- Multiple endocrine neoplasia (MEN) type 2
Essential Evidence Topics, 2-Aug-2021
Overall Bottom Line: Multiple endocrine neoplasia (MEN) type 2 is an autosomal dominant neoplasia syndrome dominated by medullary thyroid cancer (MTC) with high penetrance. It has several variants including familial medullary thyroid cancer (FMTC), MEN 2a - Multiple myeloma
Essential Evidence Topics, 20-Oct-2021
Overall Bottom Line: Suspect multiple myeloma (MM) in patients with bone pain, especially if associated with back pain, fatigue, nerve compression, or recurrent bacterial infections. Patients diagnosed with MM should be evaluated for evidence of end-org - Neuroblastoma
Essential Evidence Topics, 15-Oct-2021
Overall Bottom Line: No routine screening is recommended for neuroblastoma. Suspect neuroblastoma in children with abdominal mass or bone pain. Urine catecholamine metabolites, vanillylmandelic acid (VMA) and homovanillic acid (HVA), are useful for ev - Neurofibromatosis
Essential Evidence Topics, 7-Jan-2021
Overall Bottom Line: Neurofibromatosis 1 (NF1) is an autosomal dominant disorder characterized by multiple cafe-au-lait spots, inguinal and axillary freckling, neurofibromas (tumors of peripheral nerves), and Lisch nodules (iris hamartomas). An annual o - Nipple discharge
Essential Evidence Topics, 26-Jan-2022
Overall Bottom Line: Pathologic discharge and discharge associated with a palpable mass or mammographic abnormality is more likely to be malignant, as is discharge in postmenopausal women or in men. A careful breast examination, ultrasound, and mammogra - Oropharyngeal cancer
Essential Evidence Topics, 28-Feb-2022
Overall Bottom Line: Risk factors for oropharyngeal (OP) cancer include tobacco and alcohol use as well as human papillomavirus (HPV) infection. Suspect OP cancer in patients with an OP mass or ulceration, or suspicious cervical lymphadenopathy. Tissu - Osteosarcoma
Essential Evidence Topics, 27-Feb-2022
Overall Bottom Line: Suspect osteosarcoma in a patient with bone pain and swelling, especially in children and patients with a history of retinoblastoma, Li-Fraumeni syndrome, or Paget's Disease. When osteosarcoma is suspected, obtain radiographs with a - Ovarian teratoma
Essential Evidence Topics, 30-Jul-2021
Overall Bottom Line: Transvaginal ultrasound (TVUS) is the recommended initial imaging study for evaluation of ovarian masses. Most imaged teratomas have the classic dermoid cyst appearance whether they are benign or malignant. Surgical removal of matur - Ovarian tumor (benign)
Essential Evidence Topics, 23-Jun-2020
Overall Bottom Line: Any palpable adnexal mass in a postmenopausal female must be evaluated for malignancy. The initial study is transvaginal ultrasound; obtain CA-125 with masses larger than 5 cm or if changes occur in size or character at follow-up. - Ovarian tumor (malignant)
Essential Evidence Topics, 27-Jul-2021
Overall Bottom Line: Women with a family history of BRCA gene mutations and a positive screening should be referred for genetic counselling. They should be counselled on the risks, benefits, and limitations of genetic screening. Routine screening is not - Paget disease of the breast
Essential Evidence Topics, 24-Sep-2021
Overall Bottom Line: Suspect Paget disease of the breast (PDB) in patients presenting with erythema, ulceration, crusting, or scaling of the nipple. Perform full-thickness nipple biopsy, mammography, and breast ultrasonography if PDB is suspected. Consi - Pancreatic cancer
Essential Evidence Topics, 6-Oct-2020
Overall Bottom Line: Suspect pancreatic cancer in middle-aged or older patients with weight loss or jaundice. Initial imaging is with ultrasound or helical CT; confirm the diagnosis with endosonographic fine needle aspiration biopsy (FNAB). Pancreatic - Paraneoplastic syndromes
Essential Evidence Topics, 8-Jul-2021
Bottom Line: Overall Suspect paraneoplastic syndromes in patients with cancer who have fatigue, weakness, myalgias, or electrolyte abnormalities that cannot be explained by their condition or treatment. If you suspect a paraneoplastic syndrome, screen f - Pelvic mass
Essential Evidence Topics, 23-Apr-2022
Overall Bottom Line: There is no evidence to support ovarian cancer screening by ultrasound or CA-125; there is moderate-quality evidence that harms outweigh benefits. The current evidence is insufficient to assess the balance of benefits and harms of p - Pheochromocytoma
Essential Evidence Topics, 30-Dec-2021
Overall Bottom Line: Pheochromocytomas are rare chromaffin cell tumors typically arising in the adrenal glands. They are characterized by excessive production of catecholamines, often leading to elevated blood pressure and symptoms of catecholamine exce - Prostate cancer
Essential Evidence Topics, 28-Feb-2022
Overall Bottom Line: Prostate cancer screening is inexact and in its current state provides a small cancer-specific mortality benefit (NNT ~800 over 13 years) and reduction in metastatic disease (3 per 1000 person-years), and no all-cause mortality benefi - Pulmonary nodule
Essential Evidence Topics, 9-May-2020
Overall Bottom Line: Patients with a solitary pulmonary nodule (SPN) on CXR should have a chest CT without contrast to better characterize the nodule. Patients with benign calcification or no change in the nodule in 2 years do not warrant further evalua - Punch biopsy (procedure)
Essential Evidence Topics, 14-Apr-2021
Indications: To diagnose of skin lesion to determine appropriate care, i.e. unknown dermatitis or possible malignant lesion. Punch biopsy is superior to shave biopsy for diagnosis and staging of malignant skin cancers. Removal of suspected pre-malignant s - Renal cancer
Essential Evidence Topics, 2-Feb-2022
Overall Bottom Line: Screening asymptomatic individuals is not recommended. Workup includes history and physical, laboratory tests, urinalysis, and imaging with abdominal/pelvic CT or MRI. Consider surgery, even in the setting of metastatic disease (s - Retinoblastoma
Essential Evidence Topics, 22-Mar-2021
Overall Bottom Line: Retinoblastoma is a childhood intraocular cancer caused by the defect or absence of a tumor suppressor gene; retinoblastoma may be familial or sporadic. Children with a family history should undergo ophthalmic screening from birth u
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