Endocrine Abstracts

Metastasis to the pituitary gland is a rare occurrence. Here we discuss our experience managing a patient with pituitary neuroendocrine metastasis who first presented with ocular symptoms. A 65-year-old lady presented in July 2015 with progressive diplopia. An MRI scan revealed a pituitary mass lesion with aggressive features and two abnormal enhancing nodules within the brain white matter, raising suspicion of metastatic disease. Radiotherapy was commenced on the basis that t...

Introduction: Neuroendocrine tumours of the gastrointestinal tract often cause carcinoid syndrome and in advance cases carcinoid heart disease. These tumours secrete serotonin, which can bind to heart valves and cause fibrosis and eventually valve incompetence. Most cases involve the tricuspid valve +/− pulmonary valve. Medical management comprises diuretics for fluid overload and somatostatin analogues to reduce circulating serotonin. Definitive treatment is heart-valve...

Introduction Chronic heart failure is a catabolic state leading to cachexia in 5-15% of patients, predicting poor survival outcomes. Malnutrition affects 40% of patients with NETs and 58% with carcinoid syndrome (CS). Case 45M with severe carcinoid heart disease, on referral and admission was cachectic with BMI of 16, having lost 32 kg or 30% of body weight, meeting 50% of dietary requirements and at risk of refeeding syndrome. Nasogastric feeding (NG) w...

Introduction: Here we present our experience of managing patients with orbital well-differentiated neuroendocrine tumour (NET) metastases.Methods: Six patients were identified from the hospital NET database: four male; two female.Results: Median age at diagnosis of primary NET: 69.5 years (range: 40-74 years). Three patients were alive at time of data capture. Of those who passed away: mean survival from diagnosis of primary NET = ...

Carcinoid syndrome occurs in 20% patients, presenting with flushing, abdominal pain, diarrhoea, and wheeze and can be challenging to manage. The standard of care for carcinoid syndrome is somatostatin analogues (SSAs) with add-on Creon, codeine and loperamide therapy. Nonetheless, half of patients experience debilitating diarrhoea. Telotristat-ethyl is a peripheral tryptophan-hydroxylase inhibitor approved for treatment of diarrhoea, supported by Phase 3 clinical trials but la...

Purpose: Neuroendocrine neoplasms are known to have heterogeneous biological behavior. G3 neuroendocrine tumours (NET G3) are characterized by well-differentiated morphology and Ki67>20%. The prognosis of this disease is understood to be intermediate between NET G2 and neuroendocrine carcinoma (NEC). Clinical management of NET G3 is challenging due to limited data to inform treatment strategies.Methods: We describe clinical characteristics, treatment, an...