Searchable abstracts of presentations at key conferences in endocrinology

ea0086hdi1.5 | How do I...? 1 | SFEBES2022

How do I monitor a patient on mitotane?

Ronchi Cristina

Adrenocortical carcinoma (ACC) is a rare endocrine tumour with a generally poor prognosis. Mitotane is the only approved drug for treatment of advanced ACC (“palliative” setting). However, response is relatively poor with up to 20% of patients experiencing objective response (Megerle 2018). Moreover, adjuvant treatment with mitotane is frequently recommended for patients at high risk of disease recurrence after surgery (Terzolo 2007, Fassnacht 2018). Of note, mitotan...

ea0077s6.1 | Characterising the cortex to improve clinical care | SFEBES2021

Characterizing the Cortex to Improve Clinical Care. Single cell sequencing: lessons for the pathogenesis of adrenocortical tumours

Ronchi Cristina L

Key learning points• Adrenocortical tumors comprise frequent benign adenomas and rare aggressive carcinomas (ACC).• cAMP/PKA pathway plays a central role in the pathogenesis of cortisol-producing adenomas - associated with Cushing syndrome, while molecular alterations in Wnt/β-catenin, Rb/p53 pathway and chromatin remodeling are frequent in ACCs.<p class="a...

ea0077lb33 | Late Breaking | SFEBES2021

Complex management of unilateral post-Covid-19 adrenal haemorrhage during pregnancy

Yousuf Quratulain , Elhassan Yasir S , Arlt Wiebke , Jehanzeb Qazi , Krishnasamy Senthil-Kumar , Ronchi Cristina L

Background: Management of large indeterminate adrenal masses detected during pregnancy is challenging due to the risk of malignancy and the obstetric risks of surgical intervention. The spectrum of endocrine-related complications of Covid-19 is expanding. We present a case that highlights the challenging management of a large adrenal mass during pregnancy and draws attention to a rare complication of Covid-19.Case description: 26 yr-old lady presented wi...

ea0065p8 | Adrenal and Cardiovascular | SFEBES2019

Clinical outcomes in adrenocortical carcinoma: evaluation of single and combined prognostic markers in a UK single centre cohort

Elhassan Yasir , O'Reilly Michael , Asia Miriam , Chortis Vasilis , Sutcliffe Robert , Skordilis Kassiani , Arlt Wiebke , Ronchi Cristina

Background: Adrenocortical carcinoma (ACC) has an aggressive but variable behaviour. ENSAT tumour stage and Ki67 proliferation index are used to predict clinical outcome but they are limited in distinguishing patients with best outcome. We aimed to investigate the prognostic role of clinical/histopathological parameters alone or in combination according to previously proposed points-based score (mGRAS, Lippert JCEM 2018).Methods: We assessed 112 patients...

ea0049gp121 | Endocrine Tumours | ECE2017

Immunity in adrenocortical carcinoma patients – interplay between anti-cancer immunity and steroid hormones

Sbiera Silviu , Dexneit Thomas , Sbiera Iuliu , Schreiner Jochen , Ronchi Cristina L. , Kroiss Matthias , Fassnacht Martin

Adrenocortical carcinoma (ACC) is one of the most aggressive endocrine malignancies. By applying a ‘multiple omics’ approach, we recently identified two distinct subgroups of ACC patients, a good prognosis “immune” and bad prognosis “steroid” phenotype.We hypothesized that the steroid phenotype is associated with glucocorticoid-induced suppression that can be ‘rescued’ by reactivating the immune system using immune...

ea0041ep15 | Adrenal cortex (to include Cushing's) | ECE2016

Impact of the chemokine receptors CXCR4 and CXCR7 on metastatic potential and survival in adrenocortical carcinoma

Chifu Irina , Fusz Carmina , Ronchi Cristina , Marienfeld Katja , Fassnacht Martin , Hahner Stefanie , Heinze Britta

Background: The chemokine receptor CXCR4 and its associate receptor CXCR7, that modulates CXCR4 function, have been associated with tumor progression and metastasis in human cancers. In ACC, Ki67 index and ENSAT stage are the most important prognostic parameters.Objective: To assess expression of CXCR4 and CXCR7 in adrenal cancer and correlate results with clinical outcome.Methods: CR expression was assessed by immunohistochemistry...

ea0035p533 | Endocrine tumours and neoplasia | ECE2014

High JAG1 expression in adrenocortical carcinomas is associated with better prognosis

Ronchi Cristina , Sbiera Silviu , Steinhauer Sonja , Scott-Wild Vanessa , Fassnacht Martin , Allolio Bruno

Background: Adrenocortical tumors consist of benign adenomas (ACA) and highly malignant carcinomas (ACC). Dysregulation of the Notch signalling pathway is implicated in several cancers with oncogenic or tumor suppressor functions. JAG1 is a Notch1 ligand of the Jagged family and a common target gene for Notch and Wnt/β catenin pathways. It has been reported that upregulated expression of JAG1 enhances cell proliferation in ACC.Material and methods: ...

ea0035p535 | Endocrine tumours and neoplasia | ECE2014

Expression of inhibitor of apoptosis protein BIRC7/livin in adrenocortical tumors

Altieri Barbara , Sbiera Silviu , Steinhauer Sonja , Fassnacht Martin , Allolio Bruno , Ronchi Cristina L

Introduction: Adrenocortical tumors consist in frequent benign adenomas (ACA) and rare highly malignant carcinomas (ACC). BIRC7/livin gene, a member of the inhibitors of apoptosis family, plays an important role in tumorigenesis in a variety of malignancies. Different studies demonstrated that BIRC7 overexpression represent a risk factor for cancer development and progression. The aim of our study was to evaluate the expression of BIRC7 in normal adrenals and adrenocortical tu...

ea0032oc4.2 | Adrenal | ECE2013

Single nucleotide polymorphism array profiling of adrenocortical tumors: evidence for an adenoma carcinoma sequence?

Ronchi Cristina , Sbiera Silviu , Leich Ellen , Rosenwald Andreas , Allolio Bruno , Fassnacht Martin

Background: Adrenocortical tumors consist of benign adenomas (ACA) and highly malignant carcinomas (ACC) with a still incompletely understood pathogenesis. Our aim was to test, whether there is evidence for an adenoma-carcinoma sequence.Patients and methods: High-resolution single nucleotide polymorphism (SNP) microarrays (Affymetrix SNP 6.0) were used to detect copy number alterations (CNAs) and copy neutral losses of heterozygosity (cnLOH) in 46 adreno...

ea0077p140 | Adrenal and Cardiovascular | SFEBES2021

Should the 1 mg -overnight dexamethasone suppression test be repeated in patients with benign adrenal incidentalomas and no overt hormone excess?

Narayanan Rengarajan Lakshmi , Knowles Gregory , Asia Miriam , Elhassan Yasir S , Arlt Wiebke , Ronchi Cristina L , Prete Alessandro

Background: Benign adrenal incidentalomas (AI) are found in 3-5% of adults. All patients should undergo a 1 mg -overnight dexamethasone suppression test (1 mg -DST) to exclude cortisol excess (non-functioning adrenal tumours, NFAT; serum cortisol ≤50 nmol/l) or diagnose possible mild autonomous cortisol secretion (MACS; serum cortisol >50 nmol/l). Current guidelines discourage repeating hormonal work-up in patients with benign AI. However, data underpinning this reco...