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Article: Comprehensive review of SGLT2 inhibitors' efficacy through their diuretic mode of action in diabetic patients.

Lam-Chung, Cesar Ernesto

2023 Volume 14, Page(s) 1174692

Abstract: SGLT2 inhibitors (SGLT2i) are now the mainstay therapy for both diabetes and heart failure. ...

Abstract	SGLT2 inhibitors (SGLT2i) are now the mainstay therapy for both diabetes and heart failure.
MeSH term(s)	Humans ; Canagliflozin/therapeutic use ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Diuretics/therapeutic use ; Glucosides/therapeutic use ; Heart Failure/complications ; Observational Studies as Topic ; Sodium-Glucose Transporter 2 Inhibitors/adverse effects
Chemical Substances	Canagliflozin (0SAC974Z85) ; Diuretics ; Glucosides ; Sodium-Glucose Transporter 2 Inhibitors
Language	English
Publishing date	2023-07-20
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2592084-4
ISSN	1664-2392
ISSN	1664-2392
DOI	10.3389/fendo.2023.1174692
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Article: Recent Understanding and Future Directions of Recurrent Corticotroph Tumors.

Hinojosa-Amaya, José Miguel / Lam-Chung, César Ernesto / Cuevas-Ramos, Daniel

Frontiers in endocrinology

2021 Volume 12, Page(s) 657382

Abstract: Corticotroph tumors (CTs) are pituitary neoplasms arising from the Tpit lineage, which may or not express adrenocorticotrophic hormone (ACTH). Functioning CTs cause Cushing's disease (CD), which has high morbidity and mortality due to hypercortisolemia. " ...

Abstract	Corticotroph tumors (CTs) are pituitary neoplasms arising from the Tpit lineage, which may or not express adrenocorticotrophic hormone (ACTH). Functioning CTs cause Cushing's disease (CD), which has high morbidity and mortality due to hypercortisolemia. "Non-functioning" or silent CTs (SCT) and the Crooke's cell subtypes do not cause CD and may be asymptomatic until manifested by compressive symptoms and are more frequently found as macroadenoma. Both tend toward more aggressive behavior, recurrence, and a higher rate of malignant transformation to pituitary carcinoma. Tumorigenesis involves genetic, epigenetic, and post-transcriptional disruption of cell-cycle regulators, which increase cell proliferation,
MeSH term(s)	Adenoma/metabolism ; Adenoma/pathology ; Corticotrophs/metabolism ; Corticotrophs/pathology ; Gene Expression Regulation, Neoplastic ; Humans ; Neoplasm Recurrence, Local/metabolism ; Neoplasm Recurrence, Local/pathology
Language	English
Publishing date	2021-04-26
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2592084-4
ISSN	1664-2392
ISSN	1664-2392
DOI	10.3389/fendo.2021.657382
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Article ; Online: Patients with Gilbert syndrome and type 2 diabetes have lower prevalence of microvascular complications.

Uribe-Weichers, Ana Cecilia / Gómez-Pérez, Francisco J / Lam-Chung, César Ernesto / Cuevas-Ramos, Daniel

Metabolism open

2021 Volume 11, Page(s) 100114

Abstract: Objective: Accumulating clinical evidence indicates an inverse relationship between oxidative stress and unconjugated hyperbilirubinemia. This study aimed to compare the prevalence of diabetes microvascular complications in patients with Gilbert ... ...

Abstract	Objective: Accumulating clinical evidence indicates an inverse relationship between oxidative stress and unconjugated hyperbilirubinemia. This study aimed to compare the prevalence of diabetes microvascular complications in patients with Gilbert syndrome and type 2 diabetes mellitus (T2D). Methods: A total of 1200 electronic records with T2D were reviewed. From them, 50 patients with Gilbert syndrome (cases [indirect bilirubin ≥1.2 mg/dl without evidence of hemolysis or liver disease]) and 50 controls (T2D without hyperbilirubinemia) were included. Linear and logistic regression models were performed to evaluate the independent association between indirect hyperbilirubinemia with microvascular complications related with T2D. Results: Both case and control group had the same proportion of gender (female = 20 [40 %]) and diabetes duration (14.0 ± 6.5 years) and similar mean of age (60 ± 9.6 and 60 ± 9.2 years, respectively, Conclusions: Patients with Gilbert syndrome and T2D had a lower prevalence of diabetes microvascular complications.
Language	English
Publishing date	2021-07-28
Publishing country	England
Document type	Journal Article
ISSN	2589-9368
ISSN (online)	2589-9368
DOI	10.1016/j.metop.2021.100114
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Article: An Unusual Simultaneous Existence of Parathyroid Carcinoma and Papillary Thyroid Carcinoma: Case Report and Review of Literature.

Lam-Chung, César Ernesto / Rodríguez-Orihuela, Diana Lizbeth / Anda González, Jazmín De / Gamboa-Domínguez, Armando

Case reports in endocrinology

2020 Volume 2020, Page(s) 2128093

Abstract: Synchronous parathyroid and papillary thyroid carcinoma are extremely rare. To our knowledge, only 15 cases have been reported in the last four decades. We describe a 50-year-old female without significant past medical or family history and no previous ... ...

Abstract	Synchronous parathyroid and papillary thyroid carcinoma are extremely rare. To our knowledge, only 15 cases have been reported in the last four decades. We describe a 50-year-old female without significant past medical or family history and no previous trauma presented with left heel pain that prompted her to seek medical attention. Physical examination was notable for a painless nodule at the left thyroid lobe. Laboratory evaluation showed a serum calcium level of 14.3 mg/dL (8.6-10.3 mg/dL) and intact parathyroid hormone level of 1160 pg/mL (12-88 pg/mL). 99Tc-sestamibi dual-phase with single-photon emission computed tomography fused images showed increased uptake at the left-sided inferior parathyroid gland. Neck ultrasound showed a 1.4 cm heterogeneous nodule in the middle-third of the left thyroid gland and a solitary 1.9 cm vascularized and hypoechoic oval nodule that was considered likely to represent a parathyroid adenoma. Due to its clinical context (severe hypercalcemia and very high levels of PTH), parathyroid carcinoma (PC) was suspected although imaging studies were not characteristic. The patient underwent en bloc resection of the parathyroid mass and left thyroid lobe and central neck compartment dissection. Pathology analysis revealed classical papillary thyroid carcinoma of classical subtype and parathyroid carcinoma. Immunohistochemical staining was positive for cyclidin D1 and negative for parafibromin. High clinical suspicion is required for parathyroid carcinoma diagnosis in the presence of very high level of parathyroid hormone, marked hypercalcemia, and the existence of any thyroid nodule should be approached and the coexistence of other carcinomas should be considered.
Language	English
Publishing date	2020-03-31
Publishing country	United States
Document type	Case Reports
ZDB-ID	2627633-1
ISSN	2090-651X ; 2090-6501
ISSN (online)	2090-651X
ISSN	2090-6501
DOI	10.1155/2020/2128093
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Article: Correlation Between Hemoglobin Glycation Index Measured by Continuous Glucose Monitoring With Complications in Type 1 Diabetes.

Ibarra-Salce, Raul / Pozos-Varela, Francisco Javier / Martinez-Zavala, Nestor / Lam-Chung, Cesar Ernesto / Mena-Ureta, Tania Sofia / Janka-Zires, Marcela / Faradji, Raquel N / Madrigal-Sanroman, Juan Ramon / de la Garza-Hernandez, Natalia Eloisa / Almeda-Valdes, Paloma

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

2023 Volume 29, Issue 3, Page(s) 162–167

Abstract: Objective: HbA1C is the "gold standard" parameter to evaluate glycemic control in diabetes; however, its correlation with mean glucose is not always perfect. The objective of this study was to correlate continuous glucose monitoring (CGM)-derived ... ...

Abstract	Objective: HbA1C is the "gold standard" parameter to evaluate glycemic control in diabetes; however, its correlation with mean glucose is not always perfect. The objective of this study was to correlate continuous glucose monitoring (CGM)-derived hemoglobin glycation index (HGI) with microvascular complications. Methods: We conducted a cross-sectional study including permanent users of CGM with type 1 diabetes mellitus or latent autoimmune diabetes of the adult. HGI was estimated, and presence of microvascular complications was compared in subgroups with high or low HGI. A logistic regression analysis to assess the contribution of high HGI to chronic kidney disease (CKD) was performed. Results: In total, 52 participants who were aged 39.7 ± 14.7 years, with 73.1% women and 15.5 years (IQR, 7.5-29 years) since diagnosis, were included; 32.7% recorded diabetic retinopathy, 25% CKD, and 19.2% neuropathy. The median HbA1C was 7.6% (60 mmol/mol) and glucose management indicator (GMI) 7.0% (53 mmol/mol). The average HGI was 0.55% ± 0.66%. The measured HbA1C was higher in the group with high HGI (8.1% [65 mmol/mol] vs 6.9% [52 mmol/mol]; P < .001), whereas GMI (7.0% [53 mmol/mol] vs 7.0% [53 mmol/mol]; P = .495) and mean glucose were similar in both groups (153 mg/dL vs 153 mg/dL; P = .564). In the high HGI group, higher occurrence of CKD (P = .016) and neuropathy were observed (P = .025). High HGI was associated with increased risk of CKD (odds ratio [OR]: 5.05; 95% CI: 1.02-24.8; P = .04) after adjusting for time since diagnosis (OR: 1.09; 95% CI: 1.02-1.16; P = .008). Conclusion: High HGI measured by CGM may be a useful marker for increased risk of microvascular diabetic complications.
MeSH term(s)	Adult ; Humans ; Female ; Male ; Diabetes Mellitus, Type 1/complications ; Glycated Hemoglobin ; Blood Glucose ; Diabetes Mellitus, Type 2/complications ; Maillard Reaction ; Blood Glucose Self-Monitoring ; Cross-Sectional Studies ; Hemoglobins ; Renal Insufficiency, Chronic
Chemical Substances	Glycated Hemoglobin ; Blood Glucose ; Hemoglobins
Language	English
Publishing date	2023-01-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	1473503-9
ISSN	1530-891X
ISSN	1530-891X
DOI	10.1016/j.eprac.2023.01.001
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Article ; Online: Occurrence of Klinefelter Syndrome Mosaic 45,X/46,XY/47,XXY/48,XXYY/48,XXXY and Primary Hyperparathyroidism.

Lam-Chung, César Ernesto / Rodríguez, Larissa López / Kato, Yayoi Segura / Jiménez González, Iván Josué / Mena-Hernández, Lourdes / Rivera-Juárez, Renata / Almeda-Valdes, Paloma / Vázquez, Jazmín Arteaga

AACE clinical case reports

2021 Volume 7, Issue 5, Page(s) 293–298

Abstract: Objective: The presence of primary hyperparathyroidism (PHPT) and Klinefelter syndrome (KS) is rare, and its association with KS mosaicism is even rarer. We report an unusual combination of these entities with a mild phenotype of KS.: Methods: The ... ...

Abstract	Objective: The presence of primary hyperparathyroidism (PHPT) and Klinefelter syndrome (KS) is rare, and its association with KS mosaicism is even rarer. We report an unusual combination of these entities with a mild phenotype of KS. Methods: The patient was a 44-year-old male with a history of PHPT who had recurrent urolithiasis despite being treated with a successful parathyroidectomy. On examination, he had axillary hair growth, bilateral gynecomastia, a large port-wine stain at the right hemithorax and upper right limb, and genitalia and pubic hair corresponding to Tanner IV classification with small, normal consistency testicles. Results: Laboratory findings were unremarkable except for a slightly elevated luteinizing hormone, which was normal on repeat testing. Because of the picture of unexplained gynecomastia, laboratory findings, and low-volume testis, a diagnosis of KS was considered. Chromosomal analysis revealed a rare 45,X/46,XY/47,XXY/48,XXYY/48,XXXY KS mosaic. Conclusions: KS phenotypes are largely variable, and their association with PHPT remains to be elucidated.
Language	English
Publishing date	2021-03-13
Publishing country	United States
Document type	Case Reports
ISSN	2376-0605
ISSN (online)	2376-0605
DOI	10.1016/j.aace.2021.03.001
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Article ; Online: Association of estimated glucose disposal rate and chronic diabetic complications in patients with type 1 diabetes.

Lam-Chung, César Ernesto / Martínez Zavala, Néstor / Ibarra-Salce, Raúl / Pozos Varela, Francisco Javier / Mena Ureta, Tania S / Berumen Hermosillo, Francisco / Campos Muñoz, Alejandro / Janka Zires, Marcela / Almeda-Valdes, Paloma

Endocrinology, diabetes & metabolism

2021 Volume 4, Issue 4, Page(s) e00288

Abstract: Introduction: The role of insulin resistance in diabetic chronic complications among individuals with type 1 diabetes (T1D) has not been clearly defined. The aim of this study was to examine the performance of insulin resistance, evaluated using the ... ...

Abstract	Introduction: The role of insulin resistance in diabetic chronic complications among individuals with type 1 diabetes (T1D) has not been clearly defined. The aim of this study was to examine the performance of insulin resistance, evaluated using the estimated glucose disposal rate (eGDR) for the identification of metabolic syndrome (MS) and diabetic chronic complications. Methods: Cross-sectional study in a tertiary care centre. We included patients of 18 years and older, with at least 6 months of T1D duration. Anthropometric, clinical and biochemical data were collected. Results: Seventy patients, 41 (58.6%) women, with a median age of 36.6 years (range 18-65). Mean age of onset and duration of diabetes was 13.5 ± 6.5 and 23.6 ± 12.2 years, respectively. Twenty-one (30%) patients met the metabolic syndrome (MS) criteria. Patients with MS had lower eGDR compared to patients without (5.17 [3.10-8.65] vs. 8.86 [6.82-9.85] mg/kg/min, respectively, p = .003). Median eGDR in patients with nephropathy, retinopathy and neuropathy compared with those without was 6.75 (4.60-8.20) versus 9.53 (8.57-10.3); p < .001, 6.45 (4.60-7.09) versus 9.50 (8.60-10.14); p < .001, 5.56 (4.51-6.81) versus 9.49 [8.19-10.26] mg/kg/min; p < .001, respectively. The eGDR showed an area under the curve of 0.909, 0.879, 0.897 and 0.836 for the discrimination of MS, retinopathy, neuropathy and nephropathy, respectively. Conclusions: Patients with T1D diabetic complications have higher insulin resistance. The eGDR discriminates patients with chronic diabetic complications and MS. While more ethnic-specific studies are required, this study suggests the possibility to incorporate eGDR into routine diabetes care.
MeSH term(s)	Adolescent ; Adult ; Aged ; Child ; Cross-Sectional Studies ; Diabetes Complications/complications ; Diabetes Mellitus, Type 1/metabolism ; Female ; Glucose/metabolism ; Humans ; Insulin Resistance ; Middle Aged ; Young Adult
Chemical Substances	Glucose (IY9XDZ35W2)
Language	English
Publishing date	2021-07-15
Publishing country	England
Document type	Journal Article
ISSN	2398-9238
ISSN (online)	2398-9238
DOI	10.1002/edm2.288
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Article ; Online: A Novel, Likely Pathogenic

Lam-Chung, César Ernesto / Rodríguez, Larissa López / Vázquez, Jazmín Arteaga / Chávarri-Guerra, Yanin / Arízaga-Ramírez, Rebeca / Antonio, Orlando Falcon / De Anda González, Jazmín / López-Hernández, María Aurelia / Weitzel, Jeffrey N / Castillo, Danielle / Gómez-Pérez, Francisco Javier / Cuevas-Ramos, Daniel

Journal of the Endocrine Society

2021 Volume 5, Issue 8, Page(s) bvab085

Abstract: Context: Inherited MYC-associated factor X (: Objective: This report highlights an important approach.: Methods: Clinical assessment, including blood chemistry, imaging studies, and genetic testing were performed.: Results: A 38-year-old ... ...

Abstract	Context: Inherited MYC-associated factor X ( Objective: This report highlights an important approach. Methods: Clinical assessment, including blood chemistry, imaging studies, and genetic testing were performed. Results: A 38-year-old Hispanic woman was diagnosed with PCC in 2015, treated with adrenalectomy, and referred to endocrinology clinic. Notably, she presented to her primary care physician 3 years earlier complaining of left flank pain, intermittent diaphoresis, and holocranial severe headache. We confirmed severe hypertension (180/100 mm Hg) over multiple antihypertensive regimens. Biochemical and radiological studies workup revealed high plasma metanephrine of 255 pg/mL (normal range, < 65 pg/mL) and plasma normetanephrine of 240 pg/mL (normal range, < 196 pg/mL). A noncontrast computed tomography scan of the abdomen revealed a 4.2 × 4.3 × 4.9-cm, round-shaped and heterogenous contrast enhancement of the left adrenal gland, and a 2-mm nonobstructive left kidney stone. A presumptive diagnosis of secondary hypertension was made. After pharmacological therapy, laparoscopic left adrenalectomy was performed and confirmed the diagnosis of pheochromocytoma. Based on her age, family history, and a high suspicion for genetic etiology, genetic testing was performed that revealed the presence of a novel likely pathogenic variant involving a splice consensus sequence in the Conclusion: The phenotype of
Language	English
Publishing date	2021-06-03
Publishing country	United States
Document type	Journal Article
ISSN	2472-1972
ISSN (online)	2472-1972
DOI	10.1210/jendso/bvab085
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Article: High Molecular Weight ACTH-Precursor Presence in a Metastatic Pancreatic Neuroendocrine Tumor Causing Severe Ectopic Cushing's Syndrome: A Case Report.

Mehta, Roopa / Lam-Chung, César Ernesto / Hinojosa-Amaya, José Miguel / Roldán-Sarmiento, Paola / Guillen-Placencia, Maria Fernanda / Villanueva-Rodriguez, Gerladine / Juarez-Leon, Oscar Alfredo / Leon-Domínguez, Jefsi / Grajales-Gómez, Mariana / Ventura-Gallegos, Jose Luis / León-Suárez, Andrés / Gómez-Pérez, Francisco J / Cuevas-Ramos, Daniel

Frontiers in endocrinology

2020 Volume 11, Page(s) 557

Abstract: Ectopic ACTH-secretion causing Cushing's syndrome is unusual and its diagnosis is frequently challenging. The presence of high-molecular-weight precursors throughout pro-opiomelanocortin (POMC) translation by these tumors is often not reported. We ... ...

Abstract	Ectopic ACTH-secretion causing Cushing's syndrome is unusual and its diagnosis is frequently challenging. The presence of high-molecular-weight precursors throughout pro-opiomelanocortin (POMC) translation by these tumors is often not reported. We present the case of a 49-year-old woman with a 3-month history of proximal muscular weakness, skin pigmentation, and weight loss. Upon initial evaluation, she had a full moon face, hirsutism, and a buffalo hump. Laboratory workup showed hyperglycemia, hypokalemia and metabolic alkalosis. ACTH, plasma cortisol, and urinary free cortisol levels were quite elevated. Serum cortisol levels were not suppressed on dexamethasone suppression testing. An octreo-SPECT scan showed enhanced nucleotide uptake in the liver and pancreas. Transendoscopic ultrasound-guided biopsy confirmed the diagnosis of a pancreatic ACTH-secreting neuroendocrine tumor (NET). Surgical excision of both pancreatic and liver lesions was carried out. Western blot analysis of the tumor and metastases revealed the presence of a high-molecular-weight precursor possibly POMC (at 30 kDa) but not ACTH (normally 4.5 kDa). ACTH-precursor secretion is more frequent in ectopic ACTH-secreting tumors compared with other causes of Cushing's syndrome. Hence, the measurement of such ACTH precursors warrants further evaluation, especially in the context of ACTH-dependent hypercortisolism.
MeSH term(s)	ACTH Syndrome, Ectopic/blood ; ACTH Syndrome, Ectopic/etiology ; ACTH Syndrome, Ectopic/pathology ; Adrenocorticotropic Hormone/blood ; Female ; Humans ; Middle Aged ; Neuroendocrine Tumors/blood ; Neuroendocrine Tumors/complications ; Neuroendocrine Tumors/pathology ; Pancreatic Neoplasms/blood ; Pancreatic Neoplasms/complications ; Pancreatic Neoplasms/secondary
Chemical Substances	Adrenocorticotropic Hormone (9002-60-2)
Language	English
Publishing date	2020-08-13
Publishing country	Switzerland
Document type	Case Reports ; Journal Article
ZDB-ID	2592084-4
ISSN	1664-2392
ISSN	1664-2392
DOI	10.3389/fendo.2020.00557
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Article ; Online: ACROMEGALY AND A GIANT RETROPERITONEAL LIPOSARCOMA PRODUCING IGF-1.

Lam-Chung, César Ernesto / Rodríguez-Orihuela, Diana Lizbeth / Arízaga-Ramírez, Rebeca / Almeda-Valdés, Paloma / Castillo-Valdez, Ana Karen / Magaña-Pérez, Kassandra / Ventura-Gallegos, José Luis / Gamboa-Domínguez, Armando / De Anda González, Jazmín / Gómez-Pérez, Francisco J / Cuevas-Ramos, Daniel

AACE clinical case reports

2020 Volume 6, Issue 4, Page(s) e165–e169

Abstract: Objective: Liposarcoma is the most common histotype of retroperitoneal sarcomas, representing up to 45% of all cases. We report a rare combination of acromegaly and liposarcoma in the same individual.: Methods: Laboratory and imaging studies ... ...

Abstract	Objective: Liposarcoma is the most common histotype of retroperitoneal sarcomas, representing up to 45% of all cases. We report a rare combination of acromegaly and liposarcoma in the same individual. Methods: Laboratory and imaging studies including an oral glucose tolerance test, measurements of growth hormone (GH) and insulin-like growth factor-1 (IGF-1), and a computed tomography scan were performed. Results: The patient was a 60-year-old male with a history of acromegaly diagnosed on the basis of elevated IGF-1 at 1,373 ng/mL (age-appropriate reference range is 87 to 225 ng/mL) and macroadenoma treated with transsphenoidal surgery. He presented 8 years later with a history of abdominal distension and weight loss. Physical examination was notable for a right-sided abdominal mass that was tense and non-fluctuant. Two years earlier, he had a post oral glucose tolerance test GH level <0.25 ng/mL and IGF-1 level of 256 ng/mL (age-appropriate reference range is 55 to 206 ng/mL). Pituitary magnetic resonance imaging reported a 3.7 × 2.0-mm left-sided parasagittal lesion. Computed tomography scan showed a 25.0 × 22.0 × 32.3-cm heterogeneous giant mass in the right abdomen corresponding to a liposarcoma causing displacement of kidney, liver, and bowel loops. The patient was treated with a complete en bloc resection of the liposarcoma with the right kidney (45 × 33 × 17 cm) and tumor (9,400 g). Immunohistochemical examination revealed positive IGF-1 and GH staining. The patient suffered postoperative gastrointestinal bleeding that resulted in hemorrhagic shock and died on the 29th postoperative day after a cardiorespiratory arrest. Conclusion: Acromegalic patients are at increased risk of developing various types of neoplasms. This is the first documented coexistence of liposarcoma and history of acromegaly.
Language	English
Publishing date	2020-04-03
Publishing country	United States
Document type	Case Reports
ISSN	2376-0605
ISSN (online)	2376-0605
DOI	10.4158/ACCR-2020-0061
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