Diagnosis and Management of Endocrine-related Tumors

Patients with a variety of tumors present to the physician because of clinical manifestations of hormones secreted in excess. This phenomenon attracted the investigative interest of such pioneers as Harvey Cushing who recognized that pituitary tumors may cause acromegaly and Charles Mayo who associated hyper tension with adrenal medullary neoplasms. Current int~rest in endocrine-related tumors has intensified because of the explosive development of newer methodol ogy for their study. Specific measurements of secretory products, hybridization assays to identify products of genomic translation and quantitative assessment of tissue hormone receptors have provided means of characterizing and precisely following patients with endocrine-related tumors. Treatments based upon these advances are rapidly proliferating. The current volume attempts to synthesize much of this recent information with the goal of providing a sound basis for making clinical judgements regarding diagnosis and management. Tumors of endocrine glandular tissues commonly confront practicing physi cians with difficult management problems. Several unique features of these tumors necessitate collaboration among various specialty disciplines in order to resolve these problems and to provide a high level of clinical care. For example, endocrine neoplasms secrete active hormones or hormone precursors which produce clinical manifestations most familiar to endocrinologists. Certain thera pies such as radioactive iodine for thyroid cancer take advantage of the hormone responsiveness of these tumors to facilitate treatment. These aspects require individuals trained in endocrinology to implement complex diagnostic and thera peutic maneuvers.

Contenu

1. Approach to the pituitary tumor: anatomic, diagnostic and surgical considerations.- 2. Acromegaly.- 3. Prolactin secreting pituitary adenomas in women.- 4. Anterior-pituitary function before and after transsphenoidal micro-surgery for pituitary tumors.- 5. Medical treatment of thyroid carcinoma.- 6. The impact of needle biopsy on the diagnosis of the thyroid nodule.- 7. Endocrine neoplasms: carcinomas of the thyroid.- 8. Primary hyperparathyroidism: pathophysiology, differential diagnosis and management.- 9. Surgery of the parathyroid glands.- 10. Adrenocortical tumors.- 11. Diagnosis and treatment of 'insulinoma'.- 12. Endocrine tumors of the gastroenteropancreatic axis.- 13. The diagnosis and treatment of gastrinoma and Zollinger-Ellison syndrome.- 14. The syndrome of multiple endocrine neoplasia type I.- 15. Endocrine neoplasms: pheochromocytoma.- 16. Controversies in the treatment of endocrine tumors: medical and surgical management of prolactinomas, acromegaly and thyroid cancer.