Endocrine Abstracts

Introduction: Thyrotropin-producing adenomas (TSH-omas) constitute about 1% of pituitary adenomas. TSH-omas are a rare cause of hyperthyroidism. In conjunction with biochemical parameters and dynamic endocrine testing, image evaluation of the pituitary gland and sella turcica is mandatory for establishing a correct diagnosis. TSH-omas are usually large tumors and tend to be invasive. Greater amounts of invasion correlate with incomplete surgical removal of the tumor and, thus,...

Introduction: Just-glomerular tumours (reninomas) are rare causes of secondary hypertension (HT). They typically present with difficult to manage-HT, hypokalemia, hyperreninemia and secondary hyperaldosteronism. They are usually small lesions (<1 cm) and are more common in adolescents or young adults. Despite being rare, they should be considered in the diagnostic approach of secondary HT, as it they are a potentially curable cause.Case report: Femal...

Introduction: The TNM classification of the American Joint Committee on Cancer (AJCC) and the Union for International Cancer Control (UICC) is the most widely used thyroid cancer staging system. The 8th edition was published in 2016 and introduced modifications to the N0 classification. Histological analysis is no longer necessary for patients to be classified as N0, as long as there is no evidence of lymph node (LN) metastasis in the preoperative imaging tests or clinical eva...

Introduction: Multiple endocrine neoplasia type 2A syndrome (MEN 2A) is caused by a germline mutation in the RET proto-oncogene and its phenotype includes medullary thyroid cancer, pheochromocytoma and primary hyperparathyroidism (PHPT). Parathyroid reimplantation in the sternocleidomastoid muscle or in the brachioradial muscle can be performed in case of intraoperative lesion of the parathyroid glands. In some cases, PHPT may occur due to the proliferation of autotransplanted...

Introduction: LMTK3 is an oncogenic Receptor Tyrosine Kinase (RTK) implicated in resistance to endocrine therapy in breast cancer. Initially, LMTK3 was described as a regulator of Estrogen Receptor alpha (ERα) since it was found able to protect it from ubiquitin-mediated proteasomal degradation. In a cohort of breast cancer (BC) patients (n>600), LMTK3 protein levels and intronic polymorphisms were significantly associated with disease-free and overall surviv...

Levothyroxine (L-T4) is the mainstay of treatment of hypothyroidism. Marked elevation of thyrotropin (TSH) in patients on high replacement doses is rare and can result from malabsorption, drug interaction or poor compliance. The levothyroxine absorption test is required to distinguish these causes and has proved to be safe. This test measures the serum free thyroxine (FT4) response to 1 mg of oral L-T4 over 4–24 h.Clinical cases: Case no 1: A 28-yea...

IntroductionSevere hyperandrogenism is a warning sign in young women. Differential diagnosis includes neoplastic, non-neoplastic and iatrogenic causes. The association of hyperandrogenism and congenital or acquired portosystemic shunt (PSS) has been rarely described, with its pathophysiology being unclear.Case 1A 22 year-old woman with diagnosis of autoimmune hepatitis, portal hypertension and PSS since 15 ye...

IntroductionThe toxic solitary thyroid nodule is a major cause of hyperthyroidism, especially in iodine-deprived regions. The most widely used therapy is iodine-131, which is effective in achieving normal thyroid function and reducing nodule dimensions, however, it may induce hypothyroidism. The aim of this study was to evaluate the outcomes of radioiodine therapy in patients with toxic solitary nodules and to determine predictive factors for the develop...

IntroductionThe measurement of serum thyroglobulin (Tg), a glycoprotein produced exclusively by follicular thyroid cells, is an important tumour marker used in the follow-up of patients with differentiated thyroid carcinoma (DTC) and residual or recurrent disease. However, its role as a screening tool before thyroid surgery is not yet defined, as benign conditions can result in its increase.ObjectiveThe aim o...

Objective: Oxidative stress has been implicated in the pathogenesis of hyperthyroidism, and its complications. Advanced glycation end products (AGEs), compounds derived from non-enzymatic transformation of macromolecules, are able to increase oxidative stress and promote inflammation and are increased in several oxidative stress-related disorders, including autoimmune thyroiditis. In the same diseases, the activity of paraoxonase-1 (PON-1), an anti-oxidant enzyme protecting ag...