Endocrine Abstracts

Adrenocortical carcinoma (ACC) is a rare and highly malignant tumour with a poor prognosis with an incidence of 1 – 2 per million population per year. We report 2 cases of functioning ACC.Case 1: An 80 yr old with a history of hypertension, paroxysmal atrial fibrillation and cerebrovascular disease presented with leg ulcers, peripheral oedema, tiredness, weight gain, plethora and proximal myopathy. ACTH-independent Cushing’s syndrome was confir...

Bilateral laparoscopic adrenalectomy is a treatment option for ACTH-dependent Cushing's syndrome after failed pituitary surgery (Cushing's disease) or when the ACTH source cannot be resected or localized (ectopic ACTH syndrome). It has not, to our knowledge, been reported in the treatment of ectopic ACTH secretion in patients with small cell lung cancer.A 47 year old presented with haemoptysis and a right hilar mass, biopsy of which confirmed inoperable ...

A 69-year-old woman was admitted with new uncontrolled diabetes, severe hypertension and bilateral leg oedema. Cushing’s syndrome was suspected when she developed resistant hypokalemic alkalosis on diuretic therapy. Detailed questioning also revealed a history of episodic sweating, palpitation and tremor.Investigation & management: ACTH-dependant Cushing’s syndrome was confirmed: Serum ACTH 516 ng/l; urine free cortisol 20 045 nmol/24 h; 09...

Case report: A 56-year old man presented with a 3 month history of painful bilateral gynaecomastia and sexual dysfunction. Investigations revealed hypogonadotrophic hypogonadism with markedly elevated serum E2, but otherwise normal baseline anterior pituitary function. Tumour markers were negative and adrenal androgens and LFTs were normal. Imaging identified a ∼6 cm right adrenal mass. Preoperative workup excluded phaechromocytoma, but identified low-grade, ACTH-indepen...