Endocrine Abstracts

Introduction: The management of large non secreting adrenal tumors (at least 4 cm) is still a matter of debate as it is unclear whether imaging, especially 18F-FDG, can be used to characterize their potential malignancy. Moreover, the risk of new hypersecretion in non-operated tumors is uncertain. Our aim was to better characterize these large adrenal incidentalomas.Methods: Patients followed in our Center for a non-secreting large (at least 4 cm) adrena...

With the early management of medullary thyroid carcinoma, multiple endocrine neoplasia type 2 has become an example of chronic disease with prolonged follow-up to look for pheochromocytoma diagnosis and appropriate management. In any genetic disease where pheochromocytoma can happen bilaterally, the surgery has long been based on bilateral adrenalectomy (even in the presence of a single pheochromocytoma), and as a consequence on a life long treatment for adrenal insufficiency....

Surgery remains the first line treatment of Cushing’s disease. However, recent studies based on long term follow-up showed that the risk of late recurrence was close to 20–30% cases, whatever the immediate post-surgical cortisol level. In other cases, surgery is not possible due to contra-indications, or refusal by the patient. Medical treatment is thus of major importance in the management of Cushing’s disease, also taking into account the delay to obtain maxim...

Transsphenoidal neurosurgery is the gold standard treatment for pituitary adenomas; however, it can be contra-indicated or ineffective. In these cases, medical treatment based on somatostatin analogs or GH receptor antagonist, can be used. Another approach is to use radiation therapy.Stereotactic radiosurgery (SR) is a procedure aiming at controlling hormone hypersecretion and tumor size of pituitary adenomas. This talk will mainly deal with the long-ter...

Background: Multiple endocrine neoplasia type 2 associated medullary thyroid carcinoma (MTC) is driven by a strong genotype-phenotype correlation, the risk of aggressiveness being defined by the germline RET pathogenic variant (American Thyroid Association (ATA) guidelines). Based on this classification, the germline c.2370G>C, p.Leu790Phe (L790F) RET variant is considered to be of moderate risk of aggressive MTC, while the germline c.2753T>C, p.Met918Thr (M9...

Context: Following the recent evolution in therapeutic strategies for GH-secreting pituitary adenomas, determining optimal individualized patient management is now crucial.Objective: To determine whether pre-surgical medical treatment (PSMT) in patients with acromegaly improves surgical outcome and to specify thresholds for such a strategy.Methods and design: This retrospective study included 110 newly diagnosed acromegalic patient...

Aim and methods: Cortisol substitution in adrenal insufficiency (AI) is a matter of debate. We performed a pharmacokinetic analysis of plasma and salivary cortisol following oral hydrocortisone intake in patients with AI, and a pharmacokinetic modelling simulation. Fifty patients with primary (n=20) or secondary (n=30) AI were recruited. After 24-h plasma and salivary cortisol measurements under usual hydrocortisone treatment, a pharmacokinetic modelling with dif...

Objective: To analyze characteristics of patients who had surgery for a GH-secreting adenoma in the past decade in our centre, to evaluate their initial outcome and long-term recurrence rate using stringent criteria and identify potential predictive factors of surgical remission.Methods: This retrospective study included 115 consecutive patients with acromegaly operated at the neurosurgical department of the Timone Hospital Marseille between 1997 and 200...

Aim of the studyA relative can be an asset in dealing with chronic illnesses such as acromegaly where quality of life is altered even after remission. However, it has been shown that quality of life of caregivers can also be impacted. Our main objective was to explore the consequences of acromegaly in remission in the patient-relative dyad in a matter of quality of life and self-esteem.MethodsIn this French m...

Background: Medical treatment with cortisol-lowering drugs is commonly used following pituitary surgical failure or recurrence of hypercortisolism in patients with Cushing’s disease (CD). Studies using late-night salivary cortisol (LNSF) measurement have shown persistent disruption of the circadian secretion of cortisol despite normalization of UFC in a subset of medically treated CD patients. Study aim Our objective was to assess the long-term cortisol exposure in CD pat...