Endocrine Abstracts

Disruption of the normal cell cycle is one of the most frequent alterations in tumour cells, contributing to uncontrolled cell proliferation during tumour development. The CDK inhibitor p27 plays a pivotal role in controlling cell proliferation during development and tumourigenesis, and has been implicated in tumorigenesis in rats. Previous studies have demonstrated changes in p27 protein expression, in human pituitary tumours,especially in corticotroph tumours, where p27 prot...

Aim: Clinical acromegaly is characterized by high GH secretion in the presence of high circulating IGF-I levels. We therefore hypothesized that the physiological IGF-I-GH negative feedback loop may be reset in somatotroph adenomas, and we investigated the role of type 1 IGF receptor (IGF-R) and GH receptor (GHR) by quantifying mRNA expression in somatotroph tumours, and investigated the possible presence of mutations of the GHR gene.Methods: Pituitary t...

The opportunity to study the effects of prolonged fasting is rare. In this study we recorded anthropometric, biochemical and endocrine changes during the refeeding period following a 44 day fast, and compared them with results from 16 age-, sex- and body mass index (BMI)-matched controls.The index subject took only water to drink during the fast. He lost 24.5kg changing his BMI from 29 to 21.6. He underwent careful slow refeeding for the first 4 days usi...

Hyperprolactinaemia in the presence of pituitary tumour can occur from tumour secretion or from stalk compression causing loss of dopaminergic inhibition. It is generally accepted that, in the presence of a large pituitary mass, a serum prolactin level up to 3000mU/l indicates stalk compression rather than a prolactinoma; the clinical diagnosis of prolactinoma depends on the degree of hyperprolactinaemia in the context of pituitary tumour size. Our aim was to examine more form...

The results of transsphenoidal surgery for acromegaly by a single neurosurgeon (MP) operated between 1981 and July 2002 were examined retrospectively. 141 database and case note records for patients with a clear pre-operative diagnosis of acromegaly were reviewed. Patients with incomplete pre- or postoperative data on growth hormone (GH) status were excluded from further analysis (n=14). The remaining 127 formed the audit group.Pituitary imaging data was available in 84 of...

Large corticotroph adenomas are uncommon pituitary mass lesions, representing around 10% of cases of Cushing's disease, and are often found to be locally invasive. 'Silent' corticotrophinomas stain for ACTH, but do not secrete sufficient ACTH to cause Cushing's disease. We describe a patient with an unusual mass presentation of a pituitary adenoma in whom there was also a marked discrepancy between the clinical and laboratory findings in the assessment of suspected Cushing's d...

Pituitary apoplexy is a rare condition caused by haemorrhage or infarction into a pituitary tumour. The majority of patients do not have any identifiable triggering event, although situations altering the blood flow to the pituitary gland and pre-existing systemic hypertension have been identified as potential causal factors.We retrospectively reviewed the presentation and outcome of 15 patients with pituitary apoplexy (8 men, 7 women; age 16-87, mean 5...

Late onset Cushing’s disease, occurring years following the diagnosis of a silent corticotroph adenoma (SCA) is rare, with very few previously reported cases. We present a series of 5 subjects with SCA, aggressive tumour recurrences and late onset Cushing’s disease.The mean age of subjects at initial presentation was 41 yrs (35–52), sex 3:2 (M:F). There were no clinical features of hypercortisolism at diagnosis. Two subjects had hypocortis...

We report two patients (AB 41 years, LS 55 years) presenting with symptoms of hyperprolactinaemia. Prolactin levels were moderately elevated: 1539 (AB), 1186 (LS) (NR 59-619 mU/L). The remainder of the pituitary profile was normal. Neither patient had visual field defects. MRIs (without contrast) reported pituitary macroadenoma with suprasellar extension but no optic chiasm compression. The initial diagnosis was of probable non-functioning adenoma causing stalk compression. Bo...

A 32 year old man with a history of epilepsy since childhood presented in 1992 with a grand mal seizure and clinical features of tuberous sclerosis (TSC). One year later he was referred with classical Cushingoid features. His serum Na was 140 mmol/l, K 3.4 mmol/l, 9 AM cortisol 1018 nmol/l with lack of diurnal variation and ACTH 42-50 ng/l. Urinary cortisol: 797 nmol/24 h. After overnight, low and high dose dexamethasone suppression, cortisol was 1018, 1154, and 62 nmol/l resp...