Pheochromocytomas

Paragangliomas are rare neuroendocrine tumors that arise from the extra-adrenal autonomic paraganglia, small organs consisting mainly of neuroendocrine cells that are derived from the embryonic neural crest and have the ability to secrete catecholamines (1). They are closely related to pheochromocytomas, which are sometimes referred to as intra-adrenal paragangliomas (2). The majority appear to be sporadic, but approximately one-third to one-half are associated with an inherited syndrome (3, 4). The four genetic syndromes that are associated are: multiple endocrine neoplasia 2A and 2B, neurofibromatosis type 1, von Hippel Lindau, and the Carney-Stratakis dyad. The male-to-female ratio is approximately equal among patients with hereditary paraganglioma,

There are few drugs that are absolutely contraindicated in pheochromocytoma based on the pathophysiology of the disease.

Mrs. Ledina Lushko was diagnosed with adrenocortical carcinoma (ACC) which is an aggressive cancer of adrenal gland. ACC is a very rare cancer that affects approximately 0.5-3 cases per millions. Mrs. Ledina and her family went through a tough period of consulting various doctors, many tests and differing opinions from specialists. In most cases ACC will be diagnosed

fat, specially if associated with cystitis that could be incorrectly identified as tumor invasion. Vascular hyperaemia adjacent to the tumor could cause these abnormal signals

Cushing 's syndrome (CS) is characterized by pathologically elevated free glucocorticoid levels. Endogenous hypercortisolism is usually due to ACTH-secreting pituitary corticotropic adenomas and less often due to ectopic ACTH-secreting neuroendocrine neoplasms or ACTH-independent adrenal cortisol hypersecretion (Yaneva, 2010). Cushing 's disease occurs infrequently in an inherited setting in both of these conditions (Yaneva, 2010).

Another test that one can perform to measure the effect of an adrenal tumor is performing an ACTH test, which measures the level of adrenocorticotropic hormone (ACTH) in the blood. ACTH is a hormone that is produced from the pituitary gland in the brain. Thus by performing the test one can get information about its concentration in the serum. Usually if adrenal mass is influencing the corticosteroid levels the test will show a higher level of cortisol while giving a lower level of ACTH levels.

Adrenal glands are endocrine glands that sit atop the kidneys (Shier et al., 2009). The adrenal glands secrete hormones that increase heart rate, the force of cardiac muscle contraction, breathing rate, elevate blood pressure and blood glucose level. This activity prepares the body foe energy expending action, sometimes called fight or flight responses (Shier et al., 2009).

Two pt verifier name/dob confirmed. Informed the pt this a f/u call to address s/p/ pituitary Adenoma. Pt states that is doing much better but he occasional have a headache and stuffy nose. Discuss dc instructions medication, and f/u appt with the pt. Discuss s/s that would warrant the pt to seek medical attention immediately. Encourage the pt f/u with his PCM. During conversation pt request refill on his Synthroid. Informed the pt a courtesy 90 day supply was ordered. Again recommend that he f/u with his provider. Pt refused appt at this time, but states that he will call CAMO to schedule an appt. Pt agrees and verbalized

According to http://www.webmd.com/, “the adrenal glands don't make enough of a hormone called cortisol, or less often, a related hormone called aldosterone.” That's why doctors sometimes call the illness ''chronic adrenal insufficiency,'' or hypocortisolism. “most important function is to help the body respond to stress. It also helps regulate your body's use of protein, carbohydrates, and fat; helps maintain blood pressure and cardiovascular function; and controls inflammation.” Aldosterone helps your kidneys regulate the amount of salt and water in your body -- the main way you regulate blood volume and keep your blood pressure under control. When aldosterone levels drop too low, your kidneys cannot keep your salt and water levels in balance. This makes your blood pressure drop. “There are two forms of Addison's disease. If the problem is with the adrenal glands themselves, it's called primary adrenal insufficiency. If the adrenal glands are affected by a problem starting somewhere else -- such as the pituitary gland -- it's called secondary adrenal

American Cancer Society says, “The term neuro refers to nerves, while blastoma refers to a cancer that affects immature or developing cells.” It is usually found in the small glands on top of the kidneys. The glands are called adrenal glands. Places where it can develop are the belly, chest, neck, pelvis, and bones. Possible symptoms can include fatigue (a feeling of tiredness or exhaustion or a need to rest because of lack of energy or strength), loss of appetite, and fever. Mayo Clinic says, “There may be a lump or compression of tissues in the affected area.” Treatments for the cancer include surgery or chemotherapy. For smaller tumors that have not spread, surgery is usually the only treatment needed. American Cancer Society, “If the tumor is in the abdomen (belly), the surgeon may do the biopsy with the aid of a laparoscope. This is a long, thin tube with a tiny video camera on the end. It is put into the abdomen through a small incision to allow the surgeon to see inside. The surgeon then makes a second small incision to reach inside the abdomen with long, thin instruments and remove pieces of tumor.” Alex’s original tumor of Neuroblastoma was in her adrenal gland. They did a similar process to Alex for the surgery, except for that they had to make an incision near the kidney to remove the tumor from her

The source can be endogenous, the first would be Cushings disease which is a cortcotropinoma (tumour in the anterior pituitary gland) which can be a microadenoma or a macroadenoma. The second is the adrenal adenoma and adrenal carcinoma, which are tumours in the adrenal cortex

Cushing’s is a disease in which you have an abnormally elevated level of cortisol. There are two major types of Cushing’s. The first type of Cushing’s is rare and is called “Cushing’s Disease”, it’s cause by an endogenous factor, which means that something goes wrong inside your body. This type is usually characterized by the body’s own overproduction of ACTH, Which controls Cortisol. Other internal factors that may cause Cushing’s Disease is a pituitary gland tumor (can be benign or cancerous and is the most common), an ectopic tumor that secretes ACTH, an adrenal adenoma (benign) and adrenal carcinomas (cancerous). In very few rare cases people can inherit a predisposition to developing endocrine tumors (Toft 2016). The second type of Cushing’s

Paraneoplastic syndromes are rare disorders triggered by a person's immune system in response to a cancerous tumor. Paraneoplastic syndromes can affect many areas of the body systems, including the nervous system, hormone (endocrine) system, skin (dermatologic) system, blood (hematologic) system, and joints (rheumatologic) system.

Apporoximately 100 cases of JGCT have been reported in English literature. It was first described by Robertson et al in 1967 and was given this name by Kihara in 1968 (1, 2). It is seen predominantly in females in second and third decades of life (3-5). Although some cases have been reported in patients who are more than 40 years old (4) as well as in children of less than 10 years age. Most of the symptoms are attributed to hypertension, hypokalemia, hyperaldosteronism and increased renin activity due to secretion by the tumor. These non-specific symptoms are headaches, retinopathy , double vision, dizziness, nausea, vomiting, polyuria and proteinuria (3, 6). Hypertension is mostly present for several years before the diagnosis of reninoma is made. No correlation has been reported of degree or duration of hypertension with tumor size. Three clinical variants have been reported so far: ‘typical variant’ presenting with hypertension, hypokalemia, increased plasma renin secretion and hyperaldosteronism; ‘atypical variant’ presenting with hypertension but without hypokalemia; ‘non-functioning variant’ presenting without hypertension (12). Endoh et al reported a case of non-functioning variant which was discovered incidentally (7). Our patient presented with hypertension, headaches and hypokalemia and increased plasma renin