PARATHYROID ADENOMA

DEFINITION

Parathyroid adenomas are non-cancerous (benign) tumors of the parathyroid glands, which are located in the neck. The parathyroid glands are four pea-sized organs found near the thyroid gland. There are no other organs in the body that are present 4 times. When the 4 parathyroid glands are formed (before we are born), they migrate from one part of the neck to another. It is this migration of the parathyroid glands that makes finding them tricky later in life. The parathyroid anatomy is the most variable anatomy in the human body. The parathyroid glands can be located from just below the jaw to the area around the heart. These glands make parathyroid hormone (PTH or parathormone). PTH helps the body use and store calcium to keep the calcium in the blood at normal level.

CAUSES AND SYMPTOMS

Parathyroid adenomas are generally caused by a problem with your genes. The parathyroid glands help control the break down of calcium in the body. The most common cause of parathyroid adenomas is hyperparathyroidism, which leads to high levels of calcium in the blood (hypercalcemia). The hypercalcemia caused by hyperparathyroidism is more serious and life threatening than parathyroid cancer itself. Women over 60 are at highest risk, and radiation to your head or neck also increase your risk.
Many people have no symptoms. The condition is often discovered by accident when you are being examined for another problem. Symptoms that may occur include the following:
§ Lethargy
§ Confusion
§ Nausea
§ Constipation
§ Myalgias (muscle pain)
§ Kidney stones
§ Bone fractures

EXAMS AND TREATMENT

Blood tests are done to check the levels of serum calcium, serum phosphorus, serum chloride, and serum bicarbonate.
A 24 urine test is done to check for increased calcium in the urine.
Other exams include:
§ Bone density exam
§ Kidney x-rays (may show kidney stones)
§ Ultrasound or CT (may show kidney stones)
§ MRI or Tc-thallium neck scan (may show enlarged parathyroid glands)
§ Sestambi scan: a radionuclide scan used to find an overactive parathyroid gland.

Surgery is the most important treatment. The goal when performing parathyroid surgery is to remove only the bad parathyroid gland and leave the good one. Remember, in about 95% of the time, its only one parathyroid gland that has become diseased (it grows into a benign tumor about the size of an olive or grape). Some postmenopausal women might consider estrogen replacement and many patients with mild hyperparathyroidism are not treated but are monitored for escalation of symptoms.

For more info go to: http://www.nlm.nih.gov/medlineplus/ency/artcle/001188.htm
http://www.cancer.gov/ , http://parathyroid.com/

MOYAMOYA DISEASE

WHAT IS MOYAMOYA DISEASE ?

Moyamoya disease is a rare, cerebrovascular disorder caused by blocked arteries at the base of the brain in an area called basal ganglia. In Japanese the name "moyamoya" means "puff of smoke" and describes the look of the tangle of tiny vessels formed to compensate for the blockage. In the 1960's, this disease was first described in Japan and since has been found in individuals in the United States, Europe, Australia, and Africa. Moyamoya disease primarily affects children, but it can occur in adults also. Because it tends to run in families, researchers think that it is the result of inherited genetic abnormalities. Approximately 10% of the cases are genetic caused and are termed primary Moyamoya disease. Secondary Moyamoya disease refers to cases in which the disease is a result of another underlying disorder. In this case it is very important for the physician to determine the root underlying cause.

SIGNS AND SYMPTOMS

The signs most typically include paralysis of the feet, legs or upper extremities. Headaches, mental retardation, various vision problems, speech deficits, and psychiatric problems.

In children, the first symptom of Moyamoya disease is often a stroke, or recurrent transient ischemic attacks (TIA's, commonly referred to as "mini-strokes"), frequently followed by muscular weakness affecting one side of the body or seizures. Adults often experience a hemorrhagic stroke due to recurring blood clots in the affected brain vessels.

TREATMENT

There is no cure for moyamoya disease, but treatment may help manage the signs and symptoms. Treatment may include:

• Corticosteroid medications


• Blood-thinning medications to reduce the risk of blood clots


• Revascularization surgery to bypass blocked arteries or open narrowed blood vessels in order to restore blood to the brain

For more info go to: http://www.rarediseases.org , http://www.ninds.nih.gov/disorders , http://www.mayoclinic.com

Without treatment, Moyamoya disease can be fatal as a result of intracerebral hemorrhage.

PARANASAL SINUS CANCER

DEFINITION
The paranasal sinus is the spaces within the bones behind the nose and cheeks. Para nasal means “around or near the nose.” Sinuses are cavities or small tunnels. Each sinus is lined with cells that produce mucus to prevent the lining of the nose from drying out, and moisten the air that we breathe. They also give your voice an individual tone, lighten the weight of the skull, and provide a bony frame work for the eyes and face.

CAUSES
Paranasal sinus cancer is a rare type of cancer that can occur at any age, but is very rare in people under 40. Men are twice as likely to be diagnosed with it than women. Smoking has been found to increase the risk of developing cancer in this area of the body. Also people who use snuff for many years, or those who work in the wood or furniture industry and are exposed to wood dust, are more likely to develop it. Paranasal sinus cancer is not infectious or inherited and cannot be passed on to other people. Like many other forms of cancer, the exact causes are unknown.

SIGNS AND SYMPTOMS
The symptoms can vary depending on which sinuses are affected. The most common symptoms include:
Pain behind the nose or upper teeth
Blocked sinuses which do not clear
Swelling around the eyes and double vision
Numbness of the cheek, lip, upper teeth or side of the nose
Persistent nosebleeds, headaches, and speech changes

DIAGNOSIS AND TREATMENT
Paranasal sinus cancer is most likely to be cured when diagnosed at an early stage. Therefore, any of the above symptoms should be reported to your doctor if they don’t improve in over a few days. The following tests are commonly used to make a firm diagnosis:
X-rays--- to show the size and position of the cancer
CT or MRI scan---to find the exact site of the cancer, or check for any spread
Nasopharyngoscopy---biopsy to examine abnormal tissue for cancer cells
Treatment of paranasal sinus cancer will depend on the position and stage of the cancer, the type, the grade, and your health in general. The following treatments alone or in combination with one another maybe used for your situation:
Surgery---can be quite extensive and in some cases skin grafts or flaps are needed
Radiotherapy---uses high energy rays to destroy the cancer cells
Chemotherapy---uses anti-cancer (cytotoxic) drugs to destroy cancer cells
For more information on paranasal sinus cancer go to http://www.cancerbackup.org.uk/Cancertype/Headneck/typesofheadneckcancers/... http://www.cancer.org/docroot/cri/content/cri