Endocrine Abstracts

Introduction: Carcinoid crisis is a life threatening endocrine emergency. It remains unclear whether there is an optimal dose of prophylactic somatostatin analogue (SSA) therapy in the peri-operative periodCase Study: A 62 year old lady with a new diagnosis of metastatic carcinoid disease was electively admitted for a right hemicolectomy for a well differentiated neuroendocrine tumour in the terminal ileum. A multi-disciplinary decision was made to offer...

Multiple endocrine neoplasia type 1 (MEN1) is a hereditary condition characterised by the predisposition to hyperplasia or the development of solitary adenomas of multiple endocrine gland. MEN1 related disease is responsible for death in two thirds of patients with this hereditary condition and the mean age at death is 55 years. This associated mortality necessitates a vigorous surveillance protocol, however all recommendations for radiological surveillance are based on non-pr...

Case history: A 41 year old female was admitted following development of severe hypertension (226/146 mmHg), complicated by heart failure and acute kidney injury. She otherwise had no relevant past medical history. On clinical examination she was obese (BMI 51.94 kg/m2). As part of her cardiac investigations, she underwent a cardiac magnetic resonance imaging (MRI) which detected a 3 cm right sided adrenal nodule. An adrenal biochemical screen identified an elevated...

Case history: A 66-year-old man presented with a 1 month history of a productive cough, in the context of a 20 pack-year smoking history. CT chest revealed minor bronchiectasis and an incidental 3 cm right adrenal lesion. He was referred to the endocrine clinic for further evaluation. On questioning, he reported no symptoms suggestive of adrenal hormone hypersecretion and, aside from a short history (<1 month) of sweating episodes at night, he described no other constituti...

Peptide receptor radionuclide therapy (PRRT) is a targeted therapy using synthetic somatostatin analogues attached to a radionuclide, which binds to tumours expressing somatostatin receptors. The aim was to review the role of PRRT in a tertiary referral centre. We retrospectively reviewed a cohort of 25 patients (eight males, 17 females), with a median age of 65, who received Yttrium-90 DOTATATE or Lutetium-177 DOTATATE at Addenbrookes Hospital. The location of the primary tum...

Background: Adrenal incidentalomas (AI) are identified in 4–7% of patients >40 years undergoing abdominal CT/MRI. Evidence of subclinical autonomous glucocorticoid hypersecretion (SAGH) is found in 5–10% of cases depending on the diagnostic criteria/thresholds adopted.Aim: To examine the utility of basal DHEAS measurement in the detection of SAGH in a cohort of patients with AI.Methods: Ninety-six consecutive subjects...

Section 1: Case history: A 69 year old man with chronic obstructive pulmonary disease was admitted with acute onset shortness of breath. A CT pulmonary angiogram revealed no focal lung abnormality but identified an incidental 40 x 32 mm left-sided adrenal lesion. An unenhanced CT, undertaken to characterise the lesion, showed a homogeneous, well-circumscribed appearance with a radiodensity of 4 Hounsfield units. Prior to involvement of the Endocrinology team, a dedicated MRI w...

Subclinical hypercortisolism (SH) occurs in 5–30% of incidentally-detected adrenal adenomas (AIs). Common screening tests for ACTH-independent hypercortisolism have significant false positive rates, mandating further investigations that are both time and resource intensive. We investigated whether a low basal DHEAS level is a sensitive and specific screening test for the detection/exclusion of SH in patients with newly-diagnosed AI. We recruited 185 consecutive patients w...

Nineteen cases of insulinoma were treated in this centre between 2003 and 2012 (12 female, 7 male, 5 associated with MEN-1). Of the cohort, 14 had their primary investigation and management here. All presented with symptoms consistent with hypoglycaemia and had a supervised fast demonstrating serum glucose <2.2 mmol/l with inappropriately normal/elevated insulin.11 of 14 patients proceeded to surgery. Two elderly patients declined further investigati...

Aim: To review the presentation, management and outcomes in adult patients with MEN1 attending a multidisciplinary clinic.Methods: Case notes and electronic records were reviewed in patients attending a tertiary centre clinic for care of MEN1.Results: Forty-eight patients were analysed; 46% were male and 54% female. Mean age was 49 years (range 14–89) and 4% were deceased. Eighty-five percent had confirmed MEN1 mutations and 2...