[Primary hyperparathyroidism in patient with thyroid papillary cancer--case report]. / Pierwotna nadczynnosc przytarczyc u chorej leczonej z powodu raka brodawkowatego tarczycy--opis przypadku.

Patient with primary hyperparathyroidism and papillary thyroid cancer was presented. The female patient, 45 years old, because of papillary thyroid cancer was treated in the typical way by total strumectomy with lymphadenectomy following by 1131 therapy and L-thyroxine suppressive therapy. After 9 years, during one of control routine examinations, the serum levels of calcium and parathormone were increased (Ca2+: 1.449 mmol/l; Ca: 2.91 mmol/l; PTH: 256 pg/ml). Primary hyperparathyroidism was diagnosed and the patient underwent the surgery in the anterior cervical region with removal of parathyroid adenoma, histopathologically confirmed. Serum PTH level together with calcium levels decreased into the normal range. The coexistence of primary hyperparathyroidism and thyroid non-medullary cancer was already reported, but in this case the time of the onset was delayed. Due to the fact that patients after the treatment of thyroid non-medullary cancer, especially after of the neck radiation or radioactive iodine therapy, are more exposed to develop hyperparathyroidism, complete and wide examinations, even many years after treatment of thyroid cancer, are needed.

[Adrenal tumours in a selected 10-years surgical material]. / Guzy nadnerczy w wybranym 10-letnim materiale operacyjnym.

UNLABELLED: The aim of the study was to analyze the number and proportions of different adrenal tumours resected during the last 10 years in our centre. Besides, we seek correlations between the size of tumours and the age and body mass indexes (BMI) of the examined patients. MATERIAL AND METHODS: The tumours where measured on CT and MRI before surgery, and on pathological examination after resection. The examined group consisted of 69 patients, 22 males and 47 females, mean age 50.51 +/- 12.26 yrs. In 45 (65.22%) cases the right adrenal was affected, in 21 (30.43%)--the left, in 3 (4.35%)--both. RESULTS: 12 adrenocortical cancers, 20 phaeochromocytomas, 9 cortisol-secreting adenomas, 4 aldosteronomas, 18 hormonally inactive adenomas, 6 miscellaneous tumours were found. Malignant tumours where significantly larger than benign (12.20 +/- 6.81 vs 6.71 +/- 5.62 cm, p < 0.005). We observed no correlation between the age and preoperative tumor size (p = 0.1756), between the age and pathological tumor size (p = 0.3601), and between BMI and the preoperative and histopathologic size (p = 0.4204, and p = 0.6478, respectively). CONCLUSIONS: The most common tumour was phaeochromocytoma. Most tumours where found in the right adrenal. The malignant tumours where larger than benign ones. No correlations between age and BMI, and tumour size where demonstrated.

[Usefullness of scintigraphy with somatostatin analogues in the imaging of insulinoma of the pancreas]. / Przydatnosc scyntygrafii z uzyciem analogów somatostatyny w obrazowaniu wyspiaka trzustki typu insulinoma.

We present a case of a 74-years-old female with insulinoma of the pancreas. Neuroglycopenic symptoms (Whipple's triad) and a positive fast test established the diagnosis. The fast was terminated after 5 hours and 40 minutes because of neuroglycopenic symptoms with the serum glucose and insulin levels of 40 mg/dl and 34,01 microU/ml respectively. The tumor was invisible in ultrasound, abdominal CT scan and MRL The only means that enabled preoperative visualization was 111-Indium labeled octreotide scintigraphy (OctreoScan). Laparotomy was performed, and a tumor was disclosed in intraoperative ultrasonography within the head of the pancreas. The tumor of 37 mm diameter was excised. Histopatological examination revealed benign insulinoma. After surgery the symptoms alleviated completely. The patient with proper glucose levels and insulin concentration of 3,04 microU/ml was discharged in good health. This case confirms high usefulness of preoperative OctreoScan and intraoperative ultrasonography in the approach to a patient with insulinoma.

[Primary clear cell carcinoma of the thyroid--case report]. / Pierwotny rak jasnokomórkowy tarczycy--opis przypadku.

UNLABELLED: We present a case of a 59-year old woman in whom incidentally a thyroid nodule of 10 mm diameter was discovered. A fine needle aspiration biopsy was performed and it revealed follicular tumour. The patient was referred to surgery and she had a subtotal thyreoidectomy performed with a part of the left lobe spared. The histopathological examination of the nodule led to a different diagnosis. The diagnosis was clear cell carcinoma in the thyroid, probably metastatic, the most probable primary site being the kidney. A computed tomography scan of the kidneys and abdomen was performed but it revealed no changes. The patient has been seen for a year in follow-up, with CT scans performed every six months that revealed no changes. The patient has been in good condition during the whole period of observation. CONCLUSIONS: We describe an extremely rare case of a primary thyroid clear cell carcinoma.

A study of thyroglobulin concentration in the thyroid and serum of patients with different thyroid disorders.

Knowledge concerning the structure and quality of thyroglobulin (Tg) has great significance for the better understanding of the pathogenesis of different thyroid diseases. The localization of the Tg gene and studies of its structure by molecular biological techniques make possible precise investigations of its expression. The aim of our study was to evaluate Tg content in the thyroids and Tg concentrations in the serum of 108 patients suffering from benign or malignant thyroid disorders. The method of investigation was isolating total protein from thyroid tissues obtained during surgery and determining Tg content in the thyroid extracts and Tg concentrations in serum. The Tg concentrations in serum and in thyroid protein extracts were evaluated by fluoroimmunometric assay. Statistical analysis was carried out with the help of the computing programmes.

[Insulinoma of the pancreas--difficulties with imaging]. / Wyspiak trzustki--trudnosci w uwidocznieniu guzka.

We present a case of 29-year old man in whom despite the lack of finding tumor in USG and CT surgical intervention was performed and insulinoma of the pancreas was excised. Insulinoma was diagnosed on the basis of clinical picture (Whipple's triade) that was reassured by positive fast test. The fast was terminated at 11 and half hours because of neuroglycopenic symptoms with serum glucose and insulin levels 2.0 mmol/l (36 mg/dl) and 11.07 microU/ml respectively, which established the diagnosis. Laparotomy was performed, during which the tumor was palpated and seen in ultrasonography in the head of pancreas. The tumor of 12 mm diameter was excised. Histopathological examination revealed benign insulinoma. After surgery the symptoms alleviated completely. The patient with proper glucose levels was discharged in good health. The case supports high usefulness of intraoperative ultrasonography and surgeon's palpation.