Endocrine Abstracts

Aims: Although rare, craniopharyngiomas are the commonest suprasellar tumour in childhood. Despite high overall survival, children and young people <19 years with craniopharyngiomas are at risk of multiple relapses and long-term tumour- and treatment-related morbidity. We sought to provide, for the first time, a national standard for best practice based on currently available evidence for the assessment, treatment and follow-up of paediatric craniopharyngiomas under the au...

Background: Pituitary apoplexy is uncommon in childhood and adolescence. Typical clinical features are acute confusion, headache, vomiting and visual disturbance. It is caused by haemorrhage into the pituitary gland. Its association with cerebral infarction is rare. We report an unusual case associated with a cerebral infarction secondary to internal carotid artery compression.Case: 16 year old male was referred to the ‘Stroke Team’ with acute ...

Background: It is generally accepted that a post-operative cortisol of <50 nmol/l is a good predictor of long-term remission following trans-sphenoidal surgery (TSS).Aim: We wished to determine the rate of late recurrence and need for consequent intervention in patients who had initial biochemical remission after TSS for pituitary dependent Cushing’s.Methods: We performed a retrospective analysis of our patients who underw...

Objective: To describe the clinical presentation, management and treatment outcomes of prolactinomas diagnosed in childhood and adolescence in a consecutive series.Design and Methods: A retrospective review of medical records of patients with prolactinoma less than 20 years at diagnosis, referred to a tertiary paediatric endocrine service between 1996 and 2018.Results: Twenty-three patients (14 females) were identified; median age ...

Introduction: In 2017 the term ‘Atypical adenoma’ was removed from the WHO classification, and ‘High-risk adenomas’ was introduced as a term to classify those with rapid growth, radiological invasion, and a high Ki-67 proliferation index. In this retrospective cohort study we have sought to identify the clinical and histological characteristics which are associated with worse outcomes.Methods: Data: We created a dataset of 1793 pa...

Background: Pituitary metastases are a rare complication of systemic malignancy. The most common presentations of pituitary masses include visual field defects, headaches, and hypopituitarism, but cranial nerve palsies and diabetes insipidus are also recognised although unusual. We aimed to determine if these were more frequently associated with pituitary metastasis.Methods: We conducted a review of 944 patients undergoing pituitary surgery from a teachi...

Background: Cushing’s disease is caused by corticotroph tumours of the pituitary gland and the standard first-line treatment is trans-sphenoidal surgery. Published data from other centres describes post-operative endocrine remission achieved in 50–90% of cases.Table 1 Remission (cortisol <50)Cortisol (50–150 nmol/l)<td alig...

Background: General population screening for type 1 diabetes (T1D) using islet autoantibodies (IAb) is gaining international momentum, since screening reduces diabetic ketoacidosis, hospitalisation and identifies individuals eligible for future preventative treatments. Qualitative studies have only been undertaken in at-risk individuals (1). We therefore aimed to explore parents’ experiences of their child taking part in a general population T1D screening...

Case History: A 49 year old man was referred from primary care with clinical features of thyrotoxicosis, including weight loss, anxiety and palpitations, over the previous four months. The patient had a 20 year history of abnormal thyroid function, characterised by elevated fT3 and fT4 with normal TSH. He had been previously assessed by the regional thyroid service 12 years prior and diagnosed with thyroid hormone resistance syndrome (RTH). This was based on clinical and bioch...

Temozolomide has an established role as first line chemotherapy for aggressive pituitary adenoma and carcinoma. There are mixed reports whether the MGMT (methylguanine methyltransferase) and mismatch repair protein (MSH2/6) status of a tumour, assessed by immunohistochemistry (IHC) can predict response to temozolomide. This is the first series to assess combined MGMT and MSH2 status. We analysed a retrospective case series of patients treated with temozolomide at our tertiary ...