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Publications (6)4.97 Total impact

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    ABSTRACT: A woman with a previous history of hyperthyroidism and low thyroid radioiodine uptake was admitted. Abdominal computed tomography revealed an 11 × 8.2-cm mass, located in the right iliac bone. Surgical biopsy revealed a well-differentiated follicular carcinoma of the thyroid. Whole-body I131 scan revealed intense fixation of radioactive material in the lesion. The patient was treated with radioactive iodine. Functioning metastasis of differentiated carcinoma of the thyroid should be considered in patients with hyperthyroidism and low thyroid radioiodine uptake.
    The Endocrinologist 02/2010; 20(2):50-51. · 0.12 Impact Factor
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    ABSTRACT: BACKGROUND: The use of growth hormone (GH) in deficient adults has already been demonstrated to result in several benefits regarding metabolic parameters, body composition and quality of life. Due to the similarities between GH deficiency in adults and the aging process, the concept of somatopause has emerged. OBJECTIVES: Correlate the GH secretion profile in healthy men older than 50 years with anthropometric parameters and exercise capacity. PATIENTS AND METHODS: Twenty-nine healthy male were selected, with a mean age of 57.9+/-4.2 years (range 50-66). After hospital admission, body mass index (BMI), body composition (fat mass) and abdominal circumference, 24-h GH profile, GH peak and basal IGF-I were evaluated, and all the patients underwent a treadmill stress testing to estimate exercise capacity with the Bruce protocol, with evaluation of the maximum oxygen peak, maximum heart rate and METs. All the results are shown as mean+/-Std deviation: BMI -26.5+/-4.9kg/m2, percent fat mass -27.1+/-6.2%, abdominal circumference -92.1+/-10.1cm, 24h GH profile -0.3+/-0.2ng/dl, peak GH -2.5+/-2.0ng/dl, IGF-I -202.4+/-72.4ng/dl, maximum oxygen peak -31.9+/-6.8L, maximum heart rate - 161.4+/-7.5 bpm and METs - 9.1+/-1.9. After regression analysis using the GH secretion profile (mean GH in 24h, spontaneous peak GH and basal IGF-I) as dependent variable, no correlations were found between these and the other evaluated parameters.
    Growth Hormone & IGF Research 05/2008; 18(2):143-7. · 2.26 Impact Factor
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    ABSTRACT: Ectopic growth hormone-releasing hormone (GHRH)-secreting tumors are rare and cause acromegaly with somatotroph hyperplasia. We report a case of acromegaly secondary to GHRH secretion by an incidentally discovered pheochromocytoma in a normotensive patient. A 23-year-old man presented with signs and symptoms of acromegaly. Laboratory evaluation confirmed the diagnosis and magnetic resonance imaging (MRI) revealed a sellar mass which was thought to be a macroadenoma and surgically resected. The patient was not cured and medical treatment was indicated. An abdominal ultrasound performed before initiation of medical treatment showed a solid/cystic lesion superiorly to the right kidney. An abdominal MRI confirmed an adrenal tumor. Hormonal workup of the adrenal incidentaloma revealed elevated urinary catecholamine and total metanephrines findings strongly suggestive of a pheochromocytoma. Acromegaly was then suspected to be due to ectopic secretion of GHRH by the tumor. Patient underwent surgical resection and histopathologic examination confirmed a pheochromocytoma which stained positively for GHRH. Also, review of the pituitary specimen confirmed somatotrophic hyperplasia. Genetic analysis of the ret proto-oncogene showed no mutation. Pituitary MRI was repeated 10 months after pheochromocytoma resection and revealed a slightly enlarged pituitary and partial empty sella. The diagnosis of acromegaly caused by ectopic production of GHRH is a challenging task. A careful histopathological examination of the surgically excised pituitary tissue has a key role to arouse the suspicion and guide the investigation of a secondary cause of acromegaly.
    Endocrine Pathology 02/2007; 18(1):46-52. · 1.60 Impact Factor
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    ABSTRACT: Struma ovarii (SO) is a rare ovarian teratoma in which thyroid tissue constitutes more than 50% of the tumor tissue. Diagnosis is usually made after surgical excision of a pelvic tumor. Hyperthyroidism is an infrequently associated condition. Case no. 1 is a 62-year-old woman who underwent surgical resection of a cystic ovarian lesion discovered during the investigation of left lower quadrant pain. She had a history of radioiodine treatment of hyperthyroidism but no preoperative evaluation of thyroid function. After surgery, hypothyroidism was diagnosed and levothyroxine therapy was initiated. Histologic examination of the ovarian tumor revealed a struma ovarii. Case no. 2 is a 52-year-old woman who presented with a multinodular toxic goiter with low radioiodine uptake on scintigraphy. The patient was started on 30 mg methimazole per day with unsatisfactory control because of poor compliance. Pelvic ultrasound was performed because of menometrorrhagia and revealed an ovarian lesion suggestive of a dermoid tumor. After surgical excision of the ovary, thyroid function tests normalized. Histologic examination revealed struma ovarii. In conclusion, although rare, struma ovarii must be kept in mind by gynecologists and endocrinologists when evaluating patients with a pelvic mass and/or unusual thyroid function findings.
    The Endocrinologist 02/2005; 15(2):79-81. · 0.12 Impact Factor
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    ABSTRACT: To evaluate the incidence, behavior, clinical outcome and identify possible predictive factors of the association between thyroid cancer (TC) and Graves’ disease (GD), we reviewed the records from all patients submitted to thyroidectomy for treatment of GD between 01/79 and 11/02 from 2 university hospitals. Histology of the excised specimens identified TC in 7 of the 341 patients (2.1%). In the group with TC, age varied from 19 to 50 years (median: 29) and in those without TC, from 13 to 79 years (median: 34), which were not significantly different. There were 293 women (87.7%) and 41 men (12.3%) in the non-TC group and 5 women (71.5%) and 2 men (28.5%) in the TC group. By histology, all 7 cases of TC were papillary thyroid carcinoma (PTC): one with a multicentric PTC without extra-thyroidal involvement, two with the follicular variant of PTC (with 8 and 25mm diameter) but no capsular involvement, one with classic PTC (with 15mm diameter), and the remaining 3 with microcarcinomas (<10mm). Patients were followed from 6 to 16 years and none had local recurrence or distant metastasis. Our data showed an incidence of TC in patients submitted to surgery for GD concordant with those previously reported. Tumors were not more aggressive than usual, probably because of the high frequency of occult microcarcinomas.
    Arquivos Brasileiros de Endocrinologia & Metabologia 10/2003; 47(5):566-571. · 0.88 Impact Factor
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