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Pheochromocytoma is a tumor that arises from adrenal medulla and it is characterized by increased secretion of catecholamines. The incidence of pheochromocytoma is 3 to 8 cases per million inhabitants, of which about 10 to 20% of diagnosed pheochromocytomas occurs in the pediatric population, with a higher frequency in boys. In 1.7% of the pediatric population with hypertension, the cause of hypertension is pheochromocytoma. Due to headaches and verified hypertension on twenty-four-hour holter blood pressure monitoring, the 13-year-old female patient underwent ultrasound, followed by scintigraphy and magnetic resonance imaging of the abdomen, which described an oval change above the right kidney about 4.5 cm in diameter suspected of pheochromocytoma. Twenty-four-hour urine cateholamines showed elevated noradrenaline values as much as 45 times higher than the reference range, as well as elevated Dopamine values. After adequate preparation with phenoxybenzamine and bisoprolol for two weeks, a right laparoscopic adrenalectomy was performed at the University Children's Clinic in Tirsova, which is also the first operation of this type in the pediatric population. Intraoperatively, the maximum value of tension was 180/120 mmHg. Pathohistological findings confirmed pheochromocytoma. Although a rare cause of hypertension in the pediatric population, young patients with newly diagnosed hypertension should be examined for possible pheochromocytoma. Laparoscopic adrenalectomy through both the lateral transabdominal and posterior retroperitoneoscopic approach is the gold standard for the treatment of pheochromocytomas in both the adult and pediatric populations.

Ectopic thyroid tissue is a rare pathological finding bellow the diaphragm and extremely rare finding is ectopic thyroid tissue in the adrenal gland. Thyroid tissue can be located anywhere along the way of embryological migration pathway of thyroglossal duct. In most cases of ectopic thyroid tissue, it is located in the neck. Pathohistologically ectopic thyroid tissue in all cases was formed of follicular cells that expressed TTF-1, Thyroglobulin, PAX8, and cytokeratin 7, and there was lack expression of calretinin. In the literature we found 15 such cases. Women are much more affected than men (14:1), and it usually presents in the fifth decade (mean age 49). In all cases it was composed of normal follicular cells, and C cells were not found. Review of the literature reveals that adrenal ectopic thyroid tissue is almost always cystic, and has distinctive pathologic features. The most important thing is that ectopic thyroid tissue must be distinguished from metastatic deposits from thyroid gland carcinoma.

Background/Aim. Establishing a preoperative diagnosis of thyroid follicular tumors is difficult due to the fact that the cell morphology of adenomas and carcinomas are similar and that capsular and vascular invasion cannot be determined by cytology. We analyzed predictive factors of follicular carcinoma in order to enable a surgeon to indicate operative treatment and to perform an adequate operation for each patient with a follicular neoplasm. Methods. In this retrospective study, we analyzed medical records of all patients with follicular thyroid tumors operated at an endocrine surgery unit of a tertiary referral academic hospital, between 2008 and 2012. A total of 263 operated patients were included and divided into follicular adenomas (n = 97) and follicular carcinomas (n = 166) based on the histopathology results. The most important demographic and clinical characteristics were analyzed by univariate and multivariate logistic regression analysis. Results. In adenoma group (19 males, 78 females) age range was 19–79, mean age 50. In carcinoma group (35 males, 131 females) age range was 15– 78, mean age 48. Univariate analysis showed that thyroglobulin concentration ≥ 500 ng/mL, tumor diameter < 30 mm, presence of more than one thyroid nodule and an afunctional/hypofunctional nodule were significantly more frequent in follicular carcinoma than in follicular adenoma. Independent predictive factors of malignancy were: elevated preoperative thyroglobulin concentration (≥ 500 ng/mL) and presence of more than one nodule. Based on our results we formed a nomogram, a two-dimensional diagram designed to enable estimation of preoperative probability of malignancy. Conclusion. Elevated preoperative thyroglobulin concentration, ≥ 500 ng/mL, and the presence of more than one nodule are independent predictors of malignancy for follicular thyroid carcinomas.

Parathyroid glands are small endocrine gland in the neck that men secrete parathyroid hormone , or PTH ( PTH) , which together with calcitonin and vitamin - D has a primary role in regulating the concentration of calcium and phosphate in the body. The most common disease of the parathyroid gland presents increased and uncontrolled secretion of PTH , which can be defined as primary hyperparathyroidism, if occurs as a result of enhanced functions of one or more of the parathyroid glands , or secondary hyperparathyroidism, which occurs most often in chronic renal failure or as a result of the deficiency of vitamin D. In our case report we describe a patient with cancer paratioidnih gland , which is a very rare disease and is the rarest malignant endocrine tumor.

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Introduction. Parathyroid cysts (PCs) are divided into two categories: functional and nonfunctional. If large enough, both types of PCs can present as a mediastinal or cervical mass in 1-5% of patients. Case report. A retrospective analysis of the data on patients operated on for primary hyperparathyroidism or cervical/mediastinal mass from 2016 to 2021 was conducted. An analysis of the demographic data of the patients, data on preoperative fine needle aspiration biopsy, level of parathyroid hormone in serum pre- and postoperatively, level of serum calcium, as well as on clinical presentation of the disease, was carried out. In this five-year period, a total of 555 patients were operated on, in whom the parathyroid gland was described as a definitive pathohistological finding. Of the total number, PCs were found in seven cases. In five out of the seven cases, PC was nonfunctional. Four female and three male patients were operated on due to PC. The mean age of operated patients was 49.8 years. In one patient, the nonfunctional cyst was represented as a cervical and upper mediastinal mass with a maximal diameter of 10 cm. Conclusion. Although PCs represent about 0.5% of all changes in the parathyroid glands, they can be suspected preoperatively, especially if a water-like liquid is obtained by a fine needle aspiration biopsy. In order to remove the PC completely without making a lesion on the capsule, with the aim of avoiding parathyreomatosis, but to preserve the recurrent laryngeal nerves, the operation should be performed by an experienced endocrine surgeon. [ABSTRACT FROM AUTHOR]

Prema raspoloživim dijagnostičkim metodama nije moguće preoperativno razlikovati benigne od malignih folikulskih tumora štitaste žlezde, a najčešće ni intraoperativno zbog veoma slične ćelijske morfologije i nemogućnosti citološkog dokaza invazije kapsule ili krvnih sudova karakteristične za folikulske karcinome. U ovoj studiji tražili smo prediktore maligniteta pacijenata s folikulskim karcinomom štitaste žlezde koji bi omogućili ispravnu selekciju pacijenata za hirurško lečenje i izvođenje adekvatnog tipa operacije. Retrospektivnom studijom su obuhvaćeni svi pacijenti operisani zbog postojanja folikulskog tumora štitaste žlezde u Centru za endokrinu hirurgiju tokom petogodišnjeg perioda (263 pacijenta). Na osnovu definitivnog histopatološkog nalaza ispitanici su podeljeni u dve grupe: folikulske adenome (97) i folikulske karcinome (166). Najvažnije demografske i kliničke karakteristike analizirane su univarijantnom i multivarijantnom logističkom regresionom analizom. U grupi pacijenata operisanih zbog folikulskog adenoma (19 osoba muškog i 78 ženskog pola) starosna dob je iznosila 19-79 godina s prosekom 50 godina. U grupi pacijenata operisanih zbog folikulskog karcinoma (35 muških, 131 ženska osoba) starosna dob je bila 15-78 godina, a prosek 48 godina. Univarijantnom analizom pokazano je da se koncentracija tireoglobulina ≥500 ng/ml, promer tumora <30 mm, prisustvo više od jednog čvora i nalaz afunkcijskog/hipofunkcijskog čvora značajno češće nalaze kod folikulskog karcinoma nego folikulskog adenoma. Nezavisni prediktivni faktori maligniteta su povišena preoperativna koncentracija tireoglobulina ≥500 ng/ml i prisustvo više od jednog čvora. Ovi rezultati su, u cilju praktične primene, prikazani nomogramom, dvodimenzionalnim dijagramom dizajniranim da omogući približno preoperativno grafičko izračunavanje verovatnoće postojanja maligniteta. Povišena preoperativna koncentracija tireoglobulina ≥500 ng/ml i prisustvo više od jednog čvora su nezavisni prediktori maligniteta folikulskih karcinoma štitaste žlezde. [ABSTRACT FROM AUTHOR]

Copyright of Medical Gazette / Medicinski Glasnik is the property of Specijalna bolnica za bolesti stitaste zlezde i bolesti metabolizma Zlatibor and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)