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Block 5 Cancers (Endocrine (Thyroid (Papillary Carcinoma (Most common,…

- - - - Functional
        
        Prolactinoma
        
        galactorrhea/amenorrhea, low libido and HA
        
        Most common type, treat with surgery or DA agonists
        
        GH cell adenoma
        
        Leads to gigantism/acromegaly, secondary diabetes (liver stim)
        
        Tests- high GH, insulin-like GF, no GH supression by oral glucose
        
        Treat with somatostatin analog, receptor antagonist, or surgery
        
        ACTH cell adenoma
        
        Causes Cushing's
      - Nonfunctional
        
        Usually presents with mass effect
  - - - Benign, follicles w/fibrous capsule, usually nonfunctional
    - - Most common, associated w/ radiation
      - Papillae lined w/ clear nuclei ("orphan annie") and nuclear grooves. Psammoma bodies
      - Spreads to cervical nodes, excellent prognosis
    - - Like adenoma except w/ invasion through capsule
      - Spreads hematogenously
    - - Prolif. of C cells, makes calcitonin. May cause hypocalcemia
      - sheets of malignant cells in amyloid stroma
      - associated with MEN, RET oncogene
    - - Undifferentiated, seen in elderly
      - invades local structures, poor prognosis
  - - - most common cause of hyperparathyroidism
      - causes hypercalcemia, usually subclinical
      - See high PTH, high Ca, Low P, high urine cAMP, high alk phos
      - May lead to kidney stones and osteitis fibrosa cystica
  - - - Conn sydrome: high aldosterone, low renin, usually resected
    - - Made of chromaffin cells, secretes catecholamines
      - Get HA, HTN, palpitations, tachycardia, sweating
      - Diagnose by high metanephrines and urine VMA. See in MEN 2A/B, Von Hippel-Lindau, NF1
      - Treat with surgery, Follows rule of 10s
- - - - seen in facial bones, Gardner syndrome (FAP)
    - - osteoblast tumor, radiolucent osteoid inside tumor
      - see in young adults, cortex of long bones
      - vs osteosarcoma- osteoma responds to aspirin, smaller, not in vertebrae
    - - bone tumor w/ cartilage cap, most common benign bone tumor
      - lateral projection of growth plate, continuous w/ marrow
    - - osteoblast tumor, pleomorphic cells making osteoid
      - Most common in teenagers. Risk factors- radiation, Paget's, family retinoblastoma
      - found in metaphysis of long bones, like femur and tibia
      - Rad- sunburst, lifting of periosteum
    - - Seen in young adults, epiphysis of long bones, femur/tibia
      - See multinuclear giant cells and stromal cells, local aggression
      - Soap-bubble appearance
    - - Neuroectoderm cells, found in Male kids, see in diaphysis of long bones
      - Onion-skin appearance, small round blue cells
      - 11;22 translocation, see mets, chemo works well
    - - Chondroma- benign, found in medulla of hand/foot bones
      - Chondrosarcoma- found in medulla of pelvis/axial skeleton
      - Punch-out lesions, more common. Often prostate mets.
  - - - most common, benign
    - - also common, lipoblast tumor
    - - Tuberous sclerosis --> cardiac rhabdomyoma
    - - Common in kids, rhabdomyoblast tumor
      - Desmin +, usually in head/neck or vagina