Endocrine Abstracts

Introduction: Patients with acromegaly have an increased risk of colorectal cancer and pre-malignant adenomatous polyps; however the frequency of colonoscopic screening remains unclear.Aims: To determine optimum frequency for repeated colonoscopy of acromegalic patients.Methods: Since 1992, 254 patients (mean age 56.6 years) at our centre have undergone at least one fibre-optic colonoscopic surveillance; 156, 60 and 15 patients hav...

Background: Cyclical Cushing’s syndrome has been considered to be a rare clinical entity, characterised by periodic increases in cortisol levels followed by regression of the Cushing’s syndrome. The cycles of hypercortisolism may occur before the establishment of the diagnosis, rendering actual diagnosis difficult, or may occur after inadequate or ineffective treatment and affect disease management. The aim of this study was to investigate the prevalence of cyclicity...

Differentiating aldosterone-producing adenomas (APA) from bilateral adrenal hyperplasia (BAH) as a cause of Conn’s syndrome (CS) is crucial for appropriate management. We have prospectively evaluated the relative contributions of PST, adrenal imaging by Computed Tomography (CT) and AVS in the differential diagnosis of CS.We investigated 25 consecutive patients with CS referred to our unit with an identical protocol. Every patient underwent PST, CT a...

The preparation of Sandostatin LAR® injections using a 2 ml ampoule of vehicle solution may be associated with some technical difficulties of administration, with adverse consequences for patients. The development of a 2.5 ml prefilled syringe may alleviate some of these problems. We have compared these two methods of Sandostatin LAR® administration in 17 patients with acromegaly and 5 patients with neuro-endocrine tumours, (6 drug naïve, 1...

Background: Standard trans-peritoneal adrenalectomy has disadvantages, which are minimised by a less invasive procedure, but laparoscopic adrenalectomy is time consuming and unsuitable for large or malignant tumours.Aims: To evaluate our experience of all laparoscopically assisted mini-adrenalectomy using a subcostal incision 10 cm or less, since July 1999.Methods: Data were collected on wound size, operative time, blood loss (fall...

Medullary thyroid carcinoma (MTC) is a rare malignancy which has often metastasised at time of diagnosis. Surgical resection represents the only prospect for cure. However, debulking neck surgery may be beneficial in advanced cases. Prophylactic surgery is increasingly undertaken in asymptomatic patients with known mutations in the RET oncogene. The aim was to describe the outcome following initial surgical treatment for MTC at our institution. We performed a retrospe...

Objective: Remission rates in young people with Graves’ hyperthyroidism are <25% after a 2-yr course of thionamide antithyroid drug (ATD). Immunomodulatory agents might improve outcome by facilitating immune tolerance. We explored whether rituximab (RTX) would increase remission rates when administered with a short course of ATD.Design: This was an open label multi-centre single arm phase 2 trial in newly presenting young people (12-20y) with Gr...

Introduction: Adrenal venous sampling (AVS) is the criterion standard method of lateralisation in primary aldosteronism (PA). Despite this pivotal role, there is limited consensus and significant variability between centres related to many of the technical aspects of AVS. In this study, we sought to address whether variations in two different technical aspects of AVS altered parameters and interpretation, namely: 1. Peripheral sample site 2. Method of adrenal vein (AV) venesec...

Introduction: Selective transsphenoidal microadenomectomy (TSS) is the first-line treatment of paediatric Cushing’s disease (CD). Corticotroph adenomas in children are often small and difficult to visualize. We aimed to assess the utility of pituitary MRI and bilateral inferior petrosal sinus sampling (BIPSS) in confirming the diagnosis of CD and the localisation of the adenoma. We also report our early experience of STEALTH MRI (volumetric T1 weighted, contrast-enhanced ...

Adrenocortical carcinoma (ACC) is a rare malignancy with limited treatment options and a heterogenous prognosis. The histological diagnosis of ACC is complex and there is increasing interest in identifying and validating new immunohistochemical markers. Delta-like non-canonical Notch ligand 1 (DLK1) is a cleavable single-pass transmembrane protein. In humans, DLK1 is present in many tissues during foetal development, is restricted to progenitor/stem cells in a few adult tissue...