Endocrine Abstracts

BackgroundThe management of post-operative recurrences of ACC remains controversial, although the current guidelines recommend a surgical approach whenever feasible with radical intent.AimThe aim of our study was to evaluate retrospectively the management of recurrences in patients with ACC. We collected data of 106 patients with ACC followed at the San Luigi Hospital for the management of recurrence. Median ...

Background and objective: Optimization of glucocorticoid (GC) replacement therapy in adrenal insufficiency (AI) is crucial to avoid consequences of under- or overtreatment. Dosing of GC replacement is mainly based on clinical grounds; however, the impact of patient’s characteristics on daily GC requirement is poorly evaluated. The aim of the study is to assess the influence of sex (M/F) and BMI on dosing GC in patients with AI of different etiology....

Background and objectives: The role of adjuvant mitotane therapy after radical surgery for adrenocortical carcinoma (ACC) is still debated. The aim of our study is to assess the effects of adjuvant mitotane on recurrence free survival (RFS) and overall survival (OS) in non-metastatic ACC patients and to evaluate prognostic factors in adjuvant setting.Methods: Retrospective data were collected from 152 patients affected by ACC (stage I-III) referred to ou...

Background: Adrenocortical carcinoma (ACC) is a rare cancer associated with hereditary syndromes in 10% of cases. However, data on germline variants (GVs) in adult patients with sporadic ACC are limited.Methods: We analyzed germline DNA from 150 adult patients with sporadic ACC sequentially referred to our centers between 1998-2019. We designed a custom panel of 17 genes potentially involved in the pathogenesis of ACC: AIP, APC, ARMC5, ARNT, BRCA1, BRCA2...

Evidences suggest that environmental contaminants exposure and/or the impairment of intracellular xenobiotic metabolizing system could affect pituitary pathophysiology. Glutathione-S-transferase-P1 (GSTP1) gene encodes for an enzyme that is involved in cellular detoxification mechanisms. GSTP1 altered activity or expression has been reported in some tumours.We aimed to assess the GSTP1 gene promoter methylation status in acromegaly patients and its contr...

Mitotane, used in the treatment of adrenocortical cancer (ACC), is able to inhibit multiple enzymatic steps of adrenocortical steroid biosynthesis, potentially causing adrenal insufficiency (AI). Recent studies in vitro have also documented a direct inhibitory effect of mitotane at the pituitary level.The aim of the study was to assess the hypothalamic pituitary adrenal (HPA) axis in patients receiving mitotane as adjuvant treatment after radica...

Introduction: CyberKnife (CK) is an emerging treatment for pituitary tumours (PT) resistant to other therapies.Patients and methods: We report long-term CK effect on endocrine function and tumour volume in 20 PT patients (11M/10F, mean age 58.6±14.4years). Twelve patients harboured a non functioning adenoma, 2 an ACTH, 5 a GH (one case of TSH co-secretion) and 2 a PRL-secreting PT. Before CK nine patients had normal while 11 presented impaired pitui...

The association between acromegaly and increased cardiovascular morbidity and mortality is widely recognised. The aim of this retrospective multicentric study is to evaluate the impact of different therapeutic approaches on the progression of cardiovascular risk (CVR) in acromegalic patients. At diagnosis and last follow up (follow up time of 13 ± 8 years),we assessed BMI, blood pressure, glycaemic and lipid profile, GH and IGF1 levels in 199 patients with acromegaly (116...

Background and objectives: Metyrapone has been approved for the treatment of patients with Cushing’s syndrome from all causes, but only few retrospective clinical studies are available. The aim of our study was the prospective assessment of metyrapone as pre-operative treatment.Methods: Before adrenalectomy, 7 patients with ACTH-independent Cushing’s syndrome due to adrenal adenoma were prospectively treated with metyrapone for 3 months, with e...

Many patients affected by SARS-CoV-2 disease (COVID) have associated comorbidities (arterial hypertension, obesity, diabetes mellitus, thrombophilia) that are also tied to autonomous cortisol secretion. However, the prevalence of diseases of the adrenal glands in COVID patients is presently unknown. Since the visualization of the adrenal glands is almost always available in chest CT performed in patients with suspected or confirmed SARS-CoV-2 infection, the evaluation of adren...