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180 results on '"Zarroug, Abdalla E."'

3. Commentary

Author

Zarroug, Abdalla E., Sarr, Michael G., Assalia, Ahmad, editor, Gagner, Michel, editor, and Schein, Moshe, editor

Published
2006
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11. Pheochromocytoma and paraganglioma in children: a review of medical and surgical management at a tertiary care center

Author

Pham, Tuan H., Moir, Christopher, Thompson, Geoffrey B., Zarroug, Abdalla E., Hamner Chad E., Farley, David, van Heerden, Jon, Lteif, Aida N., and Young, William F.

Subjects
Chromaffin cells -- Risk factors, Pheochromocytoma -- Case studies, Pheochromocytoma -- Diagnosis, Pheochromocytoma -- Care and treatment, Children -- Health aspects
Abstract

OBJECTIVE. The aim of this study was to review our institutional experience managing pheochromocytomas and paragangliomas in children. METHODS. A retrospective chart review of the Mayo Clinic database from 1975 to 2005 identified 30 patients < 18 years of age with histologically confirmed pheochromocytoma or paraganglioma. RESULTS. There were 12 patients with pheochromocytomas and 18 with paragangliomas. The most common presenting symptoms were hypertension (64%), palpitation (53%), headache (47%), and mass-related effects (30%). Nine patients (30%) had a genetic mutation or documented family history of pheochromocytoma or paraganglioma. Fourteen patients (47%) had malignant disease, whereas 16 (53%) had benign disease. Logistic analysis showed that statistically significant risk factors for malignancy were (1) paraganglioma, (2) apparently sporadic, as opposed to familial, pheochromocytoma or paraganglioma, and (3) tumor size of >6 cm. Surgical resection was performed for 28 patients (93%), with perioperative mortality and major morbidity rates of 0% and 10%, respectively. Resection achieved symptomatic relief for 25 patients (83%). All patients with benign disease appeared cured after resection. For patients with malignant disease, the 5- and 10-year disease-specific survival rates were 78% and 31%, respectively, and the mean survival time was 157 [+ or -] 32 months. CONCLUSIONS. The incidence of malignant pheochromocytoma/paraganglioma was high in children (47%), particularly those with apparently sporadic disease, paraganglioma, and tumor diameters of >6 cm. Patients with a known genetic mutation or familial pheochromocytoma/paraganglioma were more likely to achieve resection with negative microscopic margins and had improved disease-specific mortality rates. Surgical resection remains the treatment of choice for pheochromocytoma and paraganglioma. Key Words pheochromocytoma, paraganglioma, children, surgery Abbreviations VMA--vanillylmandelic acid HVA--homovanillic acid MIBG--meta-iodobenzylguanidine, PHEOCHROMOCYTOMA AND PARAGANGLIOMA are exceptionally rare neoplasms in children. Both tumors develop from neural crest cell lineage, stain positive for chromaffin, and produce catecholamines, including dopamine, norepinephrine, and epinephrine. Tumors [...]

Published
2006

13. Primary hyperparathyroidism in pediatric patients

Author

Kollars, Josh, Zarroug, Abdalla E., van Heerden, Jon, Lteif, Aida, Stavlo, Penny, Suarez, Luis, Moir, Christopher, Ishitani, Michael, and Rodeberg, David

Subjects
Hyperparathyroidism -- Diagnosis, Hyperparathyroidism -- Care and treatment, Children -- Health aspects, Children -- Analysis
Abstract

Objective. Primary hyperparathyroidism (HPT) is unusual in children. We reviewed our experience with HPT to better characterize these children. Methods. The retrospective review of patients Results. Fifty-two patients were identified. Median age was 16.8 years (range: 4-18.9) with a female-to-male ratio of 3:2. Eighty-five percent had an elevated parathyroid hormone (PTH) level, and 15% had an inappropriately normal PTH level during hypercalcemia. Serum calcium was elevated in all patients except for 2 with multiple endocrine neoplasma (MEN)-IIA and 1 with familial non-MEN HPT, but both had elevated PTH levels. Alkaline phosphatase levels were significantly higher in children with documented bone involvement. At presentation 41 patients (79%) were symptomatic and end-organ damage (nephrocalcinosis, nephrolithiasis, acute pancreatitis, or bone involvement) occurred in 23 patients (44%). Thirty-four patients (65%) had a single adenoma; hyperplasia was identified in 16 patients (27%), and of these cases, 57% occurred in patients diagnosed with MEN-I. Short-term complications included transient hypocalcemia in 29 patients (56%) and transient vocal cord paralysis in 2 patients (4%). Long-term complications were significant for permanent hypocalcemia in 2 patients (4%) and no recurrent laryngeal nerve injuries. No parathyroid abnormalities were identified during exploration in 4 (8%) children. Long-term follow-up was achieved in 98% of patients for a mean and median of 13 years. Resolution of hypercalcemia was achieved in 94% of cases. Conclusion. The diagnosis of primary HPT in pediatric patients is frequently delayed, is commonly symptomatic, and has significant morbidity. For children in whom HPT is suspected, evaluation of serum calcium and PTH levels is diagnostic in 100% of children. Parathyroid resection is effective at restoring normal serum calcium, has few complications, and is the treatment of choice for children with primary hyperparathyroidism. Pediatrics 2005;115:974-980; children, MEN, hypercalcemia, parathyroid adenoma., ABBREVIATIONS. HPT, hyperparathyroidism; PTH, parathyroid hormone; MEN, multiple endocrine neoplasia. Hyperparathyroidism (HPT) predominantly affects adults (incidence of 1 in 1000) and is very rare in children (incidence of 2-5 in [...]

Published
2005

26. A comparison of two quality measurement tools in pediatric surgery—The American College of Surgeons National Surgical Quality Improvement Program-Pediatric versus the Agency for Healthcare Research and Quality Pediatric Quality Indicators

Author

Polites, Stephanie F., primary, Habermann, Elizabeth B., additional, Zarroug, Abdalla E., additional, Wagie, Amy E., additional, Cima, Robert R., additional, Wiskerchen, Rebecca, additional, Moir, Christopher R., additional, and Ishitani, Michael B., additional

Published
2015
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