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Treatments for Multiple endocrine neoplasia type 2

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Book Excerpts: Treatment of Multiple endocrine neoplasia type 2

Treatments of Multiple endocrine neoplasia type 2: Online Medical Books

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Multiple endocrine neoplasia: Treatment
(Professional Guide to Diseases (Eighth Edition))

Treatment must eradicate the tumors. Subsequent therapy controls residual symptoms. In MEN I, peptic ulceration is usually the most urgent clinical feature, so primary treatment emphasizes control of bleeding or resection of necrotic tissue. In hypoglycemia caused by insulinoma, oral administration of diazoxide or glucose can keep blood glucose levels within acceptable limits. Subtotal (partial) pancreatectomy is required to remove the tumor. Because all parathyroid glands have the potential for neoplastic enlargement, subtotal parathyroidectomy may also be required along with transsphenoidal hypophysectomy. In MEN II, treatment of an adrenal medullary tumor includes antihypertensives and resection of the tumor. Bromocriptine may be used for pituitary tumors that secrete prolactin. Hormonal replacement therapy is necessary when glands are removed or secretion is inadequate.

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Source: Professional Guide to Diseases (Eighth Edition), 2005

Pheochromocytoma: Treatment
(Professional Guide to Diseases (Eighth Edition))

Surgical removal of the tumor is the treatment of choice. To decrease blood pressure, an alpha-adrenergic blocker or metyrosine is given from 1 to 2 weeks before surgery. A beta-adrenergic blocker (propranolol) may also be used after achieving alpha blockade. Postoperatively, I.V. fluids, plasma volume expanders, vasopressors and, possibly, transfusions may be required for hypotension. Persistent hypertension in the immediate postoperative period can occur. If surgery isn’t feasible, alpha-adrenergic blockers and beta-adrenergic blockers — such as phenoxybenzamine and propranolol, respectively — are beneficial in controlling catecholamine effects and preventing attacks. Management of an acute attack or hypertensive crisis requires I.V. phentolamine (push or drip) or nitroprusside to normalize blood pressure.

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Source: Professional Guide to Diseases (Eighth Edition), 2005



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