Endocrine Abstracts

Background: Pregnancy does not cause differentiated thyroid cancer (DTC) recurrence in patients without structural or biochemical evidence of disease at the time of conception. However, data regarding pregnancy’s impact in patients with persistent DTC before conception are still controversial.Aim: The aim of the study was to determine whether pregnancy could significantly influence the outcome in DTC patients in persistence before pregnancy, but wit...

The management of loco-regional metastases in patients with differentiated thyroid carcinoma is still debated. Current American Thyroid Association guidelines state that in this context the main goal is to differentiate between low-volume metastatic disease that will progress and that remaining stable over time.Aim of our study was to evaluate the behavior of suspicious or cytologically confirmed lymph node metastases, detected after initial treatment (i...

Radioiodine refractory differentiated thyroid cancer can be effectively treated with multi-tyrosine-kinase inhibitors (mTKI). Due to their pleiotropic mechanism of action, these drugs may cause different side effects. Hypocalcaemia has been reported in up to 35% of patients treated with mTKI, but little is known about its pathophysiology and clinical relevance. We report the case of a 78 years old woman treated for a multifocal papillary thyroid cancer, infiltrating perithyroi...

Background: Fatigue is one of the most frequently reported adverse events in patients treated with multikinase inhibitors (MKIs). It is present in about 59% and 24% of patients treated with lenvatinib and vandetanib, respectively, associates with a decreased quality of life and often leads to treatment discontinuation. In 2018, for the first time, a correlation between fatigue and primary adrenal insufficiency (PAI) was demonstrated in 12 patients treated with lenvatinib and v...

Objectives: Lenvatinib treatment is responsible for several adverse events (AEs). Hypocalcemia has been described in the registration study in 7% of patients, being of grade ≥3 in 2.7% of cases. No real-life studies are available, and the actual impact of this AE during Lenvatinib treatment is still unknown. Aim of our study is to evaluate the frequency of hypocalcemia in our series of patients treated with Lenvatinib and the possible predictors of this side effect.<...

Objectives: Factitious disorder imposed on self or Munchausen’s syndrome (MS), is a psychiatric disorder in which physical symptoms are intentionally produced without any practical benefit. Patients with MS represent a diagnostic dilemma as laboratory and clinical results can be inconsistent with the history and physical exam. The aim of this study was to evaluate the role of the levothyroxine overload test to differentiate MS from malabsorption and to treat life-threaten...

In the last decades, multi-tyrosine-kinase inhibitors (mTKI) have emerged as an effective treatment for radioiodine refractory differentiated thyroid cancer. Due to their pleiotropic mechanism of action, these drugs may cause different side effects. Hypocalcaemia has been reported in up to 35% of patients treated with mTKI, but up to date little is known about its pathophysiology and relevance. We report the case of a 78 years old woman operated on for a papillary thyroid canc...

Background: Several adverse events are recorded during treatment with tyrosine-kinase inhibitors (TKIs). Hypocalcemia was reported during phase III clinical trials with both Lenvatinib and Vandetanib, but scanty data are available in a real-life setting. Aim of our study was to evaluate hypocalcemia occurrence and its characteristics in a cohort of patients treated with these drugs for advanced thyroid cancer. Moreover, in patients treated with Lenvatinib, we examined a possib...

Selpercatinib is a specific RET inhibitor, highly effective in the treatment of advanced RET-mutant medullary thyroid carcinoma (MTC). The consequences of selpercatinib administration in MTC patients who have not undergone thyroid surgery are still unknown. We report the case of an 84-year-old man undergoing investigations for worsening diarrhea and weight loss. Upon a neck ultrasound scan and blood exams that pointed out high levels of both calcitonin (CT, 20.583 ng/l) and ca...

Background: Hypertension (HTN) is the most frequent adverse event during treatment with Lenvatinib (LEN) for advanced Radioactive Iodine-Resistant Thyroid Cancer (RAI-R TC), but data on its best therapeutic management are limited.Objectives: To assess incidence, features and best management of LEN-related HTN in a consecutive single tertiary-care Centre.Methods: Evaluation included 29 patients treated with LEN, followed for a mean ...