female predominance at 95.45%. One patient (4.5%) had papillary microcarcinoma by fine needle aspiration biopsy (FNAB). Another patient had lymph node and distant metastases (bone) at presentation after near total thyroidectomy without ablation in another medical center and later received 200mCi of radioactive iodine therapy but was lost to follow up. Multifocality was seen in two patients (9%). Five patients (22.7%) had lobectomy while one (4.5%) underwent subtotal thyroidectomy. Near total thyroidectomy was done in five patients (22.7%) while 11 (50%) had total thyroidectomy. Only 12 patients (54.5%) received radiation remnant ablation therapy. One patient who had lobectomy was noted to have nodule recurrence in the remaining lobe while another patient who underwent total thyroidectomy with no radioactive iodine treatment had elevated thyroglobulin (Tg) on follow up. Follow up period ranged from one to 11 years (mean of six years). All patients have survived and were asymptomatic but in some of the patients the cancer activity could not be accurately assessed due to absence of thyroglobulin and thyroid ultrasound determinations.

CONCLUSIONS/RECOMMENDATIONSb>: Our study compared to foreign studies had a smaller population. Multifocality considered as a predictor of poor prognosis was seen in only two patients. PTMC may have latent/ indolent course and favorable outcomes but may be persistent/ metastatic in some. Combination therapy of near total/ total thyroidectomy with radiation remnant ablation offered greater benefit. Thyroglobulin served as a powerful prognostic factor of persistent/ recurrent disease. Repeat thyroid ultrasound/ biopsy were necessary to document thyroid cancer activity in patients not amenable to thyroglobulin determinations.

Human ; Male ; Female ; Aged (a Person 65 Through 79 Years Of Age) ; Middle Aged (a Person 45-64 Years Of Age) ; Adult (a Person 19-44 Years Of ; Biopsy ; Radiation ; Thyroglobulin ; Thyroidectomy ; Philippines ; Patients