Endocrine Abstracts

Teratomas comprise 0.5% of all intracranial tumors. 15 cases of sellar teratoma have been described in the last 24 years (yrs). A 29-yrs female pan-hypopituitaric patient (pt) was admitted to our Pituitary Unit. At 6-yrs age, for polyuria and growth delay, an endocrine evaluation revealed diabetes insipidus and hypopituitarism. Cranial contrasted-MRI (cc-MRI) showed pituitary stalk thickening and a low intensity suprasellar lesion. Histological examination (HE) was suggestive ...

Background: levothyroxine is the most common medication for the treatment of hypothyroidism. Usually, it is capable of restoring euthyroidism in most conditions. Absorption can be challenging, therefore different formulations are available (tablet, soft gel, liquid). Rarely it is necessary to use liothyronine to achieve normal TSH values.Clinical case: a 23 y/o woman was admitted to our outpatient clinic for severe hypothyroidism. She was diagnosed with ...

Pasireotide, a multireceptor-targeted somatostatin analogue, was approved for the treatment of acromegaly, after being studied in two large, randomised, multi-center clinical trials. We reported the history of a 76 years old man affected by acromegaly, treated with Pasireotide long acting release (LAR) as first line therapy. Acromegaly was diagnosed in 2009, as the result of endocrinological investigation suggested by altered facial appearance and macroglossia. Hormonal assays...

Introduction: First-generation SRL (fg-SRL) represent the treatment of choice in acromegaly patients with post-neurosurgical adenomatous remnant and GH-hypersecretion. Anyway, approximately 60% of patients do not achieve adequate disease control. The main predictors of resistance include male sex, young age, invasiveness of the lesion and its hyperintensity on T2-weighted MRI scans; but also, SSTR2 expression, the cytokeratin pattern, Ki-67 and the presence of AIP gene mutatio...

Purpose: Osteopathy is an emerging complication of acromegaly characterized by increased bone turnover, deterioration in bone microarchitecture and high risk of vertebral fractures (VFs). In somatostatin analog (SSA)-resistant patients (pts), Pegvisomant (PegV) and Pasireotide LAR (Pasi) are used for acromegaly treatment, but their effect on skeletal health is still not defined.Methods: In a longitudinal international multicenter study, we evaluated inci...

Introduction: Bilateral sampling of the inferior petrosal sinuses (IPSS) is considerate actually the best diagnostic test for Cushing.Patients and methods: We retrospectively reviewed our series of patients undergone IPSS for Cushing disease and we compared the difference between central and peripheral ACTH gradient in basal condition and after CRH stimulation in cases of localization of the tip of the catheters inside the inferior petrosal sinus or at t...

Aim: To evaluate calcium and bone metabolism in a monocentric series of acromegaly patients (pts), treated with pegvisomant (PEG) alone or in association to long acting somatostatine analogs.Patients and methods: All pts with at least 24 consecutive months PEG treatment (alone or in combination with SSA) were enrolled. All pts had been tested at least twice/year for biochemical acromegaly-disease evaluation and annually for calcium metabolism and for bon...

Introduction: A significant number of GH-secreting pituitary adenomas show an aggressive behavior, therefore, when uncontrolled acromegaly persists, a pharmaceutical combination may improve biochemical control, with reduction of disease morbidity and mortality. We aimed to describe the clinical features of four patients successfully treated with a pharmacological combination of pasireotide LAR, pegvisomant and cabergoline.Case reports: Acromegaly was dia...

Purpose: Primary hypophysitis is a rare disease, with an autoimmune etiology. As few papers have investigated its genetic, our aim was to evaluate HLA status in a single-center series of patients.Patients and method: A retrospective, longitudinal and cross-sectional study was conducted. Consecutive Caucasian patients, with clinical or histological diagnosis of primary autoimmune hypophysitis (PAH), undergone determination of HLA genotype, anti-pituitary ...

Introduction: Pasireotide Lar is a new generation long-acting somatostatin multireceptor ligand, approved for the treatment of first line somatostatin analogue resistant patients. We aimed to review Pasireotide Lar efficacy data, in our series of patients affected by aggressive acromegaly.Patients: A retrospective longitudinal study was conducted on patients with aggressive acromegaly, resistant to first-line somatostatin analogues (SSA) and on treatment...