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[Hereditary Sipple syndrome (author's transl)].

This entity, isolated by Gorlin, is characterized by the presence of cutaneous and mucous neuromas, facial disfiguration resembling acromegalia as well as morphological changes to the extremities similar to those produced by Marfan's disease. These factors are also associated with multiple endocrinological neoplasms type II of Sipple's syndrome. In other words, malignant tumors developing from thyroid "C" cells as well as from bilateral benign pheochromocytoma (neoplasias which derive from the A.P.U.D. system). It is considered to be hereditary in nature and transmitted as a dominant trait. Its evolution is triphasic, and the prognosis is extremely dismal. There may exist incomplete or benign forms, in the course of which the endocrinological neoplasms may appear very late or not at all. Generally, the diagnosis is easy. This entity can be calssified with other diseases stemming from the neural ridge, in other words "neurocristopathies" but in spite of these similarities with disease of the same embryological origin, it would seem that this particular entity is genetically autonomous. The only effective treatment is surgical, for thyroid neoplasms, as well as neoplasms occurring in the medullo-adrenal glands. It should be noted that this line of treatment must be undertaken with the utmost precaution.

Adolescent↗

[A clinico-pathologic study of 31 cases of parathyroid hyperplasia and tumours].

31 cases of primary hyperplasia and neoplasms of the parathyroid gland are reported. Among them, 23 cases were parathyroid adenoma, 6 cases parathyroid hyperplasia, one case adenoma associated with hyperplasia, and one case of parathyroid adenocarcinoma. Follow-up study demonstrated that prognosis in the adenoma group is better than that in the hyperplasia group, and one carcinoma patient died from metastasis. Regarding differential diagnosis, adenoma is usually single, with frequent presence of oppressed parathyroid tissue next to the tumor capsule; and cell atypical hyperplasia is often seen microscopically, which is usually multiple in sites, and some residual adipose tissue can be found under the microscope. Clinically, both groups manifested hypercalcemia and hypophosphatemia, especially in those cases with chief cell hyperplasia. Capsule infiltration and vascular embolism are emphasized as the differential features between benign and malignant parathyroid tumours.

Adenocarcinoma↗

Neuroendocrine neoplasms of the thymus.

Neuroendocrine tumors of the thymus bear many similarities to "carcinoids" and "oat-cell carcinomas" in other organs, and are clinicopathologically distinct from thymomas, thymic seminomas, and other primary tumors of this gland. They are associated with Cushing's syndrome or multiple endocrine neoplasia in 35% of cases, and are often locally aggressive. Approximately 30-40% of patients have distant metastases of their tumors that ultimately result in fatality, since the response of thymic neuroendocrine neoplasms to irradiation and chemotherapy is poor. Ultrastructural studies and immunohistochemical stains for chromogranin, protein gene product 9.5, and synaptophysin are effective tools for the diagnosis of thymic carcinoid and oat-cell carcinoma.

Diagnosis, Differential↗