Endocrine Abstracts

Introduction: In patients with neuroendocrine tumours (NETs) somatostatin analogues are used to control symptoms in patients with functioning tumours and as antiproliferative agents in those with non-functioning tumours. During COVID-19, the ‘Sandostatin Your Choice’ service was terminated by Novartis, removing home care nurses from administering the analogue in patients’ homes. The first generic version of depot octreotide was Olatuton® produced by Teva, a...

Background: The hypothalamic-pituitary-adrenal (HPA) axis can be suppressed by long-term exogenous glucocorticoids, resulting in tertiary adrenal insufficiency (AI). International expert consensus suggests that during weaning, prednisolone be converted to hydrocortisone to allow HPA axis reactivation(1). There is, however, little evidence to support this practice.Aim: To compare HPA axis recovery during treatment with prednisolone and immediat...

Introduction: Cushing’s disease (CD) is a rare but devastating condition, caused by hypersecretion of adrenocorticotropic hormone (ACTH) from a corticotroph adenoma in the anterior pituitary. CD is associated with a five-fold excess mortality and clinical features including hypertension, diabetes mellitus, osteoporosis, and depression. First-line treatment is transsphenoidal surgery, but this is effective in only 65% of cases and the relapse rate is high. Other treatment ...

Introduction: Pituitary Apoplexy is a rare endocrine emergency which can occur due to infarction or haemorrhage of pituitary gland. Pituitary apoplexy can occur as an initial presentation in patients who are not known to have Pituitary adenomas. Clinical Symptoms vary, however, one should have a high index of suspicion if symptoms such as acute headache, visual loss or ocular palsy occur.Precipitating factors: Hypertension, Preganancy, Head trauma, Dynam...

Case history: A 26 year old lady presented in 1999 with a 3 year history of worsening headache, increased sweating, excessive tiredness and progressive enlargement of hands and feet. She was otherwise well and had no family history of pituitary tumors, hypercalcaemia or renal stones. On examination she had typical facial features of acromegaly and acral enlargement. Her blood pressure was normal and visual fields were full.Investigations: Oral Glucose To...

Case history: A 36 year-old man was referred to our department for further evaluation of a large adrenal and multiple liver mass lesions. These had been found on an abdominal ultrasound requested for a 3 week history of mild, episodic abdominal pain. He was asymptomatic but described mild night sweats for over 10 years.Investigations, results and treatment: Hyperparathyroidism was evident, with a serum corrected calcium 3.04 mmol/l (2.15–2.65), PTH ...

Background: Assessment of psychological burden of disease forms one criterion for accreditation of a cancer specialist center. Patient Health Questionnaire-4 (PHQ-4), a validated self-report ultra-short questionnaire was used to assess anxiety and depression level in patients with GEP NETs, attending the clinics at an ENETS Centre of Excellence.Methods: PHQ-4 was completed during routine outpatient visits over a three month period by 48 patients, who wer...

Introduction: Orbital metastases from Neuroendocrine tumours (NET) are reported to be very rare, and can be the primary presentation or become evident up to 20 years after diagnosis. We report a series presented in the NET MDT, where ocular metastasis occurred.Case series: A 69-yr-old woman presented with blurred vision, pain and perception of a lump around the left eye. MRI showed a lacrimal gland mass within the orbit. Excision biopsy revealed a TTF1-p...

Background: Intracardiac metastasis of carcinoid tumours are rare (incidence 2–4%). Their presence without carcinoid valvulopathy or carcinoid syndrome is unusual.Case Discussions: A 70 year old male presented with abdominal pain. CT imaging revealed a small intestinal tumor with liver and mesenteric metastasis. Biopsy showed a neuroendocrine tumour (NET). Clinical and biochemical evidence of functionality was absent. He underwent definitive small b...

Introduction: Patients with adrenal incidentalomas and sub-clinical Cushing’s (SCH) have increased cardiovascular events and mortality. We hypothesised that these patients have a disturbed cortisol rhythm amenable to being restored to normal by using timed short-acting cortisol synthesis blockade, and that this may have a positive effect on IL6 levels.Methods: In a phase 1, prospective study (Eudract No. 2012-002586-35) we recruited eight patients w...