Angapo endocrine neoplasia (MEN) II

Multiple endocrine neoplasia, mtundu wachiwiri (MEN II) ndimatenda omwe amapitilira m'mabanja momwe gland imodzi kapena zingapo zimagwira ntchito mopitilira muyeso kapena zimapanga chotupa. Matenda a Endocrine omwe amakhudzidwa kwambiri ndi awa:

• Adrenal gland (pafupifupi theka la nthawi)
• Matenda a parathyroid (20% ya nthawi)
• Chithokomiro (pafupifupi nthawi zonse)

Multiple endocrine neoplasia (MEN I) ndichofanana.

Chifukwa cha MEN II ndikulephera mu jini lotchedwa RET. Vutoli limayambitsa zotupa zambiri kuti ziwonekere mwa munthu yemweyo, koma osati nthawi yomweyo.

Kuphatikizidwa kwa adrenal gland nthawi zambiri kumakhala ndi chotupa chotchedwa pheochromocytoma.

Kuphatikizidwa kwa chithokomiro nthawi zambiri kumakhala ndi chotupa chotchedwa medullary carcinoma cha chithokomiro.

Zotupa m'matenda a chithokomiro, adrenal, kapena parathyroid zimatha kuchitika zaka zingapo.

Vutoli limatha kuchitika msinkhu uliwonse, ndipo limakhudza amuna ndi akazi chimodzimodzi. Chowopsa chachikulu ndi mbiri yabanja ya MEN II.

Pali magawo awiri a MEN II. Ndi MEN IIa ndi IIb. MEN IIb siodziwika kwenikweni.

Zizindikiro zimasiyana. Komabe, ndizofanana ndi izi:

• Medullary carcinoma ya chithokomiro
• Pheochromocytoma
• Parathyroid adenoma
• Parathyroid hyperplasia

Kuti adziwe izi, wothandizira zaumoyo amayang'ana kusintha kwa mtundu wa RET. Izi zitha kuchitika poyesa magazi. Mayeso owonjezera amachitika kuti adziwe kuti ndi mahomoni ati omwe akupangidwa mopitirira muyeso.

Kuyezetsa thupi kumatha kuwulula:

• Kukula kwa ma lymph lymph khosi
• Malungo
• Kuthamanga kwa magazi
• Kuthamanga kwa mtima mwachangu
• Mitundu ya chithokomiro

Kujambula mayeso omwe amagwiritsidwa ntchito pozindikira zotupa angaphatikizepo:

• M'mimba mwa CT scan
• Kujambula impso kapena ureters
• MIBG scintiscan
• MRI yamimba
• Kujambula chithokomiro
• Ultrasound cha chithokomiro

Kuyezetsa magazi kumagwiritsidwa ntchito kuti muwone momwe tiziwalo tina tomwe timagwirira ntchito. Zitha kuphatikiza:

• Mulingo wa Calcitonin
• Magazi amchere phosphatase
• Kashiamu wamagazi
• Mulingo wama hormone wa parathyroid
• Phosphorous yamagazi
• Mkodzo katekolamaini
• Mkodzo metanephrine

Mayesero ena kapena njira zomwe zingachitike ndi monga:

• Chidziwitso cha Adrenal
• Electrocardiogram (ECG)
• Chithokomiro

Kuchita opaleshoni kumafunika kuchotsa pheochromocytoma, yomwe imatha kukhala pachiwopsezo cha moyo chifukwa cha mahomoni omwe amapanga.

Kwa medullary carcinoma ya chithokomiro, chithokomiro ndi ma lymph node oyandikana nawo ayenera kuchotsedwa kwathunthu. Thandizo la chithokomiro m'malo mwake limaperekedwa pambuyo pochitidwa opaleshoni.

Ngati mwana amadziwika kuti amatenga kusintha kwa majini a RET, opareshoni yochotsa chithokomiro isanakhale khansa imalingaliridwa. Izi ziyenera kukambirana ndi dokotala yemwe amadziwa bwino izi. Zitha kuchitika adakali aang'ono (asanakwanitse zaka 5) mwa anthu omwe amadziwika ndi MEN IIa, komanso asanakwane miyezi 6 mwa anthu omwe ali ndi MEN IIb.

Pheochromocytoma nthawi zambiri sichikhala khansa (chosaopsa). Medullary carcinoma ya chithokomiro ndi khansa yoopsa kwambiri komanso yomwe imatha kupha, koma kuzindikira koyambirira ndi kuchitidwa opaleshoni nthawi zambiri kumatha kuchiritsa. Kuchita opareshoni sikuchiza omwe ali pachibwenzi MEN II.

Kufalikira kwa maselo a khansa ndizotheka.

Itanani omwe akukuthandizani mukawona zizindikiro za MEN II kapena wina m'banja mwanu atazindikira izi.

Kuwunika achibale apafupi a anthu omwe ali ndi MEN II kumatha kudzetsa matendawa ndi khansa yofananira. Izi zitha kuloleza njira zopewera zovuta.

Matenda a Sipple; AMUNA II; Pheochromocytoma - AMUNA II; Khansa ya chithokomiro - pheochromocytoma; Khansa ya parathyroid - pheochromocytoma

• Matenda a Endocrine

Tsamba la National Comprehensive Cancer Network. Malangizo azachipatala mu oncology (NCCN guideines): zotupa za neuroendocrine. Mtundu 1.2019. www.nccn.org/professionals/physician_gls/pdf/neuroendocrine.pdf. Idasinthidwa pa Marichi 5, 2019. Idapezeka pa Marichi 8, 2020.

Newey PJ, Thakker RV. Angapo endocrine neoplasia. Mu: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, olemba. Buku la Williams la Endocrinology. Wolemba 14th. Philadelphia, PA: Elsevier; 2020: chap 42.

Nieman LK, Spiegel AM. Matenda a Polyglandular. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 218.

Tacon LJ, Learoyd DL, Robinson BG. (Adasankhidwa) Angapo endocrine neoplasia mtundu 2 ndi medullary chithokomiro carcinoma. Mu: Jameson JL, De Groot LJ, de Kretser DM, et al, olemba. Endocrinology: Akuluakulu ndi Ana. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier Saunders; 2016: chap 149.