Genetic testing in the diagnosis and management of multiple endocrine neoplasia type II

Article Abstract:

Advancements in understanding the genetic mechanisms involved in multiple endocrine neoplasia type II (MEN II) are reflected in new diagnosis and treatment strategies. MEN II is an inherited genetic disorder characterized by tumors of the thyroid, adrenal medulla and parathyroid glands. Children with MEN II are often affected by an aggressive form of medullary thyroid carcinoma. Early diagnosis of MEN II and removal of the thyroid gland can prevent this cancer. Biochemical screening based on calcitonin levels has been useful in early diagnosis, but up to 10% of patients may already have metastatic cancer at diagnosis. The detection of genetic mutations on chromosome 10 introduced the possibility of genetic screening for early diagnosis of MEN II. When the mutation has been identified in a patient, all family members should be screened. Affected persons should have their thyroid glands removed and should be monitored for development of pheochromocytoma (an adrenal medulla tumor) and hyperparathyroidism (excessive activity of the parathyroid glands), two other manifestations of MEN II.

Genetic screening, Genetic testing, Adenomatosis, Familial endocrine, Multiple endocrine neoplasia, Thyroid cancer

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Fine-needle aspiration biopsy of the thyroid: an appraisal

Article Abstract:

Fine-needle aspiration biopsy of the thyroid gland may be a safe and effective method for the diagnosis of nodular thyroid disease. Patients with one or more thyroid nodules should undergo some type of diagnostic test to rule out the possibility of thyroid cancer. A survey of the medical literature found that fine needle aspiration biopsy is a sensitive method for diagnosing nodular thyroid disease. The number of false-positive or false-negative biopsy results varies between 1% and 11%. Use of fine-needle aspiration biopsy has reduced the number of patients who need thyroid surgery by 25%. It has approximately doubled the number of patients with thyroid cancer who undergo a thyroidectomy. Fine-needle aspiration biopsy is an inexpensive procedure. The cost of care for patients with nodular thyroid disease has dropped 25% with the use of fine-needle aspiration biopsy.

Thyroid diseases, Biopsy, Needle, Needle biopsy

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The rise and fall of primary hyperparathyroidism: a population-based study in Rochester, Minnesota, 1965-1992

Article Abstract:

The incidence of primary hyperparathyroidism in Rochester, Minnesota has declined dramatically ever since physicians began routinely measuring blood levels of calcium in all patients. Measurement of calcium levels began in 1974, after which the incidence of hyperparathyroidism jumped from 15 cases per 100,000 person-years to 112 cases per 100,000 person-years. However, the incidence soon began to decline and reached 4 cases per 100,000 person-years by 1992. There could be many reasons for this, including estrogen use, inadequate dietary calcium or ionizing radiation.

Health aspects, Measurement, Demographic aspects, Calcium in the body, Calcium (Nutrient), Hyperparathyroidism, Rochester, Minnesota

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