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16th European Congress of Endocrinology

Poster Presentations

Clinical case reports Pituitary/Adrenal

ea0035p210 | Clinical case reports Pituitary/Adrenal | ECE2014

Diabetes insipidus and hypopituitarism in a patient with idiopathic pulmonary fibrosis

Selfa Silvia Maraver , Garach Araceli Munoz , Cesar Maria Jose Picon , Doblas Isabel Mancha , Madueno Francisco Tinahones

Diabetes insipidus is a disease characterized by the inability to concentrate urine. The common form is central diabetes insipidus (CDI) caused by a lack of AVP after destruction of supraoptic–paraventricular nuclei. Further investigations are needed to establish its cause.: Case reportA 38-year-old woman presented with prompt polyuria–polydipsia. She has been taking contraceptive tablets for 2 years, smoked four to five cigarettes per day....

ea0035p211 | Clinical case reports Pituitary/Adrenal | ECE2014

Can bexarotene be a candidate drug for the medical therapy of Cushing's syndrome?

Atmaca Hulusi , Isikli Gulsen , Senturk Nilgun , Buyukkaya Piltan

We report a patient with mycosis fungoides treated with bexarotene (Targretin), a synthetic retinoid analog with specific affinity for retinoid X receptor. This patient developed hypopituitarism characterized by hypogonadism, hypothyroidism, and hypoadrenalism. Although central hypothyroidism is a common side effect of bexarotene, central hypogonadism, and hypoadrenalism has been reported in one case. Clinicians should have high index of suspicion for hypopituitarism in patien...

ea0035p212 | Clinical case reports Pituitary/Adrenal | ECE2014

Familial 46, XY gonadal dysgenesis

Yaker Fetta Amel , Azzoug Said , Chentli Farida

46, XY disorders of sex development are rare diseases secondary to gonadal dysgenesis (GD) and disorders of androgens synthesis or action. Familial forms of GD are very rare; we report here the observations of two siblings with 46, XY GD.The first patient whose parents were relatives, raised as a girl consulted at 3 years for ambiguous genitalia, at clinical exam we found a small phallus, partial fusion of labio-scrotal folds with one orifice at the phal...

ea0035p213 | Clinical case reports Pituitary/Adrenal | ECE2014

Comorbidity of gastrointestinal stromal tumor and pituitary macroadenoma in patient referred with gastrointestinal bleeding

Tuzun Dilek , Irkorucu Oktay , Asut Elife , Guzel Aslan

We report a case of GIST comorbidity with pituitary macroadenoma presenting with gastrointestinal bleeding.Case: A 56-year-old male patient was admitted to the emergency department with complaints of hematemesis. Antral gastritis and a mass about 3 cm in diameter with irregular margins in the ampulla detected in upper gastrointestinal endoscopy. Irregular, heterogeneous, hypoechoic solid mass lesion, ~ 36×48 mm in size, was observed inferior–la...

ea0035p214 | Clinical case reports Pituitary/Adrenal | ECE2014

New-onset autoimmune disorders after successful treatment of Cushing's disease

Komerdus Irina , Dreval Alexander , Nechaeva Olga , Britvin Timur , Murzina Anastasia , Egorova Elena

Background: Excessive level of cortisol in patients with Cushing’s disease (CD) can cause an immunosuppression. Therefore after resolution of hypercorticism the underline autoimmune disorders can appears.Aim: We are presenting three cases of autoimmune disorders diagnosed in patients successfully treated for CD.Results: Case 1: Woman, 37-year-old with confirmed panhypopituitarism after transsphenoidal adenomectomy (TSA) for CD...

ea0035p215 | Clinical case reports Pituitary/Adrenal | ECE2014

An unusual clinical presentation of Sheehan's syndrome: Co-occurrence of bycitopenia, acute colonic pseudo-obstruction and acute renal failure

Cadirci Kenan , Aydin Mesut , Durmaz Senay Arikan , Karakaya Afak Durur , Tanrikulu Yusuf , Carlioglu Ayse

Sheehan’s syndrome (SS) may be defined as development of anterior pituitary ischemic necrosis, first of which is caused by failure to meet the blood build-up required due to pituitary expansion secondary to lactotroph cell proliferation during pregnancy. Vasospasm, thrombosis and vascular compression of hypophyseal arteries have been described among the possible causes of SS. Additionally, expansion of pituitary gland, small sella, disseminated intravascular coagulation (...

ea0035p216 | Clinical case reports Pituitary/Adrenal | ECE2014

Challenges in the diagnosis of pheochromocytoma: a case report

Zdrojowy-Welna Aleksandra , Bednarek-Tupikowska Grazyna

Introduction: Adrenal pheochromocytomas are rare neuroendocrine tumours and their prevalence is likely underestimated – in some series 50% of cases were diagnosed during autopsy. The clinical presentation varies among patients which may make the diagnosis difficult to establish. We present the case of a woman with certain clinical characteristics of pheochromocytomas and who was diagnosed after having suffered a stroke. Specific points suggesting a pheochromocytoma and cr...

ea0035p217 | Clinical case reports Pituitary/Adrenal | ECE2014

A huge metastatic adrenocortical carcinoma presenting with Cushing's syndrome and inferior vena cava thrombosis: case report

Kaya Mina Gulfem , Dellal Fatma Dilek , Ulas Arife , Gumus Mehmet , Kilicarslan Aydan , Yalcin Bulent , Ersoy Reyhan , Cakir Bekir

Background: Adrenocortical carcinoma (ACC) is a very rare but typically aggressive malignancy. About one to three quarters of ACC is functioning with excess hormonal production.Case: A 44-year-old female patient was admitted to out-patient clinic with obesity, oligomenorrhea and abdominal pain. She had central obesity, buffalo hump, and palpable flank mass. Hypertension, transient ischemic attack, and epilepsy history was present.S...

ea0035p218 | Clinical case reports Pituitary/Adrenal | ECE2014

Synchronous acromegaly and gastrointestinal stromal tumor: a case report

Baser Husniye , Arslan Kemal , Kucukosmanoglu Ilknur , Baser Salih , Kollu Korhan , Kalkan Kemal , Ecirli Samil

Introduction: Synchronous and asynchronous cases of acromegaly and other malignancies have been reported in literature. However, synchronous apperance of acromegaly and gastrointestinal stromal tumors (GIST) is encountered so rarely. We herein reported a case of synchronous acromegaly and GIST.Case report: A 59-year-old patient was investigated due to iron deficiency anemia. On the physical examination revealed enlarged hands and coarse facial feature; a...

ea0035p219 | Clinical case reports Pituitary/Adrenal | ECE2014

Cognitive impairment in a patient with a TART syndrome

Marczewski Krzysztof , Kawalko Agnieszka , Sawicka Agnieszka

Introduction: In the testicular adrenal rest tumor (TART) syndrome, doctors think before all to preserve fertility and oncological risk. Meanwhile, for the patient are relevant primarily those disorders that hinder him daily functioning and affect the quality of life. Because of it, we would like to introduce our patient with cognitive impairment.Case report: A 20-year-old male, working in the factory, came to an endocrinologist at the request of his mot...

ea0035p220 | Clinical case reports Pituitary/Adrenal | ECE2014

Neuropsychiatric aspects in a rare case of hypothalamic obesity

Stieg Mareike R , Buchfelder Michael , Stalla Gunter K

A 22-year-old woman presented with weight gain (class I obesity), oligomenorrhea, impaired vision, and altered concentration. With suspected craniopharyngeoma she was treated with transcranial surgery; in fact for a suprasellar haemangioma. Post-operatively, she still presented an alteration in appetite with hyperphagia and excessive weight gain up to class III obesity. This syndrome is described as ‘hypothalamic obesity’ and results from any damage to the ventromedi...

ea0035p221 | Clinical case reports Pituitary/Adrenal | ECE2014

A case with APECED syndrome

Kuzu Idris , Zuhur Sayid Shafi , Ozturk Feyza Yener , Karatas Savas , Ozkaya Hande Mefkure , Canat Muhammed Masum , Altuntas Yuksel

Introduction: APECED syndrome is characterized by the three most common components of the condition, i.e. mucocutaneous candidiasis, autoimmune hypoparathyroidism, and Addison’s disease. Presence of two of these components suffices for diagnosis.The case: A 33-year-old female patient presented to the endocrinology polyclinic for weakness, nausea, vomiting, dizziness, recurring vaginal itch, and discharge for 1 year, intermittent dysphagias and ameno...

ea0035p222 | Clinical case reports Pituitary/Adrenal | ECE2014

Hyponatremia as a first symptom of hypopituitarism in an adult patient with natural history of craniopharyngioma undiagnosed since childhood

Witek Przemyslaw , Kaminski Grzegorz , Witek Joanna , Zielinski Grzegorz

Background: Craniopharyngiomas may lead to pituitary insufficiency and neurological symptoms. However the rate of the tumor growth and the time of developing hypopituitarism are difficult to predict.Case report: A 68-year-old male of short stature (height 148 cm) was admitted to the area hospital due to loss of consciousness. The acute coronary syndrome and stroke had been excluded but laboratory tests showed hyponatremia of 106 mmol/l. Hormone measureme...

ea0035p223 | Clinical case reports Pituitary/Adrenal | ECE2014

Ineffectiveness of temozolomide in aggressive dopamine-agonist resistant prolactinoma and type 3 silent somatotropinoma

Kurowska Maria , Malicka Joanna , Tarach Jerzy S , Zielinski Grzegorz , Swiatkowska-Stodulska Renata , Sworczak Krzysztof

Introduction: Temozolomide (TMZ) can be administered as the last therapeutic option for aggressive pituitary tumors. Dopamine-agonist resistant prolactinomas are relatively frequent and remain a serious therapeutic problem. GH expressing atypical adenomas are rare and their positive response to TMZ is low. In a general opinion a lack of response to TMZ after three cycles predicts the treatment resistance.The aim of the study was presentation of two patie...

ea0035p224 | Clinical case reports Pituitary/Adrenal | ECE2014

Cushing's disease in patient with primary empty sella

Kurowska Maria , Malicka Joanna , Zielinski Grzegorz , Tarach Jerzy S , Maksymowicz Maria , Denew Piotr

Introduction: The empty sella syndrome (ESS) is defined as the penetration of the subarachnoid space into intrasellar region. In ESS pituitary hormonal function is usually normal, but several, mostly subtle, hormonal abnormalities have been also reported. The coexistence of Cushing’s disease and primary empty sella is very rare.Objective: The presentation of an exceptional case of a patient with Cushing’s disease associated with primary empty s...

ea0035p225 | Clinical case reports Pituitary/Adrenal | ECE2014

Temozolomide-induced marked regression of invasive Crooke's cells corticotropinoma in patient with Cushing's disease

Kurowska Maria , Malicka Joanna , Zielinski Grzegorz , Tarach Jerzy S , Maksymowicz Maria , Denew Piotr

Introduction: Crooke’s cells are normal corticotrophs with cytoplasmic accumulation of cytokeratin filaments in response to glucocorticoids excess. Crooke’s cell corticotropinomas are the unique cause of Cushing’s disease. Nearly all of them are invasive macroadenomas, generally aggressive, refractory to conventional therapy, with high recurrence rate.Aim of the study was to present a case study of a patient with Cushing’s disease cau...

ea0035p226 | Clinical case reports Pituitary/Adrenal | ECE2014

Treatment of aggressive corticotropinoma with temozolomide and bevacizumab in patient with Nelson's syndrome

Malicka Joanna , Kurowska Maria , Zielinski Grzegorz , Tarach Jerzy S , Maksymowicz Maria , Denew Piotr

Introduction: Aggressive corticotropinomas are more invasive than other pituitary tumors. Recent reports have documented the efficacy of temozolomide alone or in combination with an anti-angiogenic agent –bevacizumab in invasive pituitary adenomas treatment.Objective: Presentation a case of 56-year-old woman initially diagnosed as Cushing’s disease and the analysis of treatment procedures with special concentration on temozolomide and bevacizum...

ea0035p227 | Clinical case reports Pituitary/Adrenal | ECE2014

Meningitis coexisting with pituitary macroadenoma: report of two cases

Malicka Joanna , Kurowska Maria , Tarach Jerzy S

Background: Meningitis coexisting with pituitary macroadenoma is rarely observed. It occurs either as a primary meningitis (primary tumor manifestation), or as a secondary meningitis (after neurosurgery or reduction of the volume of the tumor which has destroyed the sellar floor or the skull base).Objective: Case reports of two patients with the concomitance of secondary meningitis and pituitary macroadenoma.Case 1: A 36-year-old m...

ea0035p228 | Clinical case reports Pituitary/Adrenal | ECE2014

Primary hyperaldosteronism presenting as hypokalemic periodic paralysis: two case reports

Oguz Ayten , Sahin Murat , Gul Kamile , Yuzbasioglu Fatih , Atay Didem , Cetin Gozde Yildirim , Sayar Hamide

Background: Hypokalemia is a chronic condition in primary aldosteronism (PA) and hypokalemia symptoms usually can be tolerated by the patients. Hypokalemic periodic paralysis due to primary aldosteronism is rarely reported. We reported two cases of hypokalemic paralysis due to primary aldosteronism.Case 1: A 33-year-old male admitted to the emergency service with fatigue, numbness, progressive weakness in his legs and arms for 2 months. He had a hyperten...

ea0035p229 | Clinical case reports Pituitary/Adrenal | ECE2014

A case of hypopituitarism caused by lung cancer metastasis to the pituitary

Kaluzny Marcin , Bolanowski Marek , Zielinski Grzegorz , Piesiak Pawel , Maksymowicz Maria

Pituitary tumor is a rare endocrine disorder. In the majority of cases, they are secreting prolactin and/or GH. Pituitary metastatic tumors are localized more often in the nervous than adenomatous hypophysis. Lung, breast and large intestine cancers metastases are found in the pituitary in the most cases. They cause hypopituitarism and local complications. The most often complications found are an optic nerve chiasm pressure or infiltration with a visual field loss, cavernous ...

ea0035p230 | Clinical case reports Pituitary/Adrenal | ECE2014

Transient severe polyuria in a patient with bilateral pheochromocytoma after adrenalectomy

Oguz Ayten , Sahin Murat , Bulbuloglu Ertan , Sayar Hamide , Atay Didem , Ozdemir Hakan , Gul Kamile

Background: Postoperative severe polyuria is a rare condition after adrenal pheochromocytoma resection. We presented this case due to its rarity.Case: A 50-year-old women admitted to emergency service with malaise and fatigue complaint. The patient was using triple antihypertensive combination that started 10 years ago. Her medical history included cerebrovascular event due to hypertension 5 years ago. In physical examination her BMI was 20 kg/m2</s...

ea0035p231 | Clinical case reports Pituitary/Adrenal | ECE2014

Macroprolactinoma that disappears in a short time with cabergoline treatment: case report

Oguz Ayten , Sahin Murat , Sagliker Hasan Sabit , Inci Mehmet Fatih , Bolat Hanife , Gul Kamile

Introduction: Prolactinomas are frequent in women and between 20 and 40 years but rarely seen in men especially as macroadenoma. Both in microadenomas and macroadenomes unless there is not any indication for an emergent surgery, first line treatment is always medical with dopamine agonists. In this report, we presented a patient with macroprolactinoma that disappears in a short time with dopamine agonist treatment.Case: A 20-year-old boy admitted to endo...

ea0035p232 | Clinical case reports Pituitary/Adrenal | ECE2014

A case of primary aldosteronism with the subclinical Cushing's syndrome examined the localization by double immunostaining for CYP11B1 and B2

Hayashi Takeshi , Asano Hiroshi , Sakamoto Masaya , Sakamoto Noriko , Kurihara Isao , Mukai Kuniaki , Tojo Katsuyoshi , Utsunomiya Kazunori

A 63-year-old woman was referred to our hospital for examination of three adrenal nodules. She had been diagnosed with hypertension since the age of 40 and prescribed antihypertensive drugs. Then, she was pointed out hypokalemia and bilateral adrenal tumors. She was diagnosed with primary aldosteronism (PA) at another hospital and had been prescribed spironolactone because the localization was not determined despite adrenal vein sampling (AVS) was performed.<p class="abste...

ea0035p233 | Clinical case reports Pituitary/Adrenal | ECE2014

Primary thyroid lymphoma in a patient with adrenal incidentaloma

Ivovic Miomira , Marina Ljiljana , Vujovic Svetlana , Tancic-Gajic Milina , Arizanovic Zorana , Rakovic Dragana , Micic Dragan

Introduction: Primary thyroid lymphoma (PTL) presents between 2 and 8% of all thyroid malignancies. Rapidly enlarging neck mass, especially in women with Hashimoto’s thyroiditis should steer the diagnostic procedures in the way of PTL. The most common type is diffuse large B-cell lymphoma. Adrenal incidentaloma are incidentally discovered adrenal masses without prior suspicion of adrenal disease.Case report: A 71-year-old woman with an adrenal incid...

ea0035p234 | Clinical case reports Pituitary/Adrenal | ECE2014

Takotsubo cardiomyopathy triggered by pheocromocytoma crisis

Bilbao Ismene , Yoldi Alfredo , Garcia Cristina , Egana Nerea , Aranburu Maite , Luisa Antunano Maria , Olaizola Izaskun , Elias Estela , Goena Miguel

Introduction: Pheochromocytomas are a rare catecholamine secreting tumours that can mimic numerous stress-associated disorders, such as Takotsubo cardiomyopathy, or transient left ventricular apical ballooning which is brought on by an acute coronary vasospasm due to an excessive sympathetic stimulation.Case ReportA 68-year-old woman, with previous medical history of hypertension and type 2 diabetes, who was on 30 units of isuline ...

ea0035p235 | Clinical case reports Pituitary/Adrenal | ECE2014

A history of 30 years severe uncontrolled hypertension: Conn's syndrome

Baleanu Felicia , Iconaru Laura , Bourmorck Carole , Karmali Rafik

A 65-year-old Moroccan man was regularly followed in the outpatient clinic for type 2 diabetes since 2010 and was well controlled with an oral treatment. His past medical history included severe hypertension since 1985. Despite four antihypertensive agents, his blood pressure was not controlled (BP: 220/120 mmHg). A suspicion of renal artery stenosis was excluded by an invasive procedure.He presented an impaired renal function (GFR: 50 ml/min) and his se...

ea0035p236 | Clinical case reports Pituitary/Adrenal | ECE2014

Unusual cause of hypoglycemia in a type 2 diabetic patient: panhypopituitarism

Baleanu Felicia , Iconaru Laura , Bourmorck Carole , Rafik Karmali

We report on a 50-year-old patient of Moroccan origin, with insulin treated type 2 diabetes known for several years. He presented with a 6 months history of hypoglycemia, hypotension, associated with loss of libido and erectile dysfunction, anorexia, general deterioration and weakness. He had lost 20 kg over a 6-month period. The insulin doses were diminished from 70 to 42 U/day and the antihypertensive treatment was stopped due to repeated episodes of hypotension.<p class...

ea0035p237 | Clinical case reports Pituitary/Adrenal | ECE2014

Hyperprolactinemia secondary to primary hypothyroidism with hyperplasia pituitary

Centeno Rogelio Garcia , Melero Victor Andia , Fernandez Elisa Fernandez , Salas Marcel Sambo , Gonzalez-Antiguedad Cynthia , de la Camara Marta Motilla , Solis Diego Lezcano , Gonzalez Javier , Rivadeneira Lenin , Requena Maria , Ramirez Maria Laura , Olmedilla Yoko , Arnoriaga Maria

Introduction: Although the most common causes of hyperprolactinemia are prolactinoma and iatrogenic, another possible cause is severe primary hypothyroidism, in which the increase of prolactin is a cause of pituitary stimulation by TRH, and can be presented with pituitary hyperplasia.Case report: A 31-year-old woman who comes to endocrinology clinic for hyperprolactinemia, which was detected by symptoms of amenorrhea–galactorrhea. After normal pregn...

ea0035p238 | Clinical case reports Pituitary/Adrenal | ECE2014

A rare cause of primary hyperaldosteronism unilateral adrenal hyperplasia: case report

Gul Kamile , Sahin Murat , Oguz Ayten , Yuzbasioglu Fatih , Sayar Hamide , Altunoren Orcun

Introduction: Most common two causes of primary hyperaldosateronism are bilateral idiopathic hyperplasia and aldosteron secreting adenoma but unilateral adrenal hyperplasia is a rare cause. We presented a primary hyperaldosteronism case that caused by unilateral adrenal hyperplasia.Case: A 56-year-old male admitted to endocrinology policlinic with complaints of polydipsia, polyuria, fatigue and muscle wasting. He had hypertension for 4 years. In physical...

ea0035p239 | Clinical case reports Pituitary/Adrenal | ECE2014

Clinical case of pituitary apoplexy due to hemorrhagic vasculitis

Dreval Alexander , Shestakova Tatiana , Komerdus Irina

Introduction: Pituitary apoplexy is the rare case of panhypopituitarism. We are presenting a clinical case of pituitary apoplexy in a previously healthy 37-year-old woman.Case report: A 37-year-old woman developed amenorrhea in August 2011. She did not visit a doctor in that time. In December 2011 she suddenly felt severe headache, symptoms of polyuria and polydipsia and temperature of 39 °C. Laboratory results revealed an increased erythrocyte sedi...

ea0035p240 | Clinical case reports Pituitary/Adrenal | ECE2014

Temporary adrenal failure due to tuberculosis: a rare phenomenon in recent years

Baser Husniye , Polat Sefika Burcak , Aydin Cevdet , Ersoy Reyhan , Cakir Bekir

Introduction: Adrenal failure due to tuberculosis is rarely seen nowadays. There are few reports in the literature suggesting that adrenal insufficiency may improve with anti-tuberculosis therapy during the active phase of the disease. Herein, we presented a case of reversible adrenal failure in a patient with active tuberculosis.Case report: A 50-years-old-female patient admitted to our clinics with the complaints of weakness and darkening of the skin. ...

ea0035p241 | Clinical case reports Pituitary/Adrenal | ECE2014

Malignant feminising adrenal tumor without gynecomastia

Chentli Farida , Zellagui Hadjer

Introduction: Malignant feminizing adrenal tumors are very rare occurring generally in men. The lack of gynecomastia is even rarer in those tumor secreting estrogens alone, or with other adrenal hormones especially cortisol as in the following case.Case report: A male aged 44, consulted in May 2012 for abdominal pain. Radiological assessment discovered a large tumor measuring 120×95 mm located in the left adrenal with numerous metastases (pulmonary,...

ea0035p242 | Clinical case reports Pituitary/Adrenal | ECE2014

Congenital panhipopituitarism and ectopic posterior pituitary

Laura Iconaru , Felicia Baleanu , Carole Bourmorck , Rafik Karmali

Introduction: Congenital hypopituitarism may be the result of complications linked with delivery or may sometimes result of insufficient development of the gland in the context of specific genetic abnormalities (PROK2 and PROKR2, LHX4, HESX1, OTX2, GLI2 and SOX3). Interruption or lack of pituitary stalk represents a frequent feature of congenital hypopituitarism.Case description: We present a patient 39-year-old with congenital panhypopituitarism, mental...

ea0035p243 | Clinical case reports Pituitary/Adrenal | ECE2014

A case report: functioning cystic pheocromocytoma

Boysan Serife Nur , Kokdas Suleyman , Gungor Tuba , Citil Rana , Citil Serdal , Dagoglu Besra , Caglar Serkan

Introduction: Cystic adrenal neoplasms are uncommon and were defined with foci of tumor presented in the cyst wall. Adrenal cortical adenoma, adrenal cortical carcinoma and pheocromocytoma may be associated. We report a case of functioning cystic pheocromocytoma.Case report: A 44-year-old man had abdominal pain on the right side. Abdominal ultrasonography showed a noduler cystic lesion measured 4 cm in diameter with thin septas and thickened wall in the ...

ea0035p244 | Clinical case reports Pituitary/Adrenal | ECE2014

Primary adrenal failure due to primary antiphospholipid syndrome

Sahin Murat , Oguz Ayten , Boysan Serife Nur , Mese Bulent , Sahin Hatice , Akgul Omer Faruk , Gul Kamile

Introduction: Autoimmune adrenal injury is the most common cause of primary adrenal failure (PAF) (70–90%). Antiphospholipid syndrome (APS) that characterized by thrombosis and abortus may be a reason of PAF. In this presentation we reported a case of primary adrenal failure due to primary antiphospholipid syndrome.Case: A 34-year-old boy was brought to emergency service due to loss of consciousness. In physical examination patients was confused, bl...

ea0035p245 | Clinical case reports Pituitary/Adrenal | ECE2014

Catecholamine resistance hypotension after pheochromocytoma resection

Gul Kamile , Oguz Ayten , Sahin Murat , Bulbuloglu Ertan , Oksuz Hafize , Senoglu Nimet , Akgul Omer Faruk , Metin Fatma Kesici , Bozkurt Selim

Introduction: Resecting a pheochromocytoma is a high-risk surgical procedure, life threatening complications may occur. In this presentation, we reported a case of resistance hypotension after pheochromocytoma resection.Case: A 70-year-old male with a history of prostate adenocarcinoma admitted to urology policlinic for cancer screening. Abdominal ultrasound revealed 6.5×5.5 cm mass in left adrenal gland and patient referred to endocrinology policli...

ea0035p246 | Clinical case reports Pituitary/Adrenal | ECE2014

Prepubertal male gynecomastia-issues of diagnosis

Hreniuc Ana , Gherasim Simona , Hristov Ioana , Preda Cristina , Vulpoi Carmen , Ungureanu Maria-Christina , Cristea Cristina , Mogos Voichita , Leustean Letitia

We present the case of 13 years old boy referred to our service in June 2013 for bilateral gynecomastia (appeared for ~1 year). The boy’s father presented delayed puberty (at 18-year-old). No other pathological hereditary conditions were reported.Clinical examination revealed: gynoid status with height =167 cm (−1.4 DS), weight=63.5 kg, important bilateral gynecomastia with hypo pigmented areola and painful palpation. Sexual development was PI...

ea0035p247 | Clinical case reports Pituitary/Adrenal | ECE2014

Spindle cell oncocytoma: a new presentation of a rare disease

da Silva Tiago Nunes , Pereira Bernardo Dias , Luiz Henrique Vara , Veloza Andreia , Matos Ana Catarina , Portugal Jorge

Spindle cell oncocytoma (SCO) is a rare entity with just 18 cases reported in the literature. It was first described in 2002 and was codified as a separate diagnostic entity in the 2007 WHO classification of brain tumours. SCO is a nonadenomatous sellar neoplasm with rich vascularization and intra and supra-sellar infiltration. Usual clinical presentation consists of headache, visual field defects and pan-hypopituitarism. The preoperative diagnosis is difficult due to a lack o...

ea0035p248 | Clinical case reports Pituitary/Adrenal | ECE2014

A primary adrenal adenomatoid tumor in a young woman

Krstevska Brankica , Misevska Sasha Jovanovska , Ahmeti Irfan , Jovanovska Biljana , Bitoska Iskra , Bogoeva Biljana

Adenomatoid tumors are relatively uncommon neoplasms of mesothelial origin, usually occuring in the male and female genital tracts. Rare extragenital adenomatoid tumor has been identified in adrenal gland. The differential diagnosis includes metastatic carcinoma and adrenocortical carcinoma.We present a case of 30 years old woman with incidentally radiological (ultrasound) finding of unilateral tumor in the right adrenal gland. CT and MRI were of great v...

ea0035p249 | Clinical case reports Pituitary/Adrenal | ECE2014

Infected giant cystic phaeochromocytoma masquerading as a hepatic abscess

Sirelkhatim Mazin , Asher Alex , Rahman Mohamed , Htike Zin Lin , Adhiyaman Vedamurthy , Clarke N W , Trainer P E , Wong Stephen

Introduction: Giant cystic phaeochromocytomas are an exceedingly rare variant of adrenal phaeochromocytomas. We report a case in an 83-year-old lady who initially presented with a swinging pyrexia, initially diagnosed as a hepatic abscess.Case report: An 83-year-old lady with a history of hypertension was admitted as an emergency with nausea and vomiting, dehydration and rigors. She was pyrexial and dehydrated; pulse 163 and BP 167/86. There were signs o...

ea0035p250 | Clinical case reports Pituitary/Adrenal | ECE2014

Hyponatremia and diabetes insipidus: a case report

Gomes Ana Coelho , Martins Joao Martin , do Vale Sonia , Martins Ana Filipa

Introduction: Hyponatremia is defined as a serum sodium level of <135 mEq/l and it is considered severe when the serum level is below 125 mEq/l. In patients with diabetes insipidus treated with desmopressin, it is usually secondary to desmopressin overmedication.Case report: A 79-year-old man, with a past history of post traumatic central diabetes insipidus treated with desmopressin. The patient had multiple admissions to the hospital due to hyponatr...

ea0035p251 | Clinical case reports Pituitary/Adrenal | ECE2014

Primary hyperthyroidism following successful surgical treatment for secondary hyperthyroidism due to TSH-secreting pituitary adenoma

Czajka-Oraniec Izabella , Baranowska-Bik Agnieszka , Kochman Magdalena , Zielinski Grzegorz , Zgliczynski Wojciech

Introduction: Secondary hyperthyroidism due to thyrotropin-secreting pituitary adenoma (TSHoma) is rare. Coexistence of TSHoma and primary thyroid disease that could lead to hyperthyroidism is even more unusual.Case report: A 28-year-old female with longstanding and worsening symptoms of hyperthyroidism was admitted to the hospital. Free-T4 (32.89 pmol/l) and free-T3 (6.38 pg/ml) were elevated with moderately increased TSH level (5....

ea0035p252 | Clinical case reports Pituitary/Adrenal | ECE2014

A case of addison's disease associated with ankylosing spondylitis

Atile Neslihan Soysal , Guldiken Sibel , Saritas Fatih , Celik Huseyin , Tugrul Armagan

Addison’s disease (AD), is an autoimmune disorder. However, its association with connective tissue diseases is rare. Here, we report a case of AD associated with ankylosing spondylitis (AS).Case: A 57-year-old male patient admitted to internal medicine polyclinic with complaints of debility and anorexia. In the physical examination, he has hyperpigmentation on his skin, gingiva and palm lines. Blood pressure was 80/50 mmHg, pulse was 64/min. The oth...

ea0035p253 | Clinical case reports Pituitary/Adrenal | ECE2014

A case report: posterior pituitary evaluated as microadenoma in the magnetic resonance imaging

Boysan Serife Nur , Yurttutan Nursel

Introduction: Posterior pituitary appears hyperintense in T1 series in the sagittal section of magnetic resonance imaging. We report a case whose posterior pituitary magnetic resonance images could be evaluated as microadenoma.Case report: A 20-year-old woman evaluated in Gynecology for oligomenorrhae. Serum prolactin was 27 ng/dl. Magnetic resonance imaging of pituitary showed a nodular lesion in the left measured 3 mm in diameter and hyperintense in T2...

ea0035p254 | Clinical case reports Pituitary/Adrenal | ECE2014

Acromegaly accidentally diagnosed: a typical course of the disease

Matyjaszek-Matuszek Beata , Rudzki Grzegorz , Obel Ewa , Wdowiak-Barton Barbara , Tarach Jerzy

Introduction: Acromegaly is a rare endocrinopathy which shows characteristic phenotypic and metabolic features. Primarily patients in their forties or fifties suffer from this disorder but the main problem is late diagnosis, especially in men, even 10 years after the first symptoms. We present an unusual clinical course of acromegaly with no phenotypic features to stress the need to perform complete evaluation of endocrine function in hypogonadal patients.<p class="abstext...

ea0035p255 | Clinical case reports Pituitary/Adrenal | ECE2014

Diabetes insipidus as the primary symptom of infundibuloma

Matyjaszek-Matuszek Beata , Pyzik Aleksandra , Zakoscielna Katarzyna , Tarach Jerzy

Introduction: Neurohormonal diabetes insipidus (DI) is a rare disorder caused by partial or total vasopressin deficiency which results in diluted urine characterized by polyuria and polydipsia. In 30–50% of the cases the cause of the disease is unknown; it is the so-called idiopathic diabetes insipidus. Other causes include: tumors of the CNS most commonly craniopharyngioma, pituitary macroadenomas, central nervous system trauma, inflammatory state of hypothalamus or pitu...

ea0035p256 | Clinical case reports Pituitary/Adrenal | ECE2014

An unusual case of reversible empty sella

Triggiani Vincenzo , Giagulli Vito Angelo , Guastamacchia Edoardo

A 22-year-old female complaining about irregular menses associated to a slight increase of serum PRL and the recent onset of headache, nausea, dizziness, photophobia, occasional diplopia, visual impairment, anxiety and panic attacks was evaluated for the possible presence of a cerebral mass with intracranial hypertension. Fundoscopic examination and visual field were both normal. There was an empty sella with a flattened pituitary gland along the floor of the pituitary fossa a...

ea0035p257 | Clinical case reports Pituitary/Adrenal | ECE2014

Acromegaly with a normal pituitary gland

Cruz Alfredo Sanchez , Martinez Jose H , de Lourdes Miranda Maria , Palermo Coromoto , Gonzalez Eva , Torres Oberto , Santiago Monica , Figueroa Carlos , Trinidad Rafael , Mangual Michelle , Gutierrez Madeleine

Background: Acromegaly most commonly results from an excess production of GH and secondary increase in IGF1. More than 95% of the time from the pituitary gland, but the source of excess GH secretion may not necessarily be pituitary in origin. Ectopic acromegaly may arise due to neuroendocrine tumors by production of GHRH and in <0.5% of the cases from ectopic pituitary remnants in the sphenoid sinus.Clinical case: We present a case of a 37 years old ...

ea0035p258 | Clinical case reports Pituitary/Adrenal | ECE2014

Different courses of Carpenter syndrome

Matyjaszek-Matuszek Beata , Lenart-Lipinska Monika , Rudzki Grzegorz , Tarach Jerzy

Introduction: Autoimmune polyglandular syndrome type 2 (APS type 2) is co-occurrence of primary adrenal insufficiency (Addison disease) and autoimmune thyroid disease – most commonly Hashimoto thyroiditis (Schmidt syndrome). If it is associated with type 1 diabetes mellitus it is known as Carpenter syndrome. We present clinical pictures of two 33-year-old patients (born in 1980) diagnosed with APS type 2 manifested as Carpenter syndrome to emphasize different courses of t...

ea0035p260 | Clinical case reports Pituitary/Adrenal | ECE2014

Hyporeninemic hypoaldosteronism with severe hyperkalemia following adrenalectomy for primary hyperaldosteronism : a case report

Pura Mikulas , Malina Jan , Machalekova Katarina , Imreova Helena , Kentos Peter , Urbankova Helena , Vanuga Peter

Background: Post-adrenalectomy persistent hyperkalemia, that lasts >3 months and needs to be treated, is a potentially serious, but not apprehensively investigated complication after surgical treatment in patients with aldosterone-producing adenomas (APA).Case report: A 53-year-old male presented type 2 diabetes mellitus and a 10-year history of resistant hypertension requiring multidrug treatment with antihypertensives of eight different classes. Pr...