Case of insulinoma detected in a patient after bariatric operation for morbid obesity

The prevalence of insulinomas is 1–3 cases per million population per year of which 4–14% tumor is malignant. Weight gain is one of the symptoms of the disease, often resulting in morbid obesity with indications for surgical treatment. The presented clinical case demonstrates the successful treatment of malignant insulinoma with the manifestation of hypoglycemic syndrome after carrying out biliopancreatic bypass with longitudinal gastrectomy for morbid obesity

Diagnosis and differential diagnosis of adrenal incidentalomas

This lecture focuses on the diagnosis and differential diagnosis of adrenal incidentalomas with special reference to diagnostic steps, major pharmacological tests, and instrumental studies. Strategies of management of patients with this pathology are described

Russian Association of Endocrinologists clinical practice guideline for adrenal incidentalomas differential diagnosis

This article discusses the management guidelines for serendipitously diagnosed adrenal masses cases, assessment of their hormonal activity and malignancy potential, pro- and contra indications for surgical treatment and follow-up algorithm for hormonally inactive tumors. Hypercathecholaminemya, endogenous hypercortisolism, primary hyperaldosteronism should be considered as variants of specific hormonal activity of tumor. The midnight suppression test with dexametasone 1 mg is recommended in all cases. Evaluation of basal ACTH in case of negative result of the test with dexametasone 1 mg (absence of morning cortisol level suppression) should be considered as confirmation test. For primary diagnosis of pheohromocytoma/paraganglioma (PPGL) a free plasma or fractionated urine methanephrines concentrations evaluation should be recommended. If test is positive, comprehensive examination to exclude or confirm PPGL is necessity. The aldosterone/rennin ratio exposure should be considered for patients with arterial hypertension to exclude primary hyperaldosteronism. To evaluate malignant pattern of a tumor in all unclear cases should be provide assessment of computed tomography quantitative indices. Adrenal incidentalomas treatment guidelines isnt considered in the field of this recommendations and reported in relevant guidelines

2017 Russian clinical practice guidelines for differentiated thyroid cancer diagnosis and treatment

The Russian clinical practice guidelines for diagnosis and treatment of differentiated thyroid cancer is dedicated to the management of patients with differentiated thyroid cancer. The guideline modifications 2016 include the following matters: indication for fine-needle aspiration biopsy, calcitonin screening, standards for biopsy results, new positions of postoperative risk stratification, indication for suppressive therapy and thyroid replacement therapy, targeted therapy in patients with radioiodine-refractory differentiated thyroid cancer