Endocrine Abstracts

Background: Adrenal incidentalomas are classified as adrenal lesions picked up on imaging performed due to reasons other than to look at the adrenals. With cross sectional imaging becoming more frequent, the frequency of adrenal lesions being detected and referred to endocrine services is increasing and dedicated adrenal incidentaloma clinics are being set up to screen these patients for potential pathology.Case: We present a 63 year old lady who underwe...

Background: Knowledge of Cranial Diabetes Insipidus (CDI) is poor amongst healthcare professionals. Intra-nasal Desmopressin sprays are often mistaken for pulmonary inhalers, and Diabetes Insipidus mistaken for Diabetes Mellitus, leading to incorrect management and harm. Correct Desmopressin administration and fluid management is paramount in inpatients, especially in reduced conscious states.Aim: To explore Clinicians’ concerns regarding safety iss...

Case: A 69 year old gentleman with a past medical history of essential hypertension presented to medical services with symptoms of weight loss, muscle weakness and fatigue. Following blood tests, a CT scan, liver biopsy and biochemical screening, a metastatic phaeochromocytoma was diagnosed. He was commenced on alpha and beta blockade. Further imaging, including a MIBG scan, showed non-resectable disease therefore he underwent therapeutic MIBG treatment. Following a good respo...

Introduction: Adrenocortical carcinoma (ACC) is rare, with an incidence of 0.5-2 cases per million. Although generally aggressive, prognosis is highly variable and difficult to predict. Unlike other malignancies, there are no biomarkers routinely available for use in patients with ACC to help guide management. Circulating cell free tumour derived DNA (ctDNA), the proportion of circulating cell free DNA (cfDNA) originating from tumour cells, is a liquid biopsy that is quickly g...

Introduction: The predominant management of beta-thalassemia major is repeated blood transfusions but this runs the risk of haemosiderosis leading to multiple endocrinopathies. Iron chelation therapy can reduce this risk, however universal access is poor. Case Presentation: An 18 year old male with “type 1 diabetes” was referred to Young Adult Diabetes Clinic having arrived to the UK from Syria 10 days previously. The only past medical history ...

Background: When seeing patients with gastroenteropancreatic neuroendocrine tumours (GEP-NETs) in clinic, we noticed that a significant proportion of our patients also had additional primary malignancies. This observation was also raised by patients at our local NET Patient Foundation support group. The idea that patients with GEP-NETs are more prone to additional malignancies is supported in the literature therefore we wanted to determine the proportion of our patients who ha...

Case: A 62 year old man was admitted acutely with right sided abdominal pain. A CT scan with contrast showed an acute right-sided adrenal haemorrhage with adjacent necrotic lymphadenopathy and multiple pulmonary nodules. An MRI, requested to further define the lesion, reported a malignant looking 7.4 cm right adrenal mass with direct focal invasion into the liver and inferior vena cava however no further liver lesions were identified. The images were discussed at the multi-dis...

Background: Pituitary adenomas commonly present with palsies involving the cranial nerves in the cavernous sinus. It is unusual, however, for other cranial nerve palsies to co-present and to have biochemical results that do not fit with the clinical picture.Case: A 47 year old man was admitted with 3 days of headache, vomiting, right sided facial paraesthesia and facial droop. He had no symptoms suggestive of endocrine disturbance. Neurological examinati...

Background: A large proportion of patients who attend the Endocrine clinic have thyroid dysfunction, usually thyrotoxicosis. These patients require regular thyroid function tests (TFTs) and advice on medication dose alteration, usually through frequent clinic appointments. At our University Teaching Hospital, we have a nurse-led system whereby TFT monitoring and advice is managed virtually, with patients usually attending clinic annually for review. We call this the Thyroid Sh...

Introduction: Our knowledge of the genomic background of neuroendocrine neoplasms (NENs) is rapidly expanding with more widespread use of sequencing technologies. Although known to be mutationally quiet compared to some other malignancies, many NENs harbour somatic copy number alterations (SCNAs), however the significance of these are unclear.Aims: We sought to identify SCNAs in a cohort of patients with NENs.Methods: Whole exome s...