Endocrine Abstracts

Mitotane is an inhibitor of adrenal steroidogenesis with cytostatic activity used in the adjuvant and palliative treatment of adrenocortical cancer. Evidence shows that achieving a therapeutic range of between 14 and 20 mg/l is associated with optimal disease control whereas blood levels above this can result in more severe gastrointestinal and neurological toxicity. Therapeutic drug monitoring is available but in real life achieving and remaining within the ideal range can be...

Adrenocortical carcinomas (ACCs) are a group of aggressive neuroendocrine cancers that affect 1-2 people/million/year (1) and are mostly diagnosed in advanced stages. ACCs have poor overall survival (OS) rates (2). This study aimed to determine potential factors influencing OS of ACC patients in Yorkshire by a retrospective investigation of potential factors and OS of all 30 adult patients with ACC seen at St James University Hospital (SJUH) from 01/01/2000 to 01/10/2021. Anal...

Neuroendocrine tumours presenting in the bronchial or gastrointestinal tract often present with metastatic disease. Whereas well recognised sites of metastases include liver, lymph nodes and bones, they can also arise in unusual locations sometimes causing difficulties in diagnosis. The breast is an uncommon site for neuroendocrine tumour metastasis with estimates that it represents 0.1% of all breast tumours. Due to the low incidence of these neoplasms and due to difficulties...

Cutaneous and subcutaneous metastases are very rare in well differentiated neuroendocrine tumours with a handful of case reports available to date. Head & neck and bronchial NET seem to show this feature most commonly. Such metastases can be very painful and display allodynia (pain occurring on exposure to non-painful stimuli), even if growing very slowly. We describe the case of a young patient who underwent surgical resection of a typical bronchial NET who developed pain...

Introduction: Somatostatin analogues (SSA) are a cornerstone in the treatment of neuroendocrine tumours. Two clinical trials have defined the disease control effect of these treatments; the PROMID study of Octreotide LAR v’s placebo, median time to tumour progression (TTP) 14.2 m v’s 6.0 m, and the CLARINET study (Lanreotide v’s placebo), median progression free survival (PFS) 31 m v’s 18 m. In every day practice, however, many neuroendocrine tumours commen...

The prevalence of bronchial carcinoid, both typical (TC) and atypical (AC), has increased significantly over the past 30 years, most likely as a consequence of better awareness and diagnostic tools e.g. carcinoid specific immunohistochemistry stains. The peak incidence of TC and AC are in the fourth and fifth decades of life respectively. Diagnosis at younger ages is much rarer although carcinoid represents one of the commonest pulmonary tumours in children, teenagers and youn...

A 59-year-old male patient, who is fit and well, presented with abdominal discomfort, night sweats, back pain and lower urinary tract symptoms. The CT scan, organised by the GP, demonstrated a 17 cm heterogenous mass with central necrosis and scattered calcification in right side of abdomen, possibly right adrenal origin or liver or kidney. He was referred to Adrenal MDT. Baseline functional testing showed unsuppressed cortisol level in an overnight dexamethasone, high DHEA su...