Endocrine Abstracts

We report two patients with thyroid nodules where thyroid cancer has unexpectedly been found. The first patient presented at the age of 58 years with a lump in her neck. She was clinically and biochemically euthyroid. Ultrasound revealed a solitary left hypoechoic nodule (23×17 mm), with no other suspicious sonographic features. She had two FNA’s over a two year period which were reported as showing no malignant cells (THY2). Three annual ultrasounds showed no change...

A 68 year old gentleman referred to endocrinology clinic with a few years history of erectile dysfunction (ED), which manifested as reduced libido and partial erections. Investigations revealed primary hypogonadism with a low morning serum Testosterone of 4.8 (Ref: 7.9-31 nmol/l), raised FSH at 47 (Ref:1.5-12.4 iu/l) LH at 36.8 (Ref: 1.7-8.6iu/l) and normal thyroid function tests (TFTs). The patient declined testosterone replacement therapy following a discussion of pros and c...

The prevalence of adrenal incidentaloma on abdominal Computed Tomography (CT) is around 4.4%. This prevalence is increased in obese, diabetic, hypertensive patients, and could be as high as 10% in older patients. Unilateral adrenal masses larger than 4 cm should be considered for surgical removal to avoid missing adrenal carcinoma, particularly in younger patients.This is the case of a 67 year old gentleman with Type 2 diabetes mellitus, known to have hy...

We report a case of a male patient aged 45 years who presented with a history of intermittent back discomfort over a year, but more persistent over the previous 2–3 months. His general practitioner (GP) referred him for an ultrasound of the spine for a possible encapsulated lipoma but the findings were unremarkable. He was then referred to a consultant gastroenterologist for further assessment. He had normal endoscopic examinations, however the MRI had shown a right adren...

This is a case of a 48-year-old lady initially referred to respiratory clinic with symptoms of breathlessness. She had a high-resolution CT thorax where an incidental finding of a right para-oesophageal 2.4-cm soft tissue density at the level of the thyroid gland identified. A CT neck was performed for further evaluation again showed the soft tissue mass (26 mm×37 mm) situated to the right of the oesophagus and another mass (16 mm×26 mm) left of the oesophagus. Discu...

Current UK guidelines for thyroid nodules advise a thyroid ultrasound (ThyUSS) with U-Classification with or without Fine Needle Aspiration (FNA) with Thy-Classification to determine malignancy risk. We report four cases where thyroid carcinoma was diagnosed histologically following reassuring cytology and radiological examination. This is a case of 28-year-old female who presented with neck swelling. ThyUSS showed an enlarged left thyroid with cystic and solid components; FNA...

Introduction: Thyroid cancer is the most common malignant endocrine tumour and represents 1% of all malignancies. Cancer Research UK in 2015 reported 3528 new cases and 382 deaths with annual incidence of 5.1 and 1.9 per 100,000 women and men respectively. The incidence is increasing globally, mostly due to papillary thyroid cancer.Ultrasound is the preferred examination with recommended U1-U5 grading system +/- fine-needle aspiration cytology (FNAC)...

We report a case of a 43 year old lady who was referred by her general practitioner (GP) to the endocrine team with an 8 month history of extreme fatigue, difficulty losing weight, galactorrhoea and mild breast enlargement. She has two children aged 16 and 14, all well. Her background medical history included depression, asthma and hysterectomy for fibroids 3 years ago. Examination of all systems were unremarkable including visual fields to confrontation, fundoscopy and full n...

Thyroid cancer is the most common endocrine malignancy with an increasing incidence globally predominantly due to the papillary thyroid carcinoma subtype. It is the 17th and 20th most common malignancy in females and males respectively. In 2018, Cancer Research UK reported 3865 new cases and 400 deaths. Mortality rates are predicted to continue to rise in the UK with an estimated rate of 1 per 100,000 deaths in 2035. We present a 42-year-old female who pr...

We report a case of a well 40 year old gentleman who self-referred for confirmation of diagnosis of diabetes. On further history he had been informed by other healthcare professionals the possibility of diabetes based on his elevated fasting serum glucose of 13.8 mmol/L and HbA1c of 81mmol/mol with no osmotic symptoms. His triglyceride was also elevated at 12.26 with rather variable compliance to statin. Examination of all systems were unremarkable, however on neck examination...