Endocrine Abstracts

Adrenocortical carcinoma (ACC) is a rare tumour characterised by a high rate of recurrence following radical surgery. Surgery of recurrent ACC may increase survival; thus, it is mandatory a timely and accurate detection of recurrence, either to increase the chance of radical extirpation or to avoid unnecessary surgery. This study investigated the role of PET–CT in the diagnosis of recurrence of ACC during follow-up of disease-free patients and analyzed whether this tool m...

Aim of this study is to present preliminary epidemiological data on a population of 1512 acromegalic patients attending 22 tertiary centers in Italy from 1980 to 2002. At our knowledge this is the first large–scale epidemiological Italian study on acromegaly. Gender was 624 (41.2%) men and 888 (58.8%) women. Mean age at diagnosis was 45±13 years, 43±13 for men and 47±13 for women. Median estimated duration of acromegaly before diagnosis was 74 months (range...

The existing follow-up studies on patients with incidentally discovered adrenal adenoma (AA) focused almost exclusively on repeat imaging and endocrine work-up on a short period.Of consecutive 152 patients with AA referred to our center from 1989 to 2003, we have assessed the risk of developing metabolic disorders and vascular complications in the 74 patients who did not underwent surgery (51 women and 23 men, median age 57, range 25–74 years) durin...

Recent guidelines recommend to use the 1-mg DST to screen for subclinical hypercortisolism assuming that a post-DST cortisol >5.0 μg/dl define this condition. However, several experts suggest a more sensitive cut-off at 1.8 μg/dl while others consider mandatory to confirm unsuppressibility with a 8-mg DST. A consecutive series of 64 patients (22 men, 42 women, aged 28–81 years) with clinically inapparent adrenal adenoma were studied between 2005 and 2007. Th...

Objective: Seventeen patients (9 women, 8 men aged 36 years, 22–58) radically resected for ACC were treated with adjuvant mitotane and prospectically followed from 2000 to 2006.Methods: Stage of ACC: was: 1 stage I,; 12 stage II, 4 stage III; Weiss score 6, 3–9; Ki67% 20, 4–67. Eleven patients had functional tumors. Median duration of treatment was 15 months (range:4–84) and 14 patients are currently on mitotane, 2 died, 1 discontinue...

Mitotane, used in the treatment of adrenocortical cancer (ACC), is able to inhibit multiple enzymatic steps of adrenocortical steroid biosynthesis, potentially causing adrenal insufficiency (AI). Recent studies in vitro have also documented a direct inhibitory effect of mitotane at the pituitary level.The aim of the study was to assess the hypothalamic pituitary adrenal (HPA) axis in patients receiving mitotane as adjuvant treatment after radica...

Background: Adrenal incidentalomas are found in 3–7% of radiological series and many of them are adrenal adenomas. Autonomous cortisol secretion without clinical signs of overt hypercortisolism is a common finding in these patients. Studies reported metabolic derangement and increased cardiovascular risk associated with this state of subtle cortisol excess, however scanty data are available on the natural history of this condition.Aim: To assess the...

The optimal treatment of recurrent adrenocortical cancer (ACC) remains to be established since there are discrepant opinions on the value of repeat surgery. We did a retrospective analysis of the outcome of patients who were referred to our units from 1988 to 2006 for a recurrence of ACC, which occurred 2–83 years after radical removal of the tumor. In that period, the treatment policy of ACC recurrence differed among our units, since oncologists were more accustomed to u...