Flush after unilateral adrenalectomy
MEN (multiple endocrine neoplasia) type 2A syndrome, a rare autosomal dominant condition of RET proto-oncogene gain-of-function mutations mostly involves medullar thyroid cancer and pheocromocytoma (40-50%) while primary hyperparathyroidism has a less frequent incidence (based on genotype-phenotype...
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doaj-773c1c9a67404a0baaa516780ff827ca2021-09-02T21:33:27ZengAmaltea Medical Publishing HouseRomanian Journal of Medical Practice1842-82582069-61082020-03-0115110110510.37897/RJMP.2020.1.19Flush after unilateral adrenalectomyFlorica SANDRU0Mihai Cristian DUMITRASCU1Ana VALEA2Simona Elena ALBU3Anda DUMITRASCU4Mara CARSOTE5“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; Elias Emergency University Hospital, Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; Emergency University Hospital, Bucharest, Romania Clinical County Hospital, Cluj-Napoca, Romania; “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; Emergency University Hospital, Bucharest, Romania“C.I. Parhon” National Institute of Endocrinology, Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; “C.I. Parhon” National Institute of Endocrinology, Bucharest, RomaniaMEN (multiple endocrine neoplasia) type 2A syndrome, a rare autosomal dominant condition of RET proto-oncogene gain-of-function mutations mostly involves medullar thyroid cancer and pheocromocytoma (40-50%) while primary hyperparathyroidism has a less frequent incidence (based on genotype-phenotype correlations). We introduce a female case of MEN 2A syndrome with a particular evolution. This is a case report. A 38-old year female with family history of MEN2A syndrome, is currently experiencing transitory flush associated with mild palpitations (maximum 135/80 mmHg, respective 100-100 beats/minute). 6 years ago she had total thyroidectomy for medullar thyroid cancer (normal plasma metanephrines/normetanephrines and adrenal aspects at computed tomography). 2 years later she was detected with a unilateral pheocromocytoma. Laparoscopic left adrenalectomy was done. Currently, only an increase of plasma metanephrines is postive (twice normal upper limits), not plasma normetanephrines, nor urinary 24-hour metanephrines and normetanephrines. Computed tomography showed a right adrenal tumor of 1.3/2.3 cm and a left adrenal tumor of 1.12/0.76 cm. Whole body MIBG (meta-iodo-benzyl guanidine) scintigram was done and confirmed bilateral activity. Bilateral adrenalectomy is necessary. Flush after partial adrenalectomy in patient with prior thyroidectomy for MEN2A syndrome - associated medullar thyroid cancer underlines pheocromocytoma. The newly detected bilateral adrenal masses require an adequate differential diagnosis of post-operatory aspect thus the usefulness of MIBG scintigram.https://rjmp.com.ro/articles/2020.1/RJMP_2020_1_Art-19.pdfflushpheocromocytomaadrenalectomy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Florica SANDRU Mihai Cristian DUMITRASCU Ana VALEA Simona Elena ALBU Anda DUMITRASCU Mara CARSOTE |
spellingShingle |
Florica SANDRU Mihai Cristian DUMITRASCU Ana VALEA Simona Elena ALBU Anda DUMITRASCU Mara CARSOTE Flush after unilateral adrenalectomy Romanian Journal of Medical Practice flush pheocromocytoma adrenalectomy |
author_facet |
Florica SANDRU Mihai Cristian DUMITRASCU Ana VALEA Simona Elena ALBU Anda DUMITRASCU Mara CARSOTE |
author_sort |
Florica SANDRU |
title |
Flush after unilateral adrenalectomy |
title_short |
Flush after unilateral adrenalectomy |
title_full |
Flush after unilateral adrenalectomy |
title_fullStr |
Flush after unilateral adrenalectomy |
title_full_unstemmed |
Flush after unilateral adrenalectomy |
title_sort |
flush after unilateral adrenalectomy |
publisher |
Amaltea Medical Publishing House |
series |
Romanian Journal of Medical Practice |
issn |
1842-8258 2069-6108 |
publishDate |
2020-03-01 |
description |
MEN (multiple endocrine neoplasia) type 2A syndrome, a rare autosomal dominant condition of RET proto-oncogene gain-of-function mutations mostly involves medullar thyroid cancer and pheocromocytoma (40-50%) while primary hyperparathyroidism has a less frequent incidence (based on genotype-phenotype correlations). We introduce a female case of MEN 2A syndrome with a particular evolution. This is a case report. A 38-old year female with family history of MEN2A syndrome, is currently experiencing transitory flush associated with mild palpitations (maximum 135/80 mmHg, respective 100-100 beats/minute). 6 years ago she had total thyroidectomy for medullar thyroid cancer (normal plasma metanephrines/normetanephrines and adrenal aspects at computed tomography). 2 years later she was detected with a unilateral pheocromocytoma. Laparoscopic left adrenalectomy was done. Currently, only an increase of plasma metanephrines is postive (twice normal upper limits), not plasma normetanephrines, nor urinary 24-hour metanephrines and normetanephrines. Computed tomography showed a right adrenal tumor of 1.3/2.3 cm and a left adrenal tumor of 1.12/0.76 cm. Whole body MIBG (meta-iodo-benzyl guanidine) scintigram was done and confirmed bilateral activity. Bilateral adrenalectomy is necessary. Flush after partial adrenalectomy in patient with prior thyroidectomy for MEN2A syndrome - associated medullar thyroid cancer underlines pheocromocytoma. The newly detected bilateral adrenal masses require an adequate differential diagnosis of post-operatory aspect thus the usefulness of MIBG scintigram. |
topic |
flush pheocromocytoma adrenalectomy |
url |
https://rjmp.com.ro/articles/2020.1/RJMP_2020_1_Art-19.pdf |
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