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Surgical management of primary hyperparathyroidism guided by double-phase Tc-99m-MIBI scintigraphy

The Chinese-German Journal of Clinical Oncology 2012年第1期11卷 24-32页

作者： Abdel Hamid hussein Ezzat tarek El.Baradie Amr Attia Magdy Kotb Ahmad Zaher Iman Gouda Department of Surgical Oncology National Cancer Institute Cairo University Department of Nuclear Medicine National Cancer Institute Cairo University Department of Pathology National Cancer Institute Cairo University

Objective:The aim of this work was to study the clinicopathological features of cases with primary hyperparathyroidism (PHPT) referred to National Cancer Institute (NCI), Cairo University in the last six years and to study the role of nuclear medicine techniques in the initial diagnosis and preoperative localization directing surgical management of these cases. Methods: This study included 27 patients with PHPT properly diagnosed and treated in the NCI, Cairo University from January 2005 to December 2010. Preoperative neck U/S and Tc-99m-MIBI scintigraphy were done in all cases. If preoperative localization detected a single lesion, unilateral exploration was done. Bilateral exploration was done if multiple foci of active parathyroid glands or no lesions were detected. Results: This study included 27 patients (8 males and 19 females). The median age was 43 years (range from 19 to 68 years). All cases presented with bone disease in the form of bony pain in 23 patients, bony swellings in 15 patients and pathological fractures in 6 cases. Twenty one patients (77.8%) had single adenoma, 5 cases (18.5%) had parathyroid hyperplasia, and only one case had double adenomas. The sensitivity of neck U/S in detecting single adenoma was 61.9% (13/21), with 81% positive predictive value (PPV) while the sensitivity of Tc-99m-MIBI scintigraphy was 90.5% (19/21) with 100% PPV. Based on preoperative localization tests, unilateral exploration was done in 19 patients with solitary adenomas. All cases in this group were cured with no reported case of persistent or recurrent hypercalcemia. Conclusion: Presentation of PHPT may mimic malignant bone tumors but fortunately these patients were correctly diagnosed with bone scan which confirm the presence of metabolic bone disease rather than bone metastases. This was followed by estimation of serum calcium and parathormone levels for confirmation. Unilateral exploration based on the combination of ultrasound and preoperative localization by T

关键词： primary hyperparathyroidism Tc-99m-MIBI scintigraphy

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Evaluation of Surgical Outcome after Resection of Pancreatic Tumors, Our Experience in Mansoura Oncology Center, a Middle-Volume Center in Egypt

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Journal of Cancer Therapy 2012年第5期3卷 477-481页

作者： Nazem Shams Mahmoud Mosbah Mohammad Hegazy Osama hussein Omar Farouk Sameh Roshdy Mohamed tarek Hafez Ashraf Khater Khaled Abdel Wahab Oncology Center Mansoura University Mansoura Egypt

Background: Pancreatic cancer is the fourth most common cause of cancer related deaths in the world. Surgical resection remains the only potentially curative treatment for adenocarcinoma of the pancreas;only 10% - 20% of patients are candidate for standard pancreatic resection. Objective: To evaluate perioperative mortality, morbidity and survival for patients underwent PD in middle-volume center. Patients and Methods: Sixty patients with pancreatic tumors were enrolled in this study for different surgical procedure according to type of tumors. Results: No early postoperative complications were observed in 60% of patients, whereas 40% of patients developed one or more complication, the median survival for this group was 12.3 months with standard deviation 3.8 months.

关键词： Pancreatic Cancer Whipple Complication Survival

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Role of endoscopic ultrasound and cyst fluid tumor markers in diagnosis of pancreatic cystic lesions

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World Journal of Gastrointestinal Endoscopy 2022年第6期14卷 402-415页

作者： hussein Hassan Okasha Abeer Abdellatef Shaimaa Elkholy Mohamad-Sherif Mogawer Ayman Yosry Magdy Elserafy Eman Medhat Hanaa Khalaf Magdy Fouad Tamer Elbaz Ahmed Ramadan Mervat E Behiry Kerolis Y William Ghada Habib Mona Kaddah Haitham Abdel-Hamid Amr Abou-Elmagd Ahmed Galal Wael A Abbas Ahmed Youssef Altonbary Mahmoud El-Ansary Aml E Abdou Hani Haggag tarek Ali Abdellah Mohamed A Elfeki Heba Ahmed Faheem Hani M Khattab Mervat El-Ansary Safia Beshir Mohamed El-Nady Department of Internal Medicine and Hepatogastroenterology Kasr Al-Aini HospitalsCairo UniversityKasr Al-Aini HospitalsCairo UniversityCairo 11451Egypt Department of Endemic Diseases Cairo UniversityCairo 11451Egypt Department of Tropical Medicine and Gastroenterology Minia UniversityMinia 61511Egypt Department of Internal Medicine Kasr Al-Aini HospitalsCairo UniversityCairo 11562Egypt Department of Gastroenterology Armed forces College of MedicineCairo 11451Egypt Endoscopy and Internal Medicine Consultant at Dr/Ahmed Galal Endoscopy Center Alexandria 35516Egypt Department of Internal Medicine Faculty of MedicineAssuit UniversityAssuit 71111Egypt Department of Gastroenterology and Hepatology Mansoura UniversityMansoura 35511Egypt Department of Gastroenterology and Hepatology Theodor Bilharz Research InstituteCairo 11451Egypt Department of Microbiology and Immunology Faculty of Medicine for girls Al-Azhar UniversityCairo 11451Egypt Department of Internal Medicine Faculty of MedicineAin shams UniversityCairo 11451Egypt Department of Internal Medicine Bani-suef UniversityBani-suefBani-suef 62511Egypt Department of Pathology Faculty of MedicineCairo UniversityCairo 11451Egypt Department of Clinical Pathology Faculty of MedicineCairo UniversityCairo 11451Egypt Department of Environmental Medicine&Clinical Pathology National Research CentreCairo 11451Egypt

BACKGROUND Pancreatic cystic lesions(PCLs) are common in clinical practice. The accurate classification and diagnosis of these lesions are crucial to avoid unnecessary treatment of benign lesions and missed opportunities for early treatment of potentially malignant *** To evaluate the role of cyst fluid analysis of different tumor markers such as cancer antigens [e.g., cancer antigen(CA)19-9, CA72-4], carcinoembryonic antigen(CEA), serine protease inhibitor Kazal-type 1(SPINK1), interleukin 1 beta(IL1-β), vascular endothelial growth factor A(VEGF-A), and prostaglandin E2(PGE2)], amylase, and mucin stain in diagnosing pancreatic cysts and differentiating malignant from benign *** This study included 76 patients diagnosed with PCLs using different imaging modalities. All patients underwent endoscopic ultrasound(EUS) and EUS-fine needle aspiration(EUS-FNA) for characterization and sampling of different *** The mean age of studied patients was 47.4 ± 11.4 years, with a slight female predominance(59.2%). Mucin stain showed high statistical significance in predicting malignancy with a sensitivity of 87.1% and specificity of 95.56%. It also showed a positive predictive value and negative predictive value of 93.1% and 91.49%, respectively(P < 0.001). We found that positive mucin stain, cyst fluid glucose, SPINK1, amylase, and CEA levels had high statistical significance(P < 0.0001). In contrast, IL-1β, CA 72-4, VEGF-A, VEGFR2, and PGE2 did not show any statistical significance. Univariate regression analysis for prediction of malignancy in PCLs showed a statistically significant positive correlation with mural nodules, lymph nodes, cyst diameter, mucin stain, and cyst fluid CEA. Meanwhile, logistic multivariable regression analysis proved that mural nodules, mucin stain, and SPINK1 were independent predictors of malignancy in cystic pancreatic *** EUS examination of cyst morphology with cytopathological analysis and cyst fluid ana

关键词： Pancreatic cystic neoplasm Mucinous cystic neoplasm Intraductal papillary mucinous neoplasm Mucin stain Amylase

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