ACTA ENDOCRINOLOGICA (BUC)

Graves’ orbitopathy usually occurs in thyrotoxic patients at the presentation of the\r\nhyperthyroidism.\r\nAim: we conducted a cross sectional study over 8 and a half years of the relation\r\nbetween Graves’ orbitopathy and thyroid status in patients presenting to our joint thyroidophthalmology\r\nclinic at University Hospital of Wales.\r\nMethods: Patients with active orbitopathy were diagnosed clinically and with\r\nappropriate imaging where necessary. This series excluded patients previously treated with\r\nradioiodine or surgery for Graves’ disease. Of 259 patients 140 (54%) had not had 131I or\r\nsurgical therapy. Thirty four percent of the 140 had never been hyperthyroid of whom 19\r\n(13.5%) were euthyroid. Twenty nine of the 140 (20.7%) were hypothyroid receiving\r\nlevothyroxine at referral. There were no significant differences between the hyperthyroid\r\nand non hyperthyroid groups in the incidence of cigarette smoking, family history of thyroid\r\ndisease or maximum proptosis at presentation.\r\nResults: We found a higher prevalence of smokers than reported in the literature in\r\nmoderate and severe TAO across all thyroid status groups including hypothyroid only\r\npatients. This study has emphasized the occurrence of Graves’ orbitopathy in hypothyroid\r\npatients as well as euthyroid individuals.

Introduction. The most frequent abdominal tumors in newborn girls are ovarian cysts, with an incidence of more than 30%. Smaller cysts (<4-5 cm) can regress spontaneously within the first 1-6 months after birth and usually require periodic follow-up, while larger cysts have a greater risk of torsion (50-70% of cases), rupture, hemorrhage or can determine compression on nearby organs. There still is no general consensus regarding the optimal management of ovarian cysts in newborns and infants Patients. Methods. Seven newborn female patients were referred to our hospital from maternity wards with a prenatal diagnosis of abdominal mass, over a period of 4 years (2011-2015). In all cases the postnatal ultrasound confirmed the presence of a cystic mass pertaining to the right or left ovary. We divided the patients into 2 groups taking into account the size of the cystic masses and their radiological characteristics: if the cyst was smaller than 4 cm, we followed the patient with periodic ultrasounds and in cases where the cyst was greater than 4 cm, surgical management was considered if the patient presented with complications. Of the 7 cases, 4 underwent surgery, while in 3 cases the decision was made to perform periodic followups. Conclusion. Ovarian cysts are frequently encountered in the neonatal period. No precise guide to the management of this pathology has been established. Close follow-up should be performed and surgical intervention should be done in order to avoid complications.

Introduction. Ganglioneuromas are rare, benign tumors that arise from the neural crest tissue and are usually asymptomatic and discovered accidentally. GN have good prognosis with surgical removal and the standard treatment for such lesions is laparoscopic adrenalectomy. Case report. We report the case of a 13 year old patient who presented to our hospital with abdominal pain. The ultrasound and the CT scan confirmed the presence of a well-defined mass situated in the right renal space. Taking into account the size of the tumor, its position and the fact that CT scan showed no local signs of invasion, the decision was taken to perform a laparoscopic removal of the right adrenal mass. After dividing the main adrenal vein and while dissecting the adrenal gland, we noticed an intraoperative bleeding due to the fact that one of the clips used to ligate the vein had slipped. Because we were unable to control the intraoperative bleeding we decided to convert to open surgery. The histopathological result showed that the adrenal lesion was a ganglioneuroma. Conclusion. While the role of minimal invasive adrenalectomy in patients with larger lesion is still controversial, advantages such as reduced hospital stay and postoperative morbidity, lower rate of complications, have resulted in the laparoscopic approach for adrenal pathology becoming the choice procedure in the removal of adrenal lesion.