Endocrine Abstracts

Introduction: Cushing’s disease (CD) is very rare in children and is invariably caused by a corticotroph adenoma. However, corticotroph cell hyperplasia has only been convincingly shown in two previous cases of paediatric Cushing’s disease. We report the case of a 7-year-old boy with Cushing’s disease caused by coticotroph cell hyperplasia.Case report: Our patient presented with a 10-month history of obesity, hirsutism and growth retardati...

Background: Obesity is a common sequel to tumours of the hypothalamic region and their treatment. Weight gain occurs at a rate faster than any expected age-related increase and despite treated hormone deficiencies.Methods: Retrospective review of patients with hypothalamic-pituitary tumours attending a large neuroendocrine clinic in UK.Results: Initial review in 2002 had identified 42 adults with tumours causing hypothalamic damage...

Transsphenoidal surgery (TSS) to resect a corticotroph adenoma is the first-line treatment for Cushing’s disease (CD); remission rates of up to 80% have been reported in cases of microadenomas. Endocrine Society guidelines define post-operative biochemical remission as morning serum cortisol <138 nmol/L within seven days of surgery. Our practice is to use a cut-off of <50 nmol/L at day 3 post-op to indicate biochemical remission. If serum cortisol on day 3 is 50&#...

Aims: To ascertain the incidence of hypo- and hyper-natraemia in patients admitted to a tertiary neurosurgical centre with confirmed spontaneous aneurysmal subarachnoid haemorrhage (SAH), and to determine their impact on length of hospital stay and mortality.Methods: Retrospective case note review of patients admitted between January 2008 and April 2011.Results: 402 patients with SAH were identified [mean (±sd</sma...

Aims: The United Kingdom (UK) guidelines for management of acute pituitary apoplexy recommend the Pituitary Apoplexy Score (PAS) to objectively assess clinical severity of this rare neuro-endocrine emergency. We aimed to apply retrospectively this scoring tool to a large, single centre series of patients with acute pituitary apoplexy, and to determine its applicability in the management of these patients in the acute setting.Methods: Retrospective study ...

Mr DP was referred by palliative care to ophthalmology with anisocoria, diplopia and nystagmus. He was known to have a poorly differentiated carcinoma of the prostate with skeletal metastasis (Gleason score 4+5=9). He was on hormonal therapy and had received radiotherapy to the cervical spine. PSA was normal, at 5.31 μg/l.An MRI scan revealed a 12 mm mass in the left side of the pituitary gland, displacing the stalk to the right and lying close to t...

Introduction: Pituitary adenomas are uncommon in childhood and adolescence and knowledge of long-term outcomes is sparse. We describe a large cohort of patients, now attending our adult clinic.Patients and methods: Retrospective review of patients aged ≤18 years at diagnosis of a pituitary adenoma.Results: There were 24 patients (18 female), mean age at diagnosis 15.6 (range 11–18) years, current age 25.5 (14–47). O...

Background: Pituitary apoplexy is rare resulting from acute haemorrhagic infarction of a pituitary adenoma. Optimal management in the acute stage still remains a matter of debate.Methods: Retrospective analysis of casenotes of patients presenting with acute apoplexy at a single neurosurgical centre between 1984 and 2009 in the United Kingdom.Results: Fifty-five patients (35 males, mean age 52.4 (range 14–78) years, mean years ...

The diagnosis of Cushing’s Syndrome (CS) requires demonstration of excess circulating cortisol. Measurement of late night salivary cortisol (LNSF) has been advocated as a simple, non-invasive and reliable outpatient diagnostic tool for patients with suspected CS but the usefulness of its metabolite cortisone (LNSE) remains unclear. LNSE levels are approximately six times higher than LNSF in saliva due to the rapid action of 11β-hydroxysteroid dehydrogenase type 2 (11...

Introduction: Chordomas are rare slowly growing locally aggressive neoplasms of the bone arising from embryonic remnants of notochord. These tumours typically occur in the axial skeleton and have a proclivity for the spheno-occipital region of the skull base. Parasellar/clivus chordomas account for one third of all chordomas.Methods: We conducted a retrospective chart review of 4 patients with chordomas of the clivus treated in Beaumont Hospital between ...