Endocrine Abstracts

Background: Androgen-deprivation therapy (ADT) is commonly used in the management of advanced prostate cancer. ADT can be achieved through bilateral orchidectomy, by administration of GnRH receptor agonists, or by using by the newer GnRH receptor antagonist Degarelix. The classical desired biochemical goal is to achieve a serum testosterone of <1.7 nmol/l.Case Presentation: A man with metastatic prostate cancer on androgen deprivation therapy and ser...

Case history: A 51 year old lady was referred to Endocrinology with low plasma cortisol, hyperprolactinaemia and galactorrhoea. Extensive past medical history included primary hypothyroidism, B12 deficiency, diaphragmatic paralysis requiring NIV, recurrent aspergillomas, sino-atrial node disease with PPM, immunodeficiency, inflammatory arthropathy and autoimmune pancreatic insufficiency. She took numerous medications:- Itraconazole 100 mg daily, Levothyroxine 75 μg daily,...

Background: Immune checkpoint inhibitors have revolutionized the treatment of metastatic melanoma, demonstrating durable responses, but can result in immune-related adverse events (irAEs). Endocrinopathies are amongst the more common adverse events, and thyroid dysfunction and hypophysitis being the most frequent; the latter of these has been positively correlated with oncological outcome. This study compared overall survival (OS), progression-free survival (PFS) and disease c...

Background: Immune checkpoint inhibitors have revolutionized the treatment of metastatic melanoma, demonstrating durable responses, but can result in immune-related adverse events (irAEs). Endocrinopathies are amongst the more common adverse events, and thyroid dysfunction and hypophysitis being the most frequent; the latter of these has been positively correlated with oncological outcome. This study compared overall survival (OS), progression-free survival (PFS) and disease c...

Case history: Patient 1, a 78 year old male, was diagnosed five years ago with a metastatic NET with octreotide avid disease including ileocolic/right common iliac nodal metastases and a solitary segment VII liver lesion. He elected for watchful waiting and was asymptomatic. Interval imaging showed gradual local disease progression. He was diagnosed with motor neurone disease resulting in unilateral arm weakness. He re-presented four years after diagnosis with progressive weak...

Case history: 58 year old male presented in April 2016 with haematemesis. Octreotide-avid pancreatic mass with liver metastases was identified. Liver biopsy demonstrated well differentiated Grade 2 NET (Ki-67 10–13%). He progressed on Somatostatin analogue therapy, and subsequently Sunitinib, following which he underwent four cycles of Peptide Receptor Radionuclide Therapy (PRRT) with partial response. In May 2018, there was radiological progression. He reported episodes ...

Case history: 52 year old gentleman presented in 2013 with a 1 year history of abdominal pain. Imaging to screen for gallstones identified a large adrenal mass which was radiologically suspicious for adrenal carcinoma with probable inferior vena cava (IVC) involvement.Investigations: Overnight dexamethasone suppression test (ONDST) failed to suppress cortisol (324 nmol/l) with undetectable ACTH (<5 ng/l). Failure of suppression on low dose dexamethas...

: Recent Phase 3 studies have demonstrated the clinical utility of immunotherapy with inhibitors of PD1 in cancers, including melanoma and non-small cell lung cancer. Autoimmune side effects are common. Both hypothyroidism and hyperthyroidism have been observed in up to 16% of patients. We report for the first time the endocrine evaluation of patients with anti-PD1 induced thyroid dysfunction.Methods: All patients treated in published trials of anti-PD1 ...

Tyrosine kinase inhibitors and other targeted treatments are revolutionizing the treatment of cancer. However multiple endocrine side effects of these treatments are emerging.Crizotinib, a multi-targeted small molecule tyrosine kinase inhibitor of ALK and c-met, has been approved by the FDA for the treatment of non small cell lung cancer (NSCLC) patients with a novel oncogenic gene fusion, EML4-ALK and its variants. Crizotinib is generally well tolerated...

A 37-year-old lady was referred to the endocrine clinic with a raised serum calcium of 2.73 mmol/l in the presence of an inappropriately raised parathyroid hormone of 8.7 pmol/l. Calcium:creatinine clearance ratio was elevated at 0.018, excluding familial hypercalcaemic hypocalciuria. Past medical history revealed an episode of renal stones 17 years ago but a renal ultrasound excluded nephrocalcinosis.A diagnosis of primary hyperparathyroidism was made.<...