Endocrine Abstracts

Case report: A 56-year old man presented with a 3 month history of painful bilateral gynaecomastia and sexual dysfunction. Investigations revealed hypogonadotrophic hypogonadism with markedly elevated serum E2, but otherwise normal baseline anterior pituitary function. Tumour markers were negative and adrenal androgens and LFTs were normal. Imaging identified a ∼6 cm right adrenal mass. Preoperative workup excluded phaechromocytoma, but identified low-grade, ACTH-indepen...

Adrenocortical carcinoma (ACC) is a rare and highly malignant tumour with a poor prognosis with an incidence of 1 – 2 per million population per year. We report 2 cases of functioning ACC.Case 1: An 80 yr old with a history of hypertension, paroxysmal atrial fibrillation and cerebrovascular disease presented with leg ulcers, peripheral oedema, tiredness, weight gain, plethora and proximal myopathy. ACTH-independent Cushing’s syndrome was confir...

Carcinoid tumours are the commonest neuroendocrine neoplasms (NET) with a prevalence of less than one person per 100,000 population. The proliferative index (Ki67%) has a prognostic relevance for pancreatic neuroendocrine tumours, however its value in non-pancreatic NET tumours is unclear. Our retrospective audit was done to look at factors affecting survival. Medical records of 96 patients referred to our clinic since 1999 with a diagnosis of NET tumour (excluding pancreatic ...

A 69-year-old woman was admitted with new uncontrolled diabetes, severe hypertension and bilateral leg oedema. Cushing’s syndrome was suspected when she developed resistant hypokalemic alkalosis on diuretic therapy. Detailed questioning also revealed a history of episodic sweating, palpitation and tremor.Investigation & management: ACTH-dependant Cushing’s syndrome was confirmed: Serum ACTH 516 ng/l; urine free cortisol 20 045 nmol/24 h; 09...

Clinical case: 24-year-old student nurse referred to the liver unit with a 6-month history of pyrexia, cognitive dysfunction and abnormal liver function tests. ERCP was normal; CT scan suggested multiple liver deposits; histology showed both fatty infiltration and focal cholangitis. Medical history included type 1 diabetes since age 7yrs; an unusual skin rash that spontaneously remitted 4 years previously; recurrent vulval ulceration, variously ascribed to candida and/or excor...