14 research outputs found
Elastographic presentation of medullary thyroid carcinoma
Aim of the study was to evaluate the elastographic
appearance of medullary thyroid carcinoma (MTC)
by a retrospective evaluation of 18 nodules histologically
proven as MTC. Free-hand qualitative elastography was
performed using Hitachi Logos EUB 7500. The elasticity
score (ES), was assessed based on a colour elastogram, the
blue colour being correlated with hard tissue, red colour
with soft tissue, and green with intermediate hardness.
Nodules were classified into four classes. A alleged diagnosis
of malignancy was assigned to nodules with ES3 or 4
and a presumptive diagnosis of benignity was assigned to
nodules with an ES1 or 2. More than half (55.6 %) of
MTCs have a low-intermediate grade of elasticity. The
hardest lesions (ES4) were those with ultrasonographic
features highly suspicious for malignancy. In conclusion,
most of MTCs present an elastographic pattern of benignity.
Therefore, qualitative elastography does not add
useful information in pointing out MTC on the basis of its
hardness. Our data suggest a marginal role for this technique
in MTC evaluation
Usefulness of desmopressin testing to predict relapse during long-term follow-up in patients in remission from Cushingâs disease
Recurrence of Cushingâs disease after successful transsphenoidal surgery occurs in some 30% of the patients and the response to desmopressin shortly after surgery has been proposed as a marker for disease recurrence. The aim of the present study was to evaluate the response to desmopressin over time after surgery. We tested 56 patients with Cushingâs disease in remission after transsphenoidal surgery with desmopressin for up to 20Â years after surgery. The ACTH and cortisol response to desmopressin over time was evaluated in patients on long-term remission or undergoing relapse; an increase by at least 27 pg/mL in ACTH levels identified responders. The vast majority of patients who underwent successful adenomectomy failed to respond to desmopressin after surgery and this response pattern was maintained over time in patients on long-term remission. Conversely, a response to desmopressin reappeared in patients who subsequently developed a recurrence of Cushingâs disease, even years prior to frank hypercortisolism. It appears therefore that a change in the response pattern to desmopressin proves predictive of recurrence of Cushingâs disease and may indicate which patients require close monitoring