الفهرس 
INTRODUTIONOnly 14 pages are availabe for public view
 |  | from | 264 |  |  |
| | | from | 264 | | |
Abstract
Apudoma are classified according to their specific or amines into three types. First ortho endocrine apudomas which secrete excessively their normal products of polypeptides or amines as polypeptides of pitutary adenoma, thyroid carcinoma or pancreatic islets cells or of adrenal medullary cells or kulschitzky cells of intestine. Second paraendocrine Apudomas which secrete products that normally are not produced by parent cells e.g. by medullary thyroid carcinoma. The third group includes multiple endocrine neoplasia which two or more endocrine gland are neoplastic in the. individual. Merkel cell carcinoma is the most aggressive of all primary malignant skin tumours. It is a neuroendocrine tumour which arise from the basal layer of epitheilum particulary hair follicles. The clinical diagnosis is particularly difficult because of its apparent rarity and some tumours have same characters. Treatment of this tumours involves, excision with a 30 mm saftey margin distant may be treated with surgery, radiotherapy or chemotherapy depending on their location and their Medullary thyroid carcinoma comprises 7% of all carcinoma and all cases of multiple endocrine neoplasia-ll. Patients with medullary thyroid carcinoma