Endocrine Abstracts

Thyroid cancer is the commonest endocrine cancer. It is increasingly diagnosed both due to the diagnosis of previously undiagnosed subclinical lesions as well as due to a lesser true increase in incidence. Surgery is the only treatment modality that can cure thyroid cancer and has a key role in the multidisciplinary treatment of the malignancy. The combination of the rarity of the disease and broad spectrum of clinical outcomes has hindered the accumulation of level 1 evidence...

A 60-year-old gentleman of previously good health presented with a 6 months history of resistant hypertension, newly diagnosed Diabetes Mellitus, worsening obesity and proximal muscle weakness. Clinical examination revealed a buffalo hump, truncal obesity, paper thin skin with bruising and proximal muscle wasting. His biochemistry showed elevated midnight cortisol levels, no suppression of cortisol post high dose dexamethasone and an undetectable ACTH. Accompanying abnormaliti...

Background: Post-operative hypocalcaemia affects up to 30% of patients. It may be delayed to the second or third post-operative day and is therefore the key determinant of post-operative stay. Various strategies have been used to overcome this problem including the blanket administration of calcium and discharge followed by daily blood tests.Objectives: To evaluate the use of using a parathyroid hormone (PTH) assay 4 h following surgery as a predictor of...

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...

Leiomyosarcoma is a rare, malignant tumour that can arise from smooth muscle cells anywhere in the body; common sites include uterus, GI tract and retroperitoneum. We report an unusual case of a patient with an adrenal incidentaloma confirmed as a leiomyosarcoma on histology.A 61-year-old Caucasian female was investigated for chronic abdominal pain. CT scan of the abdomen and pelvis did not show any pathology other than an inci...

We present a case of severe thyroid-associated orbitopathy in a 44-year-old man with metastatic follicular carcinoma of the thyroid. He presented with a neck lump, and following further investigations, underwent a hemithyroidectomy followed by a completion thyroidectomy. Histology of the thyroid confirmed widely invasive follicular carcinoma of Hurthle cell type with foci of vascular invasion (pT3 Nx Mx). He received radioactive iodine ablation therapy (3.7GBq), ...

Leiomyosarcoma is a rare, malignant tumour that can arise from smooth muscle cells anywhere in the body; common sites include uterus, GI tract and retroperitoneum. We report an unusual case of a patient with an adrenal incidentaloma confirmed as a leiomyosarcoma on histology.A 61-year-old Caucasian female was investigated for chronic abdominal pain. CT scan of the abdomen and pelvis did not show any pathology other than an inci...

We present a case of severe thyroid-associated orbitopathy in a 44-year-old man with metastatic follicular carcinoma of the thyroid. He presented with a neck lump, and following further investigations, underwent a hemithyroidectomy followed by a completion thyroidectomy. Histology of the thyroid confirmed widely invasive follicular carcinoma of Hurthle cell type with foci of vascular invasion (pT3 Nx Mx). He received radioactive iodine ablation therapy (3.7GBq), ...

A 26-year-old woman presented to the Endocrine clinic with features of Cushing’s syndrome (CS). Investigations revealed a non-suppressible cortisol in low dose Dexamethasone suppression test with a suppressed ACTH, and two positive 24-hour urine cortisol collections, indicating CS. CT imaging revealed a left adrenal adenoma of 3.4 cm. Following a left adrenalectomy, she was discharged on once daily Prednisolone 3 mg. She was well for a year except for one occasion where s...

Section 1: Case: A 42-year-old woman developed central chest pain four hours after undergoing right mastectomy for intraductal breast carcinoma. Serial blood pressures were recorded as significantly elevated, up to 240/130mmHg. There was no history of new-onset headaches, palpitations, anxiety, hirsutism, change in weight or easy bruising. She had no other significant past medical history or family history. Section 2: Investigations : An electrocardiogra...