Endocrine Abstracts

Background: Treatment for advanced adrenocortical carcinoma (ACC) consists of mitotane alone or combined with etoposide, doxorubicin and cisplatin (EDP), yet their efficacy is limited and burdened with significant toxicity. Moreover, markers of response are lacking. Inflammation-based scores have been proposed as prognostic factors in several malignancies including ACC, and recently also as predictors of gemcitabine+capecitabine efficacy, second-line treatment in progressive d...

Glucocorticoids play a significant role in immune modulation and regulation of inflammation. In patients with endogenous glucocorticoid excess (Cushing’s syndrome [CS]) multiple haematological alterations are recognized, such as neutrophil leukocytosis, lymphopenia, and eosinopenia, often leading to severe clinical complications. However, little is known in patients with mild autonomous cortisol secretion (MACS). Serum inflammation-based scores may reliably reflect system...

A decline in skeletal muscle nicotinamide adenine dinucleotide (NAD+) can decrease mitochondrial function and energy metabolism in age-related metabolic disease. Restoration of NAD+ using the precursor nicotinamide riboside (NR) may serve to support age and disease driven impairment of mitochondrial energy metabolism. Manipulating NAD+, and consequently cellular pyridine nucleotide NAD(P)(H) pools, may impact the flux of glucose through intermediary energy metabolism pathways....

Background: Adrenal incidentalomas are mostly non-functioning adrenal tumours (NFAT) or adenomas with mild autonomous cortisol excess (MACE), of which the natural history is unclear. We conducted a systematic review and meta-analysis focussing on NFAT and MACE to determine the: (i) proportion and degree of tumour growth, (ii) incident change in hormone function, and (iii) proportion of malignant transformation.Methods: We searched MEDLINE In-Process &#38...

Background: Adrenal masses are detected in 5-7% of adults. The European guidelines on managing adrenal incidentalomas published in 20161 have standardised the management of these patients. However, evidence of the guidelines’ impact on clinical care is still lacking.Methods: We conducted a retrospective, comprehensive review of clinical presentation, radiological characteristics, final diagnosis, and outcome of a large cohort of patients ...

Adrenocortical carcinoma (ACC) is a rare aggressive cancer with heterogeneous behaviour. Disease surveillance relies on frequent imaging, which comes with significant radiation exposure. Here we investigated the role of circulating cell-free DNA (ccfDNA) in ACC monitoring. We extracted ccfDNA from 1-4 ml EDTA-plasma using the Nonacus Cell3TMXtract or the Qiagen QIAamp MinElute kit and quantified by fluorimeter. We investigated 63 patients with ACC (25M/38F, 52±...

Adrenocortical carcinoma (ACC) is a rare endocrine malignancy. ACC may rarely occur as part of familial cancer syndromes, but the majority of the cases occur sporadically. A significant proportion of sporadic ACC cases may be preceded by other malignancies and adrenal metastasis from these primary tumours may frequently occur. Herein we present three cases where sporadic ACC was identified in patients with coexistent or previous history of melanoma.Case ...

Introduction: Immune dysregulation is a feature of Cushing’s syndrome (CS). We report a case of CS that presented with rapidly developing cutaneous Kaposi’s sarcoma (KS).Case description: A previously well 59-year-old heterosexual man presented with a two-month history of proximal muscle weakness, recurrent mouth ulcers, and purplish skin lesions. He had a background history of hypertension. Skin biopsies were compatible with KS. History of pas...

Background: Adrenal tumours are found in 3-7% of adults. The European guidelines on management of adrenal incidentalomas (first published in 2016 and recently updated) have standardised the management of these patients, but evidence of guideline impact on clinical care is lacking.Methods: Retrospective review of the mode of presentation, radiological characteristics and final diagnosis of a large cohort of patients with ...

Background: The Congenital adrenal Hyperplasia (CAH) Adult Study Executive (CaHASE) identified poor metabolic outcomes and reduced quality of life in CAH. CaHASE2 was recently established to examine the current status of CAH care. We surveyed clinical practice in the UK and Ireland, and awareness and use of the International CAH (I-CAH) Registry.Methods: We undertook an anonymised online survey targeting clinicians provi...