Endocrine Abstracts

Background: The benefit to risk ratio of mitotane high starting dose regimen in ACC remains unknown.Methods: To evaluate a high starting dose strategy, we performed a single-center, prospective study with three main objectives: 1) to assess the time taken to reach a mitotane plasma level above 14 mg/l (benefit); 2) to evaluate mitotane tolerance (risk) in the first 3 months of treatment and 3) to analyse the correlation using a regression analysis test b...

Regarding the debate about whether we should still ablate all patients undergoing total thyroidectomy, the answer is no. Most thyroid cancer patients have an excellent prognosis with a normal life expectancy and among them most of them have a low risk of recurrence. The absence of ablation in patients with thyroid cancer of 1 centimeter or less (pT1a) is already widely applied, so, we are used not to ablate all thyroid cancer patients treated with total thyroidectomy. The ques...

Targeted therapies have been used for about 10 years in patients with radioactive iodine refractory differentiated thyroid cancer (DTC) or metastatic medullary thyroid cancer (MTC). Decrease in tumor volume, improvement of symptoms, increase in progression free survivals have been observed with different drugs. So far, because of trial design and because of the long survival of patients with metastatic DTC or MTC, the benefit of these drugs on overall survival has not been dem...

Introduction: Current medical treatment of adrenocortical carcinoma (ACC) is based on mitotane alone or in combination with cytotoxic chemotherapy. However, very little is known about the pharmacokinetic properties of mitotane and dosing schedules are based on clinical experience only. The aim of this study was to investigate the relationship between mitotane dose and plasma concentration comparing two pre-defined treatment regimens. Secondary objectives were to evaluate safet...

Context: Peritoneal carcinomatosis (PC) is a rare site of distant metastasis in patients with adrenocortical cancer (ACC). One preliminary study suggests an increase risk of PC after adrenalectomy through laparoscopic approach of ACC.Objective: The objective of the study was to search for risk factors of PC including surgical approach. This was a retrospective cohort study conducted in an institutional practice.Patients: Sixty-four...

A 70-year old man was referred to the endocrinology department for the evaluation of a pituitary macroadenoma which was diagnosed during work-up for a malignant melanoma. Pituitary MRI showed a 20×21×25 mm adenoma with supra-sellar extension and no compression of the optic chiasma. Hormonal work-up revealed central hypogonadism and slight hyperprolactinemia due to stalk compression, while pituitary function was otherwise normal. MRI follow-up was scheduled in six mon...

A 25-year old woman with Hashimoto thyroiditis was referred to the endocrinology department for investigation of a 40 kilogram weight gain, polyuria, polydipsia and secondary amenorrhea. Hormonal work-up showed diabetes insipidus, central hypogonadism, secondary adrenal insufficiency, central hypothyroidism and slight hyperprolactinemia. Pituitary magnetic resonance imaging (MRI) revealed a 15 mm hypothalamic tumor expanding to the infundibulum, associated with pituitary stalk...

Interferon-α (IFN-α) has shown some activity in neuroendocrine tumors with disease stabilizations. Malignant pheochromocytoma and paraganglioma (MPPGLs) have a heterogeneous behavior with a slow progression rate, most of the time and a high frequency of bone metastases. Stabilizing disease and preventing skeletal-related events are two goals to achieve in the management of MPPGLs patients.This retrospective study evaluated a multimodal strategy...

Introduction: O,p’DDD is the drug of choice for patients with adrenocortical carcinoma (ACC). Monitoring o,p’DDD serum level has been proposed as predictor of tumour response. Measurement of o,p’DDD metabolites involved in the active pathway may provide an improved prediction of o,p’DDD activity. The objective of our study was to (1)to confirm the currently used threshold o,p’DDD serum level of 14mg/l for achieving a tumour response and (2)compare the ...

Purpose: Bone metastases (BM) are frequent in differentiated thyroid cancer (DTC). These patients may present skeletal-related events (SRE), the leading cause of DTC-related morbidity. We aimed to evaluate the clinical features, treatment approaches, and outcomes including overall survival (OS) of DTC patients with BM complicated by SRE and their evolution over time.Methods: 178 consecutive DTC patients harbouring BM were enrolled in this retrospective s...