| Component of MEN 2A |
Before Surgery |
Before
Surgery |
After Surgery |
After
Surgery |
|
Biochemical Findings |
Imaging |
Histopathology |
Imaging/ biochemical
findings |
|
Pheochromocytoma
(Pre-pregnancy)
|
24-hour Urine Adrenaline: 81.74 ug/day (Normal <
20ug/day)
Noradrenaline: 197.66 ug/day (Normal < 90 ug/day)
Urinary Free Cortisol: 76ug/day (Normal <120 ug/day)
S. DHEAS: 210 ug/dL
|
CECT abdomen:
Bilateral enlargement of adrenal gland, with heterogenous mass with
areas of necrosis and cystic changes
Size: 7.6 X 5.4 cm on right side and 5.5 X 4.4 cm on left side
68-Ga-DOTANOC Scan:
Uptake in the solid component of the lesions bilaterally
|
Bilateral pheochromocytoma; PASS-4
|
None
|
|
Medullary Thyroid Carcinoma
|
S.Calcitonin
(Pre-pregnancy): 20 pg/ml (Normal < 5 pg/ml)
S.Calcitonin
(At 22 weeks POG): 42.1pg/ml
|
USG Neck:
(pre-pregnancy)
A TIRADS 5 nodule on right lobe (5.8 x 3.7 mm).
Two TIRADS 5 on left lobe of thyroid (8 x 5 mm);
USG Neck
(At 22 weeks POG, repeated before surgery) Right thyroid nodule
(6.5 x 4.8 mm) and left thyroid nodule (6.2 x 5 mm)
|
Medullary thyroid carcinoma
|
USG Neck:
(At 32 weeks POG):
No residual Lesion
|
|
Hyper-parathyroidism
|
S. Calcium
(Pre-pregnancy): 12.1mg/dL (Normal- 8.2-10.4 mg/dL
iPTH
(Pre-pregnancy): 226 pg/ml (Normal < 65 pg/ml)
|
USG Neck:
(Pre-pregnancy)
A right inferior parathyroid adenoma (9 x 5.2 mm); repeat imaging: 8 x 6
mm
USG Abdomen:
(Pre-pregnancy)
Bilateral nephrocalcinosis,
right moderate hydronephrosis
|
Parathyroid adenoma
|
S. Calcium: (At 24 weeks POG)
9.1 mg/dL
iPTH:
(At 24 weeks POG)
8 pg/ml
|