Searchable abstracts of presentations at key conferences in endocrinology

ea0062p30 | Poster Presentations | EU2019

A dangerous master of disguise – An undiagnosed phaeochromocytoma presenting with pulmonary haemorrhage

Anandappa Samantha , Bakhit Mohamed , Diaz-Cano Salvador , Lewis Dylan , Ogunko Arthur , Whitelaw Benjamin

Case history: A 39 year old female had a first admission to her local hospital with cough and haemoptysis. She reported palpitations for the previous 6 months and had been previously investigated with an echocardiogram which showed a normal LV function. There was no other past medical history. During this first admission CT Pulmonary Angiogram (CTPA) demonstrated ground-glass opacifications. She was hypertensive and so a 24 hour urine sample was collected for metanephrines but...

ea0025p327 | Thyroid | SFEBES2011

Management of hyperfunctioning thyroid malignancy with psychiatric co-morbidity

Till David , Gilbert Jackie , Lewis Dylan , Crane James , Aylwin Simon , McGregor Alan

A 70-year-old female with known schizophrenia presented in hyperthyroid crisis. Examination revealed muscle wasting, tremor, sweating, low-grade fever, and sinus tachycardia. Biochemistry confirmed the diagnosis (TSH <0.1 mlU/l, thyroxine 41 pmol/l (9–25), tri-iodothyronine 25 pmol/l (3.5–6.5)). The patient was commenced on i.v. esmolol and carbimazole (40 mg) crushed into warm milk.However, lacking mental capacity, and refusing to take all...

ea0055oc3 | National Clinical Cases | SFEEU2018

Hyperprolactinaemia resistant to dopamine agonist due to an ectopic source of prolactin arising from a Uterine Tumour Resembling Ovarian Sex Cord Tumours (UTROCST)

Bakhit Mohamed , Arshad Sobia , Bidmead John , Haq Masud , Lewis Dylan , Diaz-Cano Salvador , Aylwin Simon J. B.

Introduction: Moderate hyperprolactinaemia occurring in a patient with a normal pituitary MRI, assuming macroprolactin and stress are excluded, is generally considered to be due to a lesion below the level of detection of the MRI scanner. Most patients with mild-moderate hyperprolactinaemia and a normal MRI respond to dopamine agonist therapy. We describe a patient who had prolactin elevation typical of a prolactin-secreting macroadenoma, but with a normal MRI, and in whom the...

ea0038p398 | Steroids | SFEBES2015

Discrimination of adrenocortical carcinoma from other adrenal lesions: use of a new 13 steroid serum panel based on LC–MS/MS

Taylor David , Ghataore Lea , Vincent Royce , Sherwood Roy , Whitelaw Ben , Dworakowska Dorota , Schulte Klaus-Martin , Diaz-Cano Salvadore , Lewis Dylan , Aylwin Simon , Taylor Norman

Adrenocortical carcinoma (ACC) is a rare malignancy, but accounts for up to 11% of adrenal masses investigated in referral centres. Diagnosis remains a challenge. Up to two thirds are biochemically inactive, resulting from de facto enzyme deficiencies in the steroid hormone biosynthetic pathways, as shown by urine steroid profiling by gas chromatography-mass spectrometry. Increased metabolites of pathway intermediates in ACC discriminate it from benign adrenal lesions...

ea0031p57 | Clinical practice/governance and case reports | SFEBES2013

Initiation and maintenance of mitotane as adjuvant therapy for adrenocortical cancer: a single centre experience

Whitelaw Benjamin , Mustafa Omar , Coskeran Patsy , Prague Julia , Kordbacheh Tiana , Lewis Dylan , Diaz-Cano Salvador , Sherwood Roy , Gilbert Jackie , McGregor Alan , Aylwin Simon

Background: Mitotane is an adrenolytic chemotherapy, currently accepted as first line adjuvant therapy in adrenocortical carcinoma. Mitotane has a narrow therapeutic window. Serum levels of >14 mg/l are required to achieve a cytotoxic effect and levels of >20 mg/l are potentially toxic. There are two strategies for mitotane initiation: a low-dose regimen (3 g) and a high-dose regimen (increase to 6g/day over 4 days and reduce to 4.5 g/day after 10 days).<p class="...

ea0028p148 | Neoplasia, cancer and late effects | SFEBES2012

Radiological diagnosis frequently precedes clinical suspicion and biochemical confirmation in phaeochromocytoma: a pilot series

Prague Julia , Lewis Dylan , Kane Pauline , Vivian Gill , Whitelaw Benjamin , Ramasamy Shamin , Vincent Royce , Schulte Klaus-Martin , McGregor Alan , Aylwin Simon

Background: Kopetschke et al. (2009) suggested that nearly thirty per-cent of adrenal/extra-adrenal phaeochromocytoma were found incidentally1. However, they included cases from 1973 to 2007, whereas in the modern era CT and MR investigations are requested more frequently and earlier in the diagnostic algorithm.Methods: We report a pilot series of consecutive referrals to a tertiary centre for adrenal and extra-adrenal phaeochromocytoma from July ...

ea0031p107 | Clinical practice/governance and case reports | SFEBES2013

Unusual presentations of adrenocortical tumours

Mustafa Omar , Whitelaw Ben , Jenkins Rebeka , Kordbacheh Tiana , Salaris Paola , Manu Chris , Taylor Norman , Sherwood Roy , Vivian Gill , Lewis Dylan , Schulte Klaus-Martin , Diaz-Cano Salvador , Gilbert Jackie , McGregor Alan , Aylwin Simon

Background: Adrenocortical tumours (adenoma or carcinoma) present in well-recognised ways: hormones excess (Cushing’s, Conn’s, virilisation) or hormonally silent with symptoms of mass effect, or found incidentally on imaging. We present 3 cases of adrenal tumours, referred to our regional adrenal multidisciplinary meeting with unusual presenting features.Case 1: post-menopausal bleeding: A previously well 57-year-old female presented with vagin...

ea0056p41 | Adrenal cortex (to include Cushing's) | ECE2018

Outcomes of patients undergoing surgery for primary aldosteronism based on adrenal venous sampling and/or radiological lateralisation indicate a role for both modalities in case selection

Davis Lauramay , Lewis Dylan , Clough Jennifer , Whitelaw Benjamin C , Gilbert Jackie , Diaz-Cano Salvador , Taylor David R , Vincent Royce P , Hubbard Jonathan , Galata Gabriele , Schulte Klaus-Martin , Aylwin Simon J B

Background: Adrenal venous sampling (AVS) is considered the gold standard for lateralisation of aldosterone production in patients with primary aldosteronism (PA). However, in some patients AVS is not technically successful and management may depend on radiological findings.Aim: To determine 1) the success rate of AVS and 2) the outcomes after surgery related to the lateralisation modality.Method: 156 patients were included who pre...

ea0056p140 | Endocrine tumours and neoplasia | ECE2018

Achievement of therapeutic mitotane concentrations in management of advanced adrenocortical cancer: a single centre experience in 47 patients

Bakhit Mohamed , Whitelaw Benjamin C , Gilbert Jackie , Coskeran Patsy , Diaz-Cano Salvador , Taylor David R , Taylor Norman T , Ghatore Lea , Lewis Dylan , Vivian Gillian , Sarker Debashis , Ross Paul , Davis Laura May , Clough Jennifer , Hubbard Johnathan G , Galata Gabriele , Prachalias Andreas , Schulte Klaus-Martin , Aylwin Simon J B

Introduction: Multi-modal therapy for adrenocortical carcinoma (ACC) includes surgery, therapy with the adrenolytic agent mitotane and systemic chemotherapy. Achievement of therapeutic mitotane concentrations (≥14 mg/l) has been related to improved outcomes.Aim: To evaluate the effectiveness of a defined* high dose protocol mitotane therapy in patients with advanced ACC (stages III and IV).Methods: Review of patients presenti...