Otutu endocrine neoplasia (MEN) II

Otutu endocrine neoplasia, ụdị nke abụọ (MEN II) bụ nsogbu na-agafe site na ezinụlọ nke otu ma ọ bụ karịa gland endocrine na-emebiga ihe ókè ma ọ bụ na-etolite etuto. Ọgwụ endocrine na-emetụtakarị gụnyere:

• Adrenal gland (ihe dị ka ọkara oge)
• Parathyroid gland (20% nke oge)
• Gland thyroid (ihe fọrọ nke nta ka ọ bụrụ oge niile)

Otutu endocrine neoplasia (MEN I) bụ ọnọdụ metụtara ya.

Ihe kpatara MEN II bụ ntụpọ na mkpụrụ ndụ ihe nketa a na-akpọ RET. Nrụrụ a na-eme ka ọtụtụ etuto pụta n’otu nwoke, mana ọ bụchaghị n’otu oge.

Ntinye aka nke gland adrenal na-enwekarị etuto a na-akpọ pheochromocytoma.

Ntinye aka nke gland thyroid na-enwekarị etuto a na-akpọ medullary carcinoma nke thyroid.

Tumor na thyroid, adrenal, ma ọ bụ parathyroid glands nwere ike ime ọtụtụ afọ.

Nsogbu a nwere ike ime n'oge ọ bụla, na-emetụta ụmụ nwoke na ụmụ nwanyị nha anya. Isi ihe kpatara nsogbu bụ akụkọ ihe mere eme nke ezinụlọ MEN II.

E nwere subtypes abụọ nke MEN II. Ha bụ MEN IIa na IIb. MEN IIb adịkarịghị.

Mgbaàmà nwere ike ịdị iche iche. Agbanyeghị, ha yiri nke a:

• Carcinoma medullary nke thyroid
• Pheochromocytoma
• Parathyroid adenoma
• Parathyroid hyperplasia

Iji chọpụta ọnọdụ a, onye nlekọta ahụike na-achọ ngbanwe na mkpụrụ ndụ RET. Enwere ike ime nke a site na nyocha ọbara. A na-eme nyocha ndị ọzọ iji chọpụta nke homonụ a na-emepụta karịa.

Nnwale anụ ahụ nwere ike ikpughe:

• Llọ lymph gbasaa n’olu
• Ahụ ọkụ
• Ọbara mgbali elu
• Otutu obi
• Nodules thyroid gị

Nlere onyonyo eji amata etuto nwere ike ịgụnye:

• Ime CT i scanomi
• Imaging nke akụrụ ma ọ bụ ureters
• MIBG scintiscan
• MRI nke afọ
• Nyocha thyroid
• Ultrasound nke thyroid

A na - eji nyocha ọbara iji hụ oke ụfọdụ glands na ahụ na - arụ ọrụ. Ha nwere ike ịgụnye:

• Calcitonin larịị
• Mmiri alkaline phosphatase
• Ọbara calcium
• Ọbara hormone parathyroid
• Achọpụta ọbara
• Mmamịrị catecholamines
• Mmamịrị metanephrine

Nlere ma ọ bụ usoro ndị ọzọ enwere ike ịme gụnyere:

• Adrenal biopsy
• Nchịkwa Electrocardiogram (ECG)
• Bioroid na-egbu egbu

Gerywa ahụ dị mkpa iji wepu pheochromocytoma, nke nwere ike ịbụ ihe na-eyi ndụ egwu n'ihi homonụ ọ na-eme.

Maka carcinoma medullary nke thyroid, a ga-ewepụrịrị thyroid gland na gburugburu lymph. A na-enye ọgwụgwọ ọgwụ na-agbanwe ọgwụ thyroid mgbe ịwachara ahụ.

Ọ bụrụ na nwatakịrị maara na ọ na-ebu mgbanwe RET gene, a na-atụle ịwa ahụ iji wepụ thyroid tupu ọ ghọọ cancer. Ekwesiri ikwurita nke a na onye dibia bekee nke maara oria a. A ga-eme ya na nwata (tupu afọ 5) na ndị nwere MEN IIa mara, yana tupu afọ isii ọnwa isii na ndị nwere MEN IIb.

Pheochromocytoma anaghị arịa ọrịa kansa (benign). Ọrịa carcinoma Medullary nke thyroid bụ ọrịa na-eme ihe ike ma nwee ike ịnwụ, mana nchọpụta mbụ na ịwa ahụ nwere ike ibute ọgwụgwọ. Surwa ahụ anaghị agwọ ọrịa MEN II.

Mgbasa nke mkpụrụ ndụ kansa bụ ihe mgbagwoju anya.

Kpọọ onye na-ahụ maka ọrụ gị ma ọ bụrụ n ’ịchọrọ ihe mgbaàmà nke MEN II maọbụ ọ bụrụ na mmadụ n’ezinaụlọ gị enweta ụdị nchoputa ahụ.

Inyocha ndị ikwu nke ndị nwere MEN II nwere ike ibute nchoputa ngwa ngwa nke ọrịa ahụ na ọrịa kansa metụtara ya. Nke a nwere ike inye ohere iji gbochie nsogbu.

Ọrịa ara ara; MM II II; Pheochromocytoma - MEN II; Ọrịa thyroid - pheochromocytoma; Parathyroid cancer - pheochromocytoma

• Ọgwụ endocrine

National Comprehensive Cancer Network weebụsaịtị. Usoro nlekọta ahụike na oncology (NCCN ndu): etuto neuroendocrine. Versiondị 1.2019. www.nccn.org/professionals/physician_gls/pdf/neuroendocrine.pdf. Emelitere March 5, 2019. Nabata March 8, 2020.

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Nieman LK, Spiegel AM. Nsogbu Polyglandular. Na: Goldman L, Schafer AI, eds. Ọgwụ Goldman-Cecil. Nke 26th. Philadelphia, PA: Elsevier; 2020: isi 218.

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