Endocrine Abstracts

Background: Although surgery is considered the first-line treatment for patients with endogenous Cushing’s syndrome (CS), medical therapy is often required to control severe hypercortisolism. Metyrapone and osilodrostat are inhibitors of 11β-hydroxylase that have not been directly compared yet.Methods: Retrospective analysis of patients with adrenocorticotropin (ACTH)-dependent and ACTH-independent CS treated with metyrapone or osilodrostat (as...

BackgroundAgouti related peptide (AgRP) is a neuropeptide, produced by the hypothalamus and by the adrenal glands. AgRP is an antagonist of proopiomelanocortin (POMC) and its principal role is to stimulate appetite. Although current evidences suggest that AgRP levels are influenced by glucocorticoids, it is still not clear, whether they depend on adrenocorticotropic hormone (ACTH) or cortisol. One of the aims of this study was to address this issue. Furt...

Background: Mitotane is regularly used in patients with adrenocortical carcinoma (ACC) adjuvantly, in patients with high risk of recurrence, and in advanced disease. Multiple effects of mitotane result in adrenal insufficiency in virtually all patients. However, it is unclear how frequently the hypothalamic-pituitary-adrenal (HPA) axis is recovering after treatment discontinuation. Here, we aim to investigate the HPA axis after treatment with mitotane.Me...

Introduction: Adrenocortical tumors consist in frequent benign adenomas (ACA) and rare highly malignant carcinomas (ACC). BIRC7/livin gene, a member of the inhibitors of apoptosis family, plays an important role in tumorigenesis in a variety of malignancies. Different studies demonstrated that BIRC7 overexpression represent a risk factor for cancer development and progression. The aim of our study was to evaluate the expression of BIRC7 in normal adrenals and adrenocortical tu...

Introduction: Sporadic neuroendocrine neoplasms (NEN) occur rarely in young-adult (YA) patients, with an estimated incidence is about 2.8 cases per million, and data specific to their epidemiology are limited. The aim of our study was to better characterize the natural history, prognosis and management of NEN in YA patients (≤ 35 years old) compared to adult-elderly (AE; >35 years old).Methods: A retrospective observational study including 204 ...

Introduction: Adrenocortical tumors (ACTs) are usually divided in adenoma (ACA) or carcinoma (ACC) according to histopathologic methods. Some lesions are occasionally difficult to classify according to these criteria. We studied the use of some immunohistochemical markers to recognise the difference between malignant and benign tumors.Materials and methods: We studied 12 patients affected by ACC and 10 by ACA. Clinical evaluation and hormone analysis wer...

Adrenocortical carcinoma (ACC) is a very severe endocrine malignancy with poor prognosis. While cancer immunotherapies have revolutionized the treatment of several cancer entities, the results of initial studies of different immune checkpoint inhibitors in ACC were heterogeneous and clinically substantial responses were observed only in a subset of patients. Expression of immune checkpoint molecules - programmed cell death 1 (PD-1) and its ligand PD-L1 - has been shown to pred...

Objective: Glucocorticoid excess impairs immune function, thereby predisposing patients with endogenous Cushing’s syndrome (CS) to infections. However, it is still not clear whether there is a CS-subtype specific pattern in white blood cell (WBC) and WBC differential (WBCD) count.Methods: Retrospective monocentric cohort study in patients with either overt endogenous CS or adrenal adenomas with autonomous cortisol secretion (ACS), with WBC and WBCD ...

Background: Standard treatment for advanced adrenocortical carcinoma (ACC) is mitotane in monotherapy or combined with etoposide, doxorubicin and cisplatin (EDP), yet biomarkers predictive of treatment response are lacking. Inflammation-based scores were proposed as predictors for gemcitabine+capecitabine efficacy, used as second-line in progressive ACC. We investigated the role of inflammation-based scores in predicting response to first-line treatment in advanced ACC.<p ...

Background: Molecular mechanisms of malignant adrenocortical tumorigenesis remain elusive despite previous comprehensive genomic studies. Nonetheless, cellular heterogeneity of primary, recurrent and metastatic adrenocortical carcinoma (ACC) haven’t been fully investigated.Aim: To characterize the molecular profile of different cell subtypes in primary, recurrent and metastatic ACC by single-nuclei RNA sequencing (snRNA-Seq), using adult human norma...