Endocrine Abstracts

Medullary thyroid cancer (MTC) accounts for 5–10% of all thyroid cancers and can be either sporadic (75%) or familial (25%). Familial MTC is associated with hereditary syndromes such as Multiple Endocrine Neoplasia (MEN) type 2A or 2B and Familial Medullary Thyroid Cancer (FMTC). Sporadic MTC most often present as thyroid nodule and fine needle aspiration cytology combined with elevated plasma calcitonin levels is diagnostic in about 90% of cases. Hereditary forms of MTC ...

Primary Hyperparathyroidism (PHPT) is, after diabetes and thyroid diseases, the third commonest endocrine disorder and its incidence and prevalence is rising globally. In the United Kingdom, the incidence of PHPT has been estimated to be 25/100,000, and prevalence has risen from 1.8 to 6.7 per 1000 between 1997-2006, implying that in the UK alone, about half a million people suffer from this condition and 12.000 develop it each year. Recognition of increased PHPT related morbi...

Genetic testing for RET gene was available in the United Kingdom within few years of its discovery, undoubtedly another bonus of universal, nationwide health care system. It was the beginning of Precision Medicine era, which became a watchword for preventative and personalized treatments based on phenotypic, biomarker and genetic characteristics. Surgical Precision on the other hand is an idiom for doing something very well and with meticulous attention to detail. In my presen...

Introduction: Correlation of papillary thyroid cancer and lymphocytic thyroiditis is well documented but the incidence of thyroid malignancies in Graves’ disease especially in the absence of nodular thyroid disease is considered to be uncommon.Method: We conducted a retrospective audit of forty-four patients with established diagnosis of Grave’s thyrotoxicosis treated with total thyroidectomy from 2010-2013 (36 months), in a tertiary care centr...

Case: A 50-years-old gentleman underwent cardiac surgery which was complicated by postoperative arrythmias and ischemic stroke. He was found to have raised calcium of 2.9 (2.2–2.6 mmol/l) subsequent to which PTH was tested and found to be raised at 34.2 (1.6–6.9 pmol/l) which increased to 41.2 pmol/l in few days. He was referred for work up and management of primary hyperparathyroidism. An USS of the neck showed 1.5 cm nodule posterior to left thyroid lobe and Sestim...

Introduction: Genetic testing for Familial Endocrine Syndromes has an important role in diagnosis, timing/extent of surgery, and follow-up. Our survey explored experiences and attitudes towards genetic testing in the UK and Abroad.Methods: Attendees of 2022 Conferences of ESES, BSPED, SfE, BAETS and AsianAES were asked to participate in an online survey (31 questions on demographics; genetic testing availability and expe...

Background: Patients with hypoparathyroidism require frequent calcium measurements and currently there is no point of care device allowing this to be done at home by patients themselves. The aim of our study was to evaluate whether ionized calcium(iCa) can be accurately measured in venous and capillary blood and saliva by a repurposed device LAQUA.(R&D Ref 18/0058– IRAS 236079)Methods: Patients undergoing thyroid and parathyroid surgery underwen...

Introduction: PHPT is reported to be rare in pregnancy, with 150 cases described in the literature. Its incidence is 8/100 000 in childbearing women/year. PHPT may lead to a loss of up to 50% of pregnancies through miscarriage or stillbirth, dehydration, hyperemesis, nephrolithiasis, pre-eclampsia, fractures and pancreatitis in mothers; and death, hypocalcaemia and tetany in neonates. Intrauterine growth retardation, low birth weight and pre-term labour were described. Rate of...

Successful surgery for pancreatic neuro-endocrine tumours (NET) requires accurate tumour localisation. Interpretation of cross-sectional imaging is often difficult, particularly after pancreatic surgery. Imaging by somatostatin-receptor-scintigraphy with indium-labelled octreotide may be useful in identifying recurrent disease; however, octreotide scans may be negative in some pancreatic NET, due to a low level of expression of somatostatin receptors. The GLP-1 receptor is abu...

Introduction: Histology is a poor predictor of the malignant potential of phaeochromocytomas and paragangliomas (PPGL) and only the presence of distant metastasis confirms malignancy. This study reviews patterns of recurrence, treatment and mortality in patients with malignant PPGL presenting to our department at UCLH over 30 years.Materials and Methods: In our series of 128 patients with PPGL, 26 (20%) with maligna...