Endocrine Abstracts

Gynaecomastia is the proliferation of the male breast glandular tissue and should be distinguished from lipomastia (weight-related fat deposition, also known as pseudogynaecomastia). The development of subareolar ductular tissue and fibrosis in gynaecomastia produces a firmer consistency compared to adipose tissue, which can be differentiated on examination. Gynaecomastia is common and can affect up to two-thirds of adult men. Typically, gynaecomastia arises from an imbalance ...

A 25-year lady was referred by her GP with a six-month history of symptoms suggestive of thyrotoxicosis; weight loss, palpitations, heat intolerance and lethargy. She also complained of thirst, polyuria and nocturia. Examination findings included tachycardia, tremor and a moderately enlarged goitre.In clinic, blood tests performed confirmed thyrotoxicosis: TSH<0.05 mU/l (NR 0.3–4.2 mU/l), free T3 >46.1 pmol/l (NR 2.5–5.7 pmol...

Pheochromocytoma crises are uncommon but have high mortality. We describe herein a case where multidisciplinary team management was crucial in safely carrying the patient through such a crisis. The patient was a 63 year old lady with a background of neurofibromatosis type 1 (NF-1), and previous renal artery stenosis bypass surgery. She was admitted via A&E with increasingly frequent episodes of sweating, headache, dyspnoea and palpitations. Her troponin was raised at admis...

Introduction: Adrenocortical carcinoma (ACC) is an uncommon aggressive malignancy. Despite surgical resection, recurrence rates are high. Two areas of contention currently involve treatment of ACC: the role of laparoscopic surgery in removal of large, potentially malignant tumours and the role of Mitotane. We present a case of a large adrenal tumour, later confirmed as ACC, where initially laparoscopic adrenalectomy was considered, and adjuvant Mitotane has been given despite ...

We present two uncommon cases of cyclical ectopic ACTH-dependent Cushing’s syndrome due to diffuse idiopathic pulmonary neuroendocrine tumour (DIPNECH).Case 1: 62 yr lady presented with rapid onset of muscle weakness, diabetes and hypokalaemia. Random cortisol:1710 nmol/l, ACTH level:610 ng/l. LDDST: failure to suppress cortisol levels. Imaging: normal pituitary gland and bilateral adrenal hyperplasia, consistent with ACTH dependent Cushing’s s...

A 31-year gentleman presented with a four day history of anxiety and confusion. Over several months, he had noticed red eyes and a ‘stomach-ache’. A collateral history revealed a previous episode of confusion and concern about excessive alcohol intake. He denied any current medication. On examination, he had bilateral conjunctivitis. Investigations demonstrated severe hypercalcaemia of 3.54 mmol/l (NR 2.15–2.6 mmol/l). He was treated with intravenous fluids and ...

Radioactive iodine (RAI) therapy is the usual treatment of choice for hyperthyroidism. We have demonstrated a success rate of 88% (euthyroidism or hypothyroidism) over a 5-year period. We are very happy to recommend RAI, however patients still express concerns.There is little literature available about patients’ reactions to RAI: to our knowledge, only two studies. We performed a survey of our RAI treated patients. Of 143 patients contacted, 87 repl...

Background: Bariatric surgery (BS) is a well-documented treatment targeting weight loss excess. There is little evidence on the impact of BS on antenatal glycaemic control. We present four cases of pregnancy post-BS, reviewed in the joint antenatal clinic, who experienced various degrees of hypoglycaemia during pregnancy.Case presentations: Four pregnant women (cases A–D, aged 25–36-years-old, 3–8years pos...