Endocrine Abstracts

29 year old African lady with a background of PCOS and type 2 diabetes, who was under the care of preconception clinic, presented to A&E with sudden onset headache associated with spontaneous closure of right eyelid. CT brain was suggestive of pituitary fossa lesion and pituitary MRI revealed pituitary necrosis. She was diagnosed with pituitary apoplexy and was commenced on appropriate hormone replacement. Examination revealed right complete third nerve palsy and reduced v...

Case history: Our patient is a 64 year old lady who had bilateral adrenalectomy in 1978 for Cushing”s disease. This was followed by radiotherapy in late 1978. To get further reduction of the ACTH producing pituitary adenoma she had transsphenoidal surgery in 1979 and then transfrontal craniotomy in 1982. This was followed by further radiotherapy in 1985. It left her with panhypopituitarism and she was on full hormone replacement. She presented to our hospital in late 2008...

32 year old female presented to her GP following a first trimester miscarriage which consequently resulted in her experiencing secondary amenorrhoea for more than 9 months. Secondary amenorrhoea is defined as cessation of regular menses for 3-6 months or the cessation of irregular menses for 6-12 months. Her main concern was around her subfertility and dry skin. She started menarche at the age of 10 with regular monthly menses until her copper coil insertion 4 years ago. She h...

A 50-year-old female with complex chronic hypoxic congenital heart disease was incidentally identified with a 2 cm extra-vesicular nodule of the bladder during a surveillance ultrasound scan. Suspicious of a bladder carcinoma she uneventfully underwent open partial cystectomy. Histology confirmed a bladder paraganglioma with local lymph node invasion. Post-operative biochemical work-up disclosed raised plasma metanephrine”s: normetadrenaline 7073 pmol/l (120-1180 pmol/l),...

A 58 year old male diagnosed with ‘Parkinson's Disease’ in 2016 following symptoms of Parkinsonism and a DaTscan, was admitted with seizures. He was given Benzodiazepines in the A&E which helped control the seizures. A CT scan of his head revealed Bilateral Basal Ganglia calcification. This was the first time he had seizures, but he did complain of having on and off facial twitching and muscle spasms. There was no history of trauma to the head, fevers, or change ...

Case history: A 68 year old woman was referred to Endocrinology with a history of vomiting, extreme fatigue of acute onset and non-specific visual changes. She had a history of primary hypothyroidism and an adenocarcinoma of the lung with bone metastases initially been treated with pemetrexed and cisplatin chemotherapy. The patient subsequently required palliative radiotherapy for metastatic spinal cord compression and was started on denosumab. Imaging shortly before her refer...

The first case is a 19-year-old male who presented to his GP with lumbar pain, scrotal bruising, and weight loss. Abdominal CT showed a left 6.4 cm x 12 cm suprarenal mass; the right adrenal gland was atrophic. Plasma metanephrines and MIBG were normal. Urinary steroid profile (USP) showed raised 11-deoxycortisol, consistent with adrenocortical carcinoma (ACC). He underwent a left nephrectomy and adrenalectomy. Histology confirmed ACC. The lesion was encapsulated with negative...

Section 1: Case history: 23 Year old Caribbean gentleman attended A&E with several month history of non-specific headaches, changes in memory/mood and joint pains. Since the age of 5 he had been medically treated for renal stones, He had a past medical history of sickle cell trait and was not on any regular medications. There was no significant family history apart from sickle cell disease. He had initial bloods which showed serum adjusted calcium level 3.7 mmol/l and PTH ...

Case history: A 72 year old male was diagnosed with primary lung adenocarcinoma grade T4N2M1b with adrenal and brain metastasis 1 year previously. On diagnosis his tumour was strongly positive for PDL-1 expression. This patient was started on dexamethasone 8 mg once a day that was weaned down to 4mg twice daily and then slowly weaned off steroids whilst receiving whole brain radiation. He was started on pembrolizumab therapy and had received ten cycles of treatment when he beg...