BACKGROUNDMalignant struma ovarii is a rare malignant germ cell tumor of the ovary. Due to the rarity of this disease, treatment has not been uniform throughout the published literature. CASESWe ...present three cases of malignant struma ovarii. Following primary surgery, all were subsequently treated with thyroidectomy and (131)I ablation therapy, two patients as first line management, one following the occurrence of metastatic disease. CONCLUSIONHistological diagnosis of malignant struma ovarii is similar to that of well differentiated thyroid carcinoma (WDTC). In line with the latest advice on treatment of WDTC, we believe that the best option for patients with malignant struma ovarii is surgical removal of the ovarian lesion followed by total thyroidectomy which allows the exclusion of primary thyroid carcinoma, and in addition, allows radioiodine ((131)I) ablation therapy for (micro) metastasis. After thyroidectomy, thyroglobulin can be used as a tumor marker for follow-up. Moreover, nuclear medicine imaging using radioiodine ((123)I) can be performed to demonstrate metastatic carcinoma. A multidisciplinary approach is essential.
Imaging of pituitary tumours de Herder, Wouter W.; Lamberts, Steven W.J.
Baillière's clinical endocrinology and metabolism,
04/1995, Letnik:
9, Številka:
2
Journal Article
In the neuroradiological study of pituitary tumours, second generation CT, dynamic CT and MRI provide information about the extent of the tumour and its anatomical relations with the surrounding ...tissues. Sometimes these techniques can distinguish primary anterior pituitary lesions from primary parasellar lesions with presentations in the sellar region. In general, contrast-enhanced MRI and dynamic CT are more sensitive than conventional CT for the diagnosis of pituitary microadenomas, as well as for the precise delineation of the parasellar invasion of macroadenomas. Radiological techniques usually cannot distinguish clinically non-functioning from functioning pituitary adenomas. BSIPSS is used for confirmation of the diagnosis of Cushing's disease as well as for the lateralization of pituitary microadenomas in Cushing's disease and some other anterior pituitary hyperfunctional states.
Neurotransmitter-receptor ligand imaging by SPECT with
123I-IBZM and/or
111In-DTPA-octreotide characterizes the dopamine D
2 and somatostatin receptor status of pituitary adenomas, respectively. In selected cases, these techniques may be used for the differential diagnosis of pituitary tumours as well as for the differential diagnosis of primary anterior pituitary lesions and primary parasellar lesions with presentations in the sellar region. If medical therapy of these tumours with receptor agonists is being considered, these techniques can help in selecting the first-line treatment. Furthermore, the effects of medical therapy on the tumour can be evaluated. The introduction of newer and more receptor-specific radioligands may expand the clinical use of these techniques in the future.
The availability of PET for the clinical diagnosis of pituitary tumours is still limited, but promising results have been described.
Peptide receptors in gut endocrine tumours de Herder, Wouter W.; Hofland, Leo J.; van der Lely, Aart-Jan ...
Baillière's clinical gastroenterology,
12/1996, Letnik:
10, Številka:
4
Journal Article
A great number of gut endocrine tumours show high expression of receptors for neuropeptides, such as SRIF and VIP. The expression of ssts is essential for the control of hormonal hypersecretion and ...tumour growth by octapeptide somatostatin analogues. Five different sst subtypes, named sst
1–5, have been cloned and characterized. The therapeutic efficacy of the octapeptide analogues is determined by the expression of sst
2 (sst
3) and sst
5 on the tumour. In general, there is a predominant expression of sst
1 and sst
2 mRNA in gut endocrine tumours. In vivo sst scintigraphy, after injection of
111Inpentetreotide, provides a useful tool for the diagnostic work-up of patients with these tumours. This technique can be used for the localization of the primary tumour(s), for the determination of the extent of metastatic spread and for the selection of potential candidates for therapy with (radiolabelled) octapeptide analogues.
Differentiated gut endocrine tumours also show a high expression of VIP-Rs. However, undifferentiated tumours show VIP-R expression to a smaller degree. In vivo scintigraphy with
123I-labelled VIP is a sensitive technique for the in vivo identification of gut endocrine tumours and their metastases. The functional role of the tumoral VIP-Rs is still unclear and at present there are no known therapeutic applications for VIP-R agonists or antagonists in humans.
To assess compliance with a periodic surveillance regimen for Von Hippel-Lindau disease.
In this nationwide study, Von Hippel-Lindau disease mutation carriers and those at 50% risk were invited to ...complete a questionnaire assessing (compliance with) advice given for periodic surveillance. Medical record data on compliance with recommended radiologic surveillance examinations were also collected.
Of the 84 (77%) participants, 78 indicated having received advice to undergo periodic surveillance. Of these, 71 reported being fully compliant with that advice. In 64% of the cases, this advice was only partially consistent with published guidelines. Based on medical record data, between one quarter and one third of individuals did not undergo surveillance as recommended in the guidelines for central nervous system lesions and one half for visceral lesions. Screening delay for central nervous system lesions was significantly higher in one hospital and in those cases where “the advice given” deviated from the guidelines.
The majority of those with or at risk of Von Hippel-Lindau disease reported having received and being fully compliant with screening advice. However, in many cases, the advice given was only partially consistent with published guidelines, and screening delays were observed. Efforts should be undertaken to stimulate guideline-based surveillance advice and to minimize screening delay.
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