Endocrine Abstracts

Thymic carcinoma is a rare but aggressive cause of ectopic ACTH secretion, with fewer than 100 reported cases.Hypokalaemic alkalosis was found in a 38 year old woman who presented with a 2-week history of leg swelling, fatigue and dyspnoea. She was not obviously Cushingoid.ACTH-dependent Cushing's Syndrome was confirmed biochemically: urinary free cortisol (UFC) >8500nmol/day and serum cortisol 4060nmol/l, (no suppression on 8...

Phaeochromocytoma in association with hypercortisolism is thought to be rare. However we have observed 4 cases in 3 years and question the rarity of this link. In each case there was a dominant adrenal mass (3.6-7.7cm) with contralateral adrenal hyperplasia. Three of the 4 tumours showed increased 123-I-mIBG uptake. Urinary catecholamines ranged from 872-22752nmol/24h (N < 600). Hypercortisolism was present in all 4 patients; sustained in 2 and cyclical in 2. Case 1 (JCEM ...

Case report: A 68 year old lady was admitted for an elective partial hepatectomy for a solitary metastasis in the liver. Two years ago she had an uneventful colectomy for a colorectal cancer. During induction for her operation she was noted to be hypertensive {blood pressure (BP) 200/120 mm of mercury (Hg)}, though had not been observed to be so previously, and hence her partial hepatectomy had to be abandoned. She was commenced on atenolol and operation rescheduled. The secon...

Case report: A 40-year old male with a background history of autism, severe learning difficulties and childhood Hirschsprung’s disease had been on long-term lithium carbonate therapy, without any history of polyuria or polydipsia. During admission he underwent a subtotal colectomy for malignant colonic polyps. Pre-operative serum urea and electrolytes, glucose and lithium levels were normal. Pre-operative fluid balance was normal. The post-operative period was turbulent; ...

Background: Isolated secondary hypothyroidism is rare. In the majority of cases the causes are genetic (gene mutations) or structural (mass effect or infiltration). Structural causes are usually associated with simultaneous deficiencies of other adenohypophyseal hormones. We present an identical twin with isolated secondary hypothyroidism.Case report: 1st Twin – 26-year-old obese lady, of Afro-carribean origin, presented with tiredness, weigh...

Background: Prolactin is found in serum in different molecular forms, differing in molecular size. Macroprolactin is a complex of prolactin with immunoglobulin and has limited biological activity due to failure to cross capillary wall because of its high molecular weight complex.Objective: To assess the response of the inactive macroprolactin and the biologically active monomeric prolactin, in patients with hyperprolactinaemia, during TRH and metoclopram...

Efficacy and Safety of High Dose Testosterone Therapy in Partial Androgen InsensitivityS. Bandyopadhyay, W.A.Watson, C. M.Park, P. Abraham, S. Philip, S. Acharya , J.S. Bevan. Department of Endocrinology, Aberdeen Royal Infirmary, Aberdeen, AB25 2ZN.INTRODUCTION: There have been few reports of the efficacy and safety of high dose androgen therapy in men with partial androgen insensitivity (PAI). We report on the responses of a p...

The high survival rate for patients with differentiated thyroid carcinoma (DTC) declines markedly in those with bony metastases. We compare the management of two patients with large dominant pelvic metastases.Case 1 63 year old man with R hip pain. Investigation revealed a 10cm lesion in the R hemi pelvis and subsequent imaging and biopsy revealed a 9th rib lesion and metastatic follicular DTC. He underwent 131 I ablation of the normal thyroi...

Objective: To establish the efficacy of CAB as primary and exclusive therapy in the management of macroprolactinomasMethod: Retrospective case note review of all patients with macroprolactinomas treated with CAB since the drug received a UK licence in 1994. Patients: Sixteen patients (8males, 8 females) with mean age at presentation of 42.3yrs (range 22-72 years) were treated with initial CAB doses ranging from 0.5-1mg/week (median 1mg/week). Results: T...