Endocrine Abstracts

Functional imaging in endocrine disease is now being increasingly used as an aid in the management of challenging cases, where conventional imaging techniques are inadequate/inconclusive. This talk will provide an overview of available nuclide imaging techniques and specifically focus on the use of 11C-Methionine PET in pituitary and 11C-Metomidate PET in adrenal tumours.11C-Methionine PET in pituitary disease</p...

We report a case of malignant hemangiopericytoma in sellar region in a 73-year-old lady who initially presented with symptomatic hyponatraemia. She was found to have hypocortisolism on short synacthen test. She was treated with hydrocortisone and was found to have secondary hypothyroidism. Her gonadotropin levels were commensurate with menopause, prolactin levels were normal and there was no suggestion of diabetes insipidus. Initial pituitary magnetic resonance imaging (MRI) w...

Background/aims/method: Evaluation/management of adrenal incidentalomas (AI) is an increasingly prevalent challenge. CT/MRI characteristics may be useful in determining whether a lesion is a benign adenoma and forthcoming ESE-ENSAT guidance suggests a role for 18F-FDG-PET/CT in distinguishing benign vs malignant lesions. We have previously demonstrated the utility of 11C-metomidate (MTO), which binds CYP11B1/B2, in localising aldosterone-producing adenoma...

TSHoma is rare, with an incidence of 1 per million, and <1% of all pituitary tumours. We reported a case involving a 49-year-old female who was first referred to our endocrine unit in 2006 with excessive lethargy and abnormal TFT’s. She was thought to have thyroid hormone resistance for several years until 2015 when she reported having persistent symptoms and further investigation suggested an alternative diagnosis.Results: Ft4=41.6 pmol/l, TSH=...

A 54-year-old lady with a 27-year history of schizoaffective disorder presented with shaking episodes, polyuria and polydipsia. She was found to have a serum sodium of 157 mmol/l. Of note, she had been on lithium for several years but this had been stopped three months previously as her serum sodium was raised at 156 mmol/l.On admission her lithium level was undetectable, confirming no recent use. Serum osmolality was 343 mOsm/kg and urine osmolality 82 ...

Introduction: CT renal tract is commonly requested by the urologists for suspected renal colic as it is recognized as the most accurate technique for the detection of ureteric stones. However, follow-up of adrenal incidentalomas identified on such scans could pose a challenge for the non-endocrinologist. We investigated the prevalence and follow-up of incidentally discovered adrenal masses after CT renal colic.Methods: We looked through the reports of al...

Several studies have pointed to a neural regulation of glucose dependent insulinotropic peptide (GIP) secretion. Bombesin is a neuropeptide found in the amphibian brain and gastrointestinal system – homologous to the C terminus of gastrin-releasing protein (GRP) in mammalians, which displays a wide range of metabolic actions.Aim: Aim of this study was to investigate the effect of intracerebroventicular infusion of bombesin in a centrally mediated re...

Background: Cross-sectional imaging (e.g. CT/MRI) can not always reliably identify the site of ACTH secretion in Cushing’s disease (CD) or the ectopic ACTH syndrome (EAS). We report our experience of localising the source of ACTH-dependent Cushing’s syndrome, using functional imaging with 11C-methionine positron emission tomography (Met-PET).Methods: Forty consecutive patients with: (i) de novo ...

Background: BIPSS is considered the gold-standard procedure for differentiating autonomous pituitary [Cushing’s Disease (CD)] and ectopic ACTH syndrome (EAS) sources of ACTH hypersecretion. A basal (i.e. unstimulated) pituitary:peripheral ACTH ratio >2, and/or a CRH stimulated pituitary:peripheral ACTH ratio >3, have been proposed as indicative of CD, with a range of sensitivities and specificities cited in the literature. Ad...

Background: Cross-sectional imaging (e.g. CT/MRI) can not always reliably identify the site of ACTH secretion in Cushing’s disease (CD) or the ectopic ACTH syndrome (EAS). We report our experience of localising the source of ACTH-dependent Cushing’s syndrome, using functional imaging with 11C-methionine positron emission tomography (Met-PET).Methods: Forty consecutive patients with: (i) de novo ...