Endocrine Abstracts

Introduction: The thyroglossal duct is an embryonic structure, lined predominantly by respiratory and squamous epithelium and typically involutes by the 10th week of gestation. If the thyroglossal duct does not involute, it can form cysts due to recurrent inflammation or infection, as it is lined by epithelium that is secretory in nature, with or without the presence of ectopic thyroid tissue. Thyroid tissue is present in the wall of the cyst/duct in 30-60% of cases.<p cla...

Adrenal/periadrenal sarcomas are very rare entity of adrenal tumours. An epidemiological analysis of primary adrenal cancers found prevalence of adrenal sarcoma of 1.3% compared to adrenocortical carcinoma (ACC) 43.8%, neuroblastoma 39.7%, pheochromocytoma 10.9% and non-Hodgkin’s lymphoma 4.3% (1). In 2021, 26 adrenalectomies in adults were performed in our institution. 12/26 had malignant histology. 9/26 lesions were > 6 cm. 7/9 lesions > 6 cm were malignant (2 a...

Introduction: Graves’ disease (GD) has a well-known association with thymic hyperplasia caused by TSHR expression in thymus and regresses by approximately 33-90% with treatment. Splenomegaly due to lymphoid hyperplasia has also been linked with GD in about 10% patients. Cerebral venous sinus thrombosis (CVST) linked with GD is documented in literature but is more common occurrence in solid cancers.Case presentation: We report a case of 32-year man a...

Introduction: Adrenal haemorrhage (AH) carries high mortality and morbidity. It can be unilateral or bilateral (BAH), trauma or non-trauma (NT) related. The predisposing factors include adrenal tumours, anticoagulation, thrombocytopenia, sepsis, thromboembolic disease, pregnancy, liver transplant and vaccine-induced-immune-thrombocytopenia-and-thrombosis. BAH can result in an adrenal crisis in up to 15%. BAH is usually associated with conditions contributing to adrenal vein sp...

Background: Hypercalcaemia of hyperthyroidism via increased bone turnover is not uncommon, however it is usually mild and asymptomatic. Corrected calcium (cCa) concentrations ≥ 3.0mmol/l are seen rarely and tend to be associated with high TSH receptor antibodies concentration. Some of the less well-known effects include thymic hyperplasia (TH) and lymphadenopathy. TH is explained by thyroid hormone acting on thyrotropin receptors in thymic tissue to increase proliferatio...

We present a case of 39y old male who underwent adrenalectomy and aortic lymph node dissection for neuroendocrine tumour in context of underlying VHL disease and previous adrenalectomy. Iatrogenic injury to his duodenum resulted in prolonged, multiple intraabdominal infections and development of enterocutaneous fistula. He had to remain NBM, relied on high dose iv hydrocortisone administration and TPN feed for several months. Conversion back to oral steroids was considered unr...

Lithium induced hypercalcaemia can occur in 4.3–6.3% patients. Lithium interacts with CaSR in parathyroid gland and can ‘unmask’ parathyroid adenoma or cause parathyroid gland hyperplasia. It can cause tubular damage leading to tubular concentration defect or nephrogenic DI. Parathyroid hyperplasia in patients with LAH is much more prevalent than in PHPT.Methods: The aim of this project was to review presentation and management in patients...

Background and aims: In 2010 pituitary service improvements were instigated, e.g., creation of local pituitary MDTs/joint pituitary clinics with surgeons. In the absence of national guidelines on post-surgical follow up of pituitary patients there was an evolution of local best practice standards. An audit was conducted in March 2015.Methods: Twenty-six patients underwent pituitary surgery at local tertiary centre in 2013/14 with endocrine care based at ...

BackgroundPancytopenia due to hypopituitarism has been reported previously in the literature. Most of these case reports relate to hypopituitarism secondary to Sheehan’s syndrome. We report a case of isolated ACTH deficiency causing pancytopenia which was successfully treated with hydrocortisone replacement.Case history: A 71-year-old lady with a known history of treated hypothyroidism and learning disabilities was referred to...

Aim: The aim of this audit was to evaluate our adherence to current recommendations by Third International Workshop on the Management of Asymptomatic Primary Hyperthyroidism.Method: We audited 50 cases from our database of patients with PHPT diagnosed between 2007 and 2012.Results: 21/50 (42%) were referred for surgery with 19/21 operated. All referred patients had SESTA MIBI preoperative localisation scan. 19/21 had USS in additio...