RESUMO
La hiperplasia suprarrenal macronodular bilateral ACTH-independiente (HAMAI) se considera hoy día una entidad diferente y separada del resto de causas de síndrome de Cushing. Su etiología es incierta aunque en los últimos años se ha demostrado la existencia de respuesta anormal de glándulas suprarrenales a distintas hormonas que estimulan la secreción de cortisol. En este artículo presentamos un caso de hipercortisolismo no suprimible con dexametasona, cifras de ACTH indetectables, hiperplasia suprarrenal bilateral de aspecto nodular y resonancia magnética nuclear hipofisaria normal. Se realizó suprarrenalectomía bilateral, objetivando cifras detectables de ACTH a los 3 meses (AU)
Assuntos
Feminino , Pessoa de Meia-Idade , Humanos , Síndrome de Cushing/fisiopatologia , Hormônio Adrenocorticotrópico/deficiência , Hiperfunção Adrenocortical/tratamento farmacológico , Dexametasona/uso terapêutico , Neoplasias das Glândulas Suprarrenais/complicaçõesRESUMO
Over the last few years, a better anatomical and functional knowledge of the adrenal glands has allowed us to diagnose and treat optimally most of these gland's conditions. A variety of medical (endocrinology, anaesthesiology) and surgical specialties have been used to this aim. This paper reviews the adrenal gland's diseases treated in our unit over the last 9 years. Pre-operative management, ways of approach, morbidity and mortality as well as results are analyzed and compared with those obtained by other authors.
Assuntos
Doenças das Glândulas Suprarrenais/cirurgia , Adolescente , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologiaRESUMO
30 patients affected by follicular carcinoma of the thyroid gland (well differentiated, poorly differentiated and Hürthle's cell) are studied. We analyse the factors which affect the mortality; the percentage was of 63% during 3 years follow-up of metastatic patients and was null in non-metastatic patients (P < 0.0001); without significant differences between sex, age and histological type. Patients without metastasis at diagnosis had increased TG in 60% of the Hürthle's cell carcinomas and in 30%. Of the follicular carcinomas; poorly differentiated and not detected in 100% of the well differentiated follicular carcinoma, after a median follow-up of 7 years. This suggests that prognosis might be different depending of histological type.
