Endocrine Abstracts

Tumour localisation in Cushing’s disease (CD) can be challenging; most are microadenomas and 50% are <5 mm in diameter. They are, therefore, often difficult to detect by conventional MRI. Volumetric MRI (3D-SGE, spoiled-gradient echo 3D sequence) is a high spatial resolution scanning technique which uses very thin slices (1 mm). Theoretically, this increases the probability of finding small pituitary lesions when compared to conventional (spin-echo, SE) MRI techniques...

Background: Ectopic-ACTH syndrome (EAS) is an extremely rare cause of Cushing’s syndrome in young children. The intensity of ACTH secretion and hypercortisolaemia is greater in EAS than in Cushing’s disease. Control of hypercortisolaemia represents a key management step while awaiting localization of the ACTH source or in preparation to surgery. Etomidate inhibits cortisol synthesis and its rapid onset of action makes it an ideal medication in severe hypercortisolaem...

Background: Endogenous Cushing’s syndrome (CS) in children remains a challenge to diagnose and exclude. 24-h urinary free cortisol (UFC) measurements are a convenient, non-invasive test for paediatric patients.Objective: To assess the screening accuracy of 24-h UFC measurements in paediatric patients referred to our centre for evaluation of possible CS.Methods: A retrospective review of children referred to our centre between ...

Background: Succinate dehydrogenase B (SDHB) associated disease has been characterised by the presence of extra-adrenal paragangliomas with a high rate of metastatic transformation. There is currently no consensus as to the appropriate surveillance regimes for these subjects. We present the surveillance data from a single UK institution with an SDHB surveillance regime which includes annual MR imaging of the abdomen, biennial imaging of the neck, thorax and pelvis and annual u...

Selective transsphenoidal adenomectomy remains the accepted first line treatment for Cushing’s disease (CD), until recently by microscopic (sublabial) transsphenoidal pituitary surgery. Endonasal transsphenoidal endoscopic surgery is emerging as a novel, less invasive treatment for pituitary adenomas with lower postoperative complications and morbidity. The safety of endoscopic surgery has been extensively reviewed in adult patients and is now considered best practice for...

Introduction: 131I-MIBG is a well-established treatment modality for patients with neuroendocrine tumours (NETs). Our centre has now accumulated over 10 years of experience with 131I-MIBG therapy, with long term data to evaluate effects on disease progress and other long term outcomes following therapy. Bone marrow effects of radionuclide therapy may include prolonged suppression, myelodysplasia or even frank leukaemia. Incidence is thought to be low, but...

Introduction: Bone mineral density (BMD) and fracture tendency are influenced by diet, activity, drugs, and hormones. Recent studies highlight an inverse relationship between serotonin and BMD, of uncertain mechanism.Purpose: We investigated the relationship between serotonin metabolites and BMD in patients with sporadic neuroendocrine tumours (NETs), with and without the carcinoid syndrome.Materials and methods: One-year prospecti...

Background/objective: Published data suggest that growth hormone replacement (GHR) may be safely given to patients with hypopituitarism consequent upon a pituitary/peri-pituitary tumour. However, to date, these series have included a preponderance of patients treated with external pituitary irradiation. We have performed a retrospective study to evaluate the recurrence rate in a group of patients with pituitary/peripituitary tumours treated with GHR.Meth...

ObjectiveActive acromegaly is associated with increased mortality. While surgery is the mainstay of treatment, it is not always curative. In selected cases, CyberKnife stereotactic radiosurgery (CK SRS) can be used as adjuvant treatment in patients with persistent disease.DesignThis is a retrospective review of the biochemical and imaging characteristics for patients with active acromegaly treated with CK SRS...

Introduction: Primary aldosteronism (PA) is both the most common form of secondary hypertension and a high-risk subset associated with increased cardiovascular, cerebrovascular and renal morbidity compared to essential hypertension. Unilateral PA is amenable to surgery, biochemical cure and reversal of this excess risk; whilst bilateral disease is best treated through mechanism-directed medical therapy. Currently, PA subtype classification relies on adrenal venous sampling (AV...