Endocrine Abstracts

Somatotroph adenomas (SA) causing acromegaly are histologically classified into densely (DG) and sparsely granulated (SG) subtypes. We1 and others have shown that these histological subtypes may be clinically relevant. In short, SGSAs are generally found in younger, mainly female patients. They are larger at presentation, more invasive and show higher proliferation indices compared with DGSAs. Fibrous bodies (FBs) are the histological hallmark of SGSAs; they consist...

Somatotroph adenomas (SA) causing acromegaly exist as two major pathological variants: densely and sparsely granulated, according to the number and distribution of growth-hormone-containing secretory granules. These variants are increasingly recognised by neuropathologists and endocrinologists, but the consequences for tumour behaviour and patient outcome remain to be defined. Sparsely granulated SAs are associated with younger, female patients and are more invasive and prolif...

This 22 year old lady presented with Haemophilus Influenza meningitis. Given an unusual organism, she had an MRI which revealed an incidental pituitary macroadenoma extending into the right cavernous sinus and breaching the anterioinferior wall of the pituitary fossa. Thyroid function showed raised T4 (24.7 pmol/L) and T3 (8.3 pmol/L) with unsuppressed TSH (1.75 munit/L). IGF-1 was also raised at 56.7 nmol/L (12–50.1 nmol/L).<p c...

This 22 year old lady presented with Haemophilus Influenza meningitis. Given an unusual organism, she had an MRI which revealed an incidental pituitary macroadenoma extending into the right cavernous sinus and breaching the anterioinferior wall of the pituitary fossa. Thyroid function showed raised T4 (24.7 pmol/L) and T3 (8.3 pmol/L) with unsuppressed TSH (1.75 munit/L). IGF-1 was also raised at 56.7 nmol/L (12–50.1 nmol/L).<p c...

We present a case of 71-year-old gentleman who presented with bitemporal hemianopia in 2008 with pituitary apoplexy compressing the optic chiasm. Prolactin was 55287MU/l, with deficiency of all other anterior pituitary hormones. He underwent transphenoidal adenectomy (TSA). Prolactin was 35633MU/l post-operatively and cabergoline was commenced. Histology was consistent with a lactotroph adenoma with MiB-1 index of 3–5%. Visual fields recovered and prolactin was normal unt...

Somatotroph adenomas causing acromegaly are histologically classified into densely and sparsely granulated subtypes and an intermediate, mixed type. Although the different subtypes are not currently taken into account when making decisions about the management of acromegaly, there is growing evidence that the subtypes represent clinically different entities.In a cohort (n=52) of somatostatin-naïve patients with acromegaly, sparsely granulat...

Craniopharyngiomas are tumours which grow in the region of the sella, with adamantinomatous (ACP) and papillary (PCP) subtypes. While usually ‘benign’, They can have devastating long term sequelae, both from the mass effects of the tumour itself on the visual, pituitary or hypothalamic pathways, but also from the neurosurgical challenge to achieve tumour control with preservation of the surrounding pituitary and hypothalamic pathways. To date there is no satisfactory...

Background: Recently, germline mutations in the aryl-hydrocarbon-receptor-interacting-protein (AIP) gene have been found to occur in familial and sometimes in early onset sporadic somatotroph adenomas. These tumours tend to respond less well to somatostatin analogues (SSA). It has been shown previously that AIP can upregulate the transcription factor Zac1 in liver cells, and we were able to also demonstrate this in pituitary cells. On the other hand, Zac1 is upregulated in res...

Background: Rathke’s cleft cysts (RCC) are benign, cystic lesions arising from remnants of Rathke’s pouch and reported in 13–22% of normal autopsies. Their prognosis after surgical intervention is not clearly defined.Aim: To analyse the outcome of patients who presented to our Department with RCC between 1/1977-3/2009.Patients and methods: Thirty-three cases were identified [13 males/20 females, median age at diagnos...

Background: Data on the relationship between the hormonal response to somatostatin analogues and morphological subtype of somatotroph adenomas are sparse. We have previously shown that nadir GH <1.75 μg/l on the octreotide suppression test (OST) has positive and negative predictive value 94 and 100%, respectively in predicting achievement of ‘safe’ GH levels following treatment with octreotide LAR (Karavitaki et al. 2005).Aim: T...