Pheochromocytoma in MEN 2A is related to the type of mutation, which can be early onset and is frequently asymptomatic. Its diagnosis requires catecholamines determinations as well as a CT scan. Correct diagnosis of bilaterality is established by CT and MIBG. Laparoscopic adrenalectomy is the treatment of choice.
The standard quality of surgery for the treatment of hernia in developing countries with few instrumental means, and in sub-optimal surgical conditions is similar to that provided in Spain.
TMG is characterized by a long evolution time and is most effectively treated by total thyroidectomy, which achieves complete remission from symptoms, without relapse, and is necessary if there is associated carcinoma. However, the incidence of complications may be high if this procedure is not carried out by surgeons with experience in endocrine surgery.
The overall recurrence rate was 27%, and the main independent prognostic factor of recurrence was tumoral vascular invasion at diagnosis. Staging, tumor size, and lymph node metastasis are prognostic factors of recurrence, although they are not significant in the multivariate analysis.
Post-surgical hypocalcemia is usually a transitory complication in thyroid and parathyroid surgery that can be resolved quickly, although it becomes a delicate matter when the problem persists. Parathyroid transplantation is the choice of treatment; however, the associated immunosuppression can cause side effects. The following case study shows the transplantation of parathyroid tissue from a patient with secondary hyperparathyroidism to another kidney transplant patient with severe hypocalcemia that was medically intractable. The graft is functioning after 2 years.
Spontaneous adrenal hemorrhage is a very rare but serious disorder of the adrenal gland that can require emergent treatment. We report on a 42-year-old man who underwent selective angiography for diagnosis and treatment of retroperitoneal hemorrhage from small adrenal artery aneurysm. This case gives further details about the value of transluminal artery embolization in the management of visceral aneurysm rupture.
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