[Comments on the treatment of thyroid nodules with thyroid hormone]. / Commentaires sur le traitement des nodules thyroïdiens par l'hormone thyroïdienne.

It is debatable whether treatment of thyroid nodules with thyroid hormones is effective, results of clinical trials, even randomized, being inconclusive, none of them showing significant efficacy of this therapy. Two questions remain unanswered: what is the natural history of these nodules and is it possible to identify patients with these heterogeneous lesions who will respond to treatment? Currently available study data show a marked level of spontaneous regression or even total disappearance of the nodules. Further long-term clinical trials appear indicated, including a sufficient number of patients and a large cohort of untreated patients.

Acute periostitis in early acquired syphilis simulating shin splints in a jogger.

Acute periostitis affecting the long bones is a characteristic but uncommon manifestation of syphilis in the adult with an early acquired infection. This report describes the history of a jogger who developed acute localized periostitis of the shaft of both tibiae during the early stage of acquired syphilis. Symptomatology was initially attributed to the medial tibial stress syndrome.

CT follow-up of microprolactinomas during bromocriptine-induced pregnancy.

In the last few years complete or partial regression of prolactinomas has been demonstrated in nonpregnant women treated by bromocriptine. Thus bromocriptine therapy appears as an attractive alternative to surgery for management of infertility related to hyperprolactinemia. However, numerous reports emphasized the possibility of an excessive growth of the pituitary adenoma with visual field defects during the last 3 months of pregnancy. To avoid these complications, the authors followed with serial CT scans the growth of microprolactinoma at the 5th or 6th month of pregnancy. Among six pregnant women, one patient presented a marked upward extension of the adenoma. Bromocriptine was then reintroduced and the effectiveness in reducing tumor growth was proved by CT scan at the 7th month. Regarding low risk of using intravenous iodinated contrast medium in pregnant women and of fetal radiation damage, the authors emphasize the value of CT in the follow-up of bromocriptine-induced pregnancies.

Computed tomographic demonstration of the effects of bromocriptine on pituitary microadenoma size.

A group of 17 strictly intrasellar prolactin-secreting pituitary adenomas between 2 and 9 mm in size was examined by computed tomography before and after bromocriptine therapy of 3 months to 1 year duration. These findings were compared with clinical and biological data. Bromocriptine therapy was effective clinically and biologically in 14 of the 17 cases. Of the 15 intrasellar adenomas in nonpregnant patients treated with bromocriptine, six disappeared completely with normalization of the pituitary appearance, five decreased approximately 50% in volume (three showed an increase in density, two a decrease), and four remained unchanged in size (two showed increased density, two showed very low densities).

[Medullary carcinomas of the thyroid. General review apropos of 3 further cases]. / Les cancers médullaires de la thyroïde. Revue générale à propos de trois nouvelles observations.

The authors report of three cases of medullary carcinoma of the thyroid and, from a review of the literature, study the definition, frequency, embryological and etiological characteristics of this disease. The physiology of thyrocalcitonin, the concept of the APUD system the secretion of active substances by the tumour cells are considered. The macroscopic and microscopic characteristics and its mode of spread are described. The two main clinical forms, the sporadic form and the familial form are described together with the other endocrine involvements. Among the factors in positive diagnosis, accent is placed on per-operative histological examination and on biological tests of familial detection. Among the forms of treatment the essential place of surgery explains partly the relatively favourable course and prognosis of the malignant disease.