Endocrine Abstracts

Somatostatin analogues (SSA) have an established role in the medical management of patients with neuroendocrine tumours (NETs). They are effective in the symptomatic treatment of some metastatic NETs and may also provide tumour stabilisation or reduction. We report two patients with disease progression who benefited from SSA. Mrs HW, 64-year old woman, was diagnosed with a grade 1 small-bowel NET with lymph node and liver metastasis in 2012: Ki-67 index < 1%. Despite a seg...

We report a 55-year-old non-smoker with a history of Graves’ disease diagnosed in 1990 at age 29 years old. Due to poor compliance to therapy, she underwent a total thyroidectomy within 1 year of diagnosis. She remained well controlled on thyroid hormone replacement for over 20 years with Levothyroxine 100 μg daily. However, in the two years before referral to the Endocrine Clinic, she had difficult to treat hypothyroidism with persistent over-replacement; at the tim...

We report a 55 year old non-smoker with a history of Graves’ disease diagnosed in 1990 at age 29 years old. Due to poor compliance to therapy, she underwent a total thyroidectomy within 1 year of diagnosis. She remained well controlled on thyroid hormone replacement for over 20 years with Levothyroxine 100 μg daily. However, in the 2 years before referral to the Endocrine Clinic, she had difficult to treat hypothyroidism with persistent over-replacement; at the time ...

54 year old lady presented to the endocrine clinic. She was diagnosed with breast cancer and right ovarian tumour at the same time in August 2015. She had right lumpectomy of breast and Salpingo-Oophorectomy in November 2015. She was not feeling very well for the last few weeks. She complained of extreme lethargy and tiredness. She had blood test done on 15th November 2016 that showed prolactin level at 2849 nmmol/l with negative macroprolactin. Hence, she was referred to the ...

We report a 61-year-old female with a history of bronchiectasis, primary Sjogren’s syndrome and osteoporosis. She had taken oral glucocorticoids initiated by the rheumatologists for 10 years, which were stopped 2 years ago. She was referred to the Endocrine Clinic with a short history of polyuria and polydipsia. Biochemistry confirmed new hypercalcaemia and an acute kidney injury: corrected calcium 3.14 mmol/l, phosphate 1.13 mmol/l and 25-hydroxyvitamin D 66.4 nmol/l. At...

Africo Caribbean gentleman was referred to our endocrine department for management of secondary hypertension. He initially presented to his doctor with headache and he was found to be hypertensive with systolic BP of 200 mmHg and hypokalaemia. A renal MRI showed a right adrenal mass, 2.9×2.4 cm, and echocardiogram showed moderate left ventricular hypertrophy and diastolic dysfunction. He had normal 24 h excretion of metanephrines and free cortisol. An aldosterone renin ra...

Phaeochromocytomas are rare neuroendocrine tumours. Prediction of aggressive tumour behaviour remains a major challenge. We report a 68-year-old female who was found to have a locally arising colonic adenocarcinoma on biopsies. Staging also identified a 10.7 cm right adrenal lesion and work-up revealed markedly raised urinary metanephrines and positive MIBG imaging. The MDT decision was to first remove the colonic cancer with appropriate alpha blockade. It was felt that a comb...

Germline mutations in the succinate dehydrogenase subunit-B gene (SDHB) are well recognised for predisposing to head and neck paraganglioma, sympathetic paraganglioma, phaeochromocytoma and renal cell carcinoma. The co-existence with pituitary adenomas remains uncommon.We report a 31-year-old female who presented at age 29 years old with 9 months of secondary amenorrhoea. Prolactin was 3000 mIU/l and a 1.7-cm macroprolactinoma revealed on MR pituitary. T...

Phaeochromocytoma and paragangliomas (PH/PG) are rare neuroendocrine tumours. Prediction of aggressive tumour behaviour remains a major challenge. The Phaeochromocytoma of the Adrenal gland Scaled Score (PASS) is used to separate benign from malignant lesions with a score > 4 showing potential for biologically aggressive behaviour. Pre-operatively, MIBG together with CT/MRI remain the diagnostic radiological gold standard.We report a 68-year-old fema...

Case history: Ectopic adrenocorticotropic hormone (ACTH) production accounts for 10–20% of all endogeneous Cushing’s syndrome. The ideal treatment is curative surgery of the underlying tumour. In difficult cases bilateral adrenalectomy is an option. We report a 58-year-old woman with an aggressive ectopic Cushing’s syndrome that required bilateral adrenalectomy undertaken in 1989 at age 32-years.Investigations: At 16 years post adrenalecto...