Endocrine Abstracts

Case history: Cyclical Cushing’s is a very rare disease with rhythmic fluctuations in cortisol production with or without phenotypic features. It is a very challenging entity to diagnose. The low index of clinical suspicion is key for timely diagnosis and prevention of long-term complications. A 66 years old male presented with intermittent, episodic bilateral leg swelling and reversible weight gain of ˜6 kg following these episodes. Background history entailed femor...

Background: It is generally accepted that a post-operative cortisol of <50 nmol/l is a good predictor of long-term remission following trans-sphenoidal surgery (TSS).Aim: We wished to determine the rate of late recurrence and need for consequent intervention in patients who had initial biochemical remission after TSS for pituitary dependent Cushing’s.Methods: We performed a retrospective analysis of our patients who underw...

Introduction: In 2017 the term ‘Atypical adenoma’ was removed from the WHO classification, and ‘High-risk adenomas’ was introduced as a term to classify those with rapid growth, radiological invasion, and a high Ki-67 proliferation index. In this retrospective cohort study we have sought to identify the clinical and histological characteristics which are associated with worse outcomes.Methods: Data: We created a dataset of 1793 pa...

Background: Pituitary metastases are a rare complication of systemic malignancy. The most common presentations of pituitary masses include visual field defects, headaches, and hypopituitarism, but cranial nerve palsies and diabetes insipidus are also recognised although unusual. We aimed to determine if these were more frequently associated with pituitary metastasis.Methods: We conducted a review of 944 patients undergoing pituitary surgery from a teachi...

Background: Cushing’s disease is caused by corticotroph tumours of the pituitary gland and the standard first-line treatment is trans-sphenoidal surgery. Published data from other centres describes post-operative endocrine remission achieved in 50–90% of cases.Table 1 Remission (cortisol <50)Cortisol (50–150 nmol/l)<td alig...

Temozolomide has an established role as first line chemotherapy for aggressive pituitary adenoma and carcinoma. There are mixed reports whether the MGMT (methylguanine methyltransferase) and mismatch repair protein (MSH2/6) status of a tumour, assessed by immunohistochemistry (IHC) can predict response to temozolomide. This is the first series to assess combined MGMT and MSH2 status. We analysed a retrospective case series of patients treated with temozolomide at our tertiary ...