Pheochromocytoma multisystem crisis treated with emergency surgery: a case report and literature review

Background: Pheochromocytoma is a neuroendocrine tumor that predominantly presents with hypertension, palpitations, and tachycardia due to excessive catecholamine excretion. Although pheochromocytoma multisystem crisis (PMC) is relatively rare, urologists and clinicians should focus on early diagnosis as delay in initiating the appropriate treatment can lead to mortality Case presentation: A 70-year-old man developed ileus after a few days of medication for hypertension. Computed tomography incidentally revealed a left adrenal mass. This finding together with his clinical course was compatible with pheochromocytoma. An α-blocker was administered immediately, and his blood pressure was well controlled. However, his general condition and laboratory data deteriorated rapidly, and the patient was diagnosed with PMC with lethal status. Thus, emergency adrenalectomy was performed without confirmation of catecholamine levels. From the resected specimen, his tumor was judged as pheochromocytoma. On immunohistochemical analysis, the proliferation index evaluated by Ki-67 staining was 9.7 %. This case report was approved by the Human Ethics Review Committee of the Nagasaki University Hospital. Conclusion: The present case of PMC was successfully treated with emergency surgery. The benign pheochromocytoma also presented with high cell proliferation potential, which may be a cause of the extreme aggressiveness of PMC

Minimally invasive follicular thyroid cancer (MIFTC) - A consensus report of the European Society of Endocrine Surgeons (ESES)

Background: This paper aims to review controversies in the management of minimally invasive follicular thyroid carcinoma (MIFTC) and to reach an evidence-based consensus. Method: MEDLINE search of the literature was conducted using keywords related to MIFTC. The search term was identified in the title, abstract, or medical subject heading. Available literature meeting the inclusion criteria were assigned the appropriate levels of evidence and recommendations in accordance with accepted international standards. Results were discussed at the 2013 Workshop of the European Society of Endocrine Surgeons devoted to MIFTC. Results: Published papers on MIFTC present inadequate power with a III-IV level of evidence and C grade of recommendation. Several issues demanded a comparison of published studies from different medical reports regarding MIFTC definition, specimen processing, characteristics, diagnosis, prognoses, and therapy. As a consequence, it is difficult to make valuable statements on MIFTC with a sufficient recommendation rating. MIFTC diagnosis requires clearer, unequivocal, and reproducible criteria for pathologist, surgeons, and endocrinologists to use in the management of these patients. If the distinction between MIFTC and WIFTC cannot be made, an expert in thyroid pathologist should be consulted. Conclusion: According to published papers, the following conclusions can be drawn. (a) Candidates for hemithyroidectomy are MIFTC with exclusive capsular invasion, patients 45 years), large tumor size (>40 mm), extensive vascular invasion, presence of distant synchronous or metachronous metastasis, positive nodes, and if recurrence is noted at follow-up

Recueil des historiens des Gaules et de la France ...

Vols. 1-8 (1738-52) edited by M. Bouquet; v. 9-10 (1757-60) by J. B. Haudiquier and C. Haudiquier; v. 11 (1767) by E. Housseau, J. Précieux and G. Poirier; v. 12-13 (1781-86) by F. Clément and M. J. J. Brial; v. 14-18 (1806-22) by M. J. J. Brial; v. 19 (1833) by M. J. J. Brial, J. Naudet and P. C. F. Daunou; v. 20 (1840) by J. Naudet and P. C. F. Daunou; v. 21 (1855) by J. D. Guigniaut and J. N. de Wailly; v. 22 (1865) by J. N. de Wailly and L. V. Delisle; v. 23 (1876) by J. N. de Wailly, L. V. Delisle and C. M. G. B. Jourdain; v. 24 (1904) by L. V. Delisle.Vol 11 was published by L. F. Delatour et compagnie: v.12-13, Chez la veuve Desaint; v. 14-15, 21-22, Impremerie impériale; v. 16-20, Imprimerie royale; v. 23- Imprimerie nationale.Vol. 1 has engraved dedication.Half-title: Rerum gallicarum et francicarum scriptores.Title in red and black with engraved vignette in v. 1-13.Mode of access: Internet

La substitution des images aux reliques, et ses limites, dans la diffusion de la virtus des saints (Espace FranÇais, fin XIIIe-XVe S.)

After an earlier study regarding the Italian corpus, this article continues for the French territory an ample research started from the pioneering views of André Vauchez regarding the substitution of images for relics in the employment of the virtus of saints away from their tomb. - The article does not deal with images of the Virgin. - On the chronological level, the French corpus fits these views much better than the Italian, since the phenomenon is only really observed there from the 14th cent. In addition, a series of new data confirm that various images became “focal points” of the cult of saints far away from their tomb. But, as for the Italian corpus, in the texts studied it is more often contact relics and tiny first-class relics that appear as efficacious carriers of virtus. The last pages of the article underline how much the presentation, in spite of everything, only gives a very partial picture of a particularly complex reality.SCOPUS: re.jinfo:eu-repo/semantics/publishe