Endocrine Abstracts

Introduction: Perhaps due to a current global epidemic of “overdiagnosis”, papillary thyroid microcarcinoma (PTM) is now the commonest endocrine malignancy (BMJ 348: 3045, 2014). Current management options vary from lobectomy or total thyroidectomy to “active surveillance”. An alternative approach, used successfully for eliminating neck nodal metastases (JCEM 96: 2717, 2011), is ultrasound-guided percutaneous ethanol ablation (UPEA). Here we present our exp...

History: A 36 year old gentleman was referred to the endocrine clinic with symptoms of fatigue, absent libido and erectile dysfunction. He had a previous history of pulmonary sarcoidosis in 2000 and he was taking no medications. Examination revealed a known Right sided Horner’s syndrome and no other abnormality.Investigations: Testosterone 1.8 nmol/l, FSH and LH<0.5, Prolactin 798 mU/l, Cortisol 507 nmol/l, ACE 67 (47–60 IU/l), CSF protein ...

Objectives: To assess the gonadotrophin suppressive effects of 2 doses of nomegestrol acetate (NOMA) alone and in combination with testosterone enanthate (TE) in men.To evaluate the potential effects of NOMA on circulating lipids in menMethods: Twelve healthy male volunteers were recruited. Subjects were randomly allocated to receive either NOMA 5 milligrams or NOMA 10 milligrams orally daily. Study duration included 28 days treatm...

Objective: To identify the optimal regime for physiological replacement in hypogonadism. We assessed the pharmacokinetics of 3 different dose-intervals for i.m. administration of the new parenteral formulation of testosterone undecanoate in castor oil (Schering AG Berlin).Methods: Ten hypogonadal subjects (primary n equals 4 or secondary n equals 6) with a baseline T at diagnosis of less than 7 nanomols per litre were recruited and randomly allocated int...

Background: Multiple Endocrine Neoplasia Type 1 (MEN1) is a rare autosomal dominant syndrome that predisposes individuals to multiple endocrine tumours, predominantly affecting the parathyroid, anterior pituitary and pancreatic islet cells. This unusual case shows features of three of the main MEN1 tumour types, yet genetic testing was negative for the MEN1 mutation.Case esentation: A 56-year-old lady first presen...

Background: Multiple Endocrine Neoplasia Type 1 (MEN1) is a rare autosomal dominant syndrome that predisposes individuals to multiple endocrine tumours, predominantly affecting the parathyroid, anterior pituitary and pancreatic islet cells. This unusual case shows features of three of the main MEN1 tumour types, yet genetic testing was negative for the MEN1 mutation.Case esentation: A 56-year-old lady first presen...

A 59 year old woman was referred for further management of Cushings syndrome confirmed in another hospital. Presenting features included proximal myopathy, hypertension and hypokalaemia. Corticotrophin releasing hormone testing suggested an ectopic ACTH source.Within 48 hours of admission for petrosal sinus sampling, the patient acutely deteriorated with type 1 respiratory failure requiring ventilatory support. A chest radiograph and computed tomography scan revealed a rig...

Background: To determine whether radioiodine remnant ablation (RRA) reduces cause-specific mortality (CSM) or tumor recurrence (TR) rates after bilateral thyroidectomy (BT) in low-risk adult papillary thyroid carcinoma (APTC) patients treated with curative intent, we compared outcome in 1836 stage I patients having BT alone with 832 having BT+RRA.Methods: THEN cohort (1966-1990) comprised 809 patients; 36% having RRA within 6 postoperative months. NOW co...

Objectives: Childhood papillary thyroid cancer (CPTC) often presents with advanced disease but rarely results in cause-specific mortality (CSM). Controversy remains regarding optimal management and association with non-thyroid second primary malignancies (NSPM). We analyzed outcome in 189 CPTC patients and assessed the influence of radioiodine remnant ablation (RRA) and the utility of the American Thyroid Association risk-groups (ATA-R) in predicting tumor recurrence (TR)....

Background: UPEA for LRR in PTC was introduced in 1993 (JCEM 96:2717, 2011). It is not appreciated that such non-invasive ablations can often be repeated over decades (Surgery 154:1448, 2013). Skin metastases (SM) from thyroid carcinoma are typically associated with disseminated disease; average survival after SM diagnosis is 19 months (JAAD 36:531, 1997). Our case provides insights into managing LRR and SM in LRPTC.Clinical case: In 2004, an open biopsy...