Endocrine Abstracts

Introduction: Adrenocortical carcinoma (ACC) is a rare disease with a poor prognosis and limited therapeutic options. Mitotane is considered as a first-line therapy but only 30% of the patients showing an objective tumour response.Erlotinib and gefitinib (tyrosine kinase inhibitors – TKI) inhibit the epidermal growth factor receptor (EGFR), which is highly expressed and occasionally mutated in various cancers. EGFR expression was found to be a good ...

Background: The low dose dexamethasone suppression test (LDDST) is an important investigation for suspected Cushing’s syndrome (CS). The traditional definition of normal suppression of serum cortisol to ≤50 nmol/l (0.5 mg 6 hrly × 48 hrs) comes from a time when biochemical auto analysers did not routinely detect very low values. Previous studies reported 5.1–8.3% of patients with Cushing’s disease (CD) suppressed to <50 nmol/l at 48 hrs. Many clin...

Introduction: Angiogenesis is regulated by different components of the tumour microenvironment (TME) including cytokines and immune cells. Although angiogenesis has been studied in pituitary adenomas (PAs), the role of individual TME components in PA angiogenesis remains largely unknown. We aimed to characterise the role of the TME components in determining the angiogenesis of PAs, focusing on PA-infiltrating immune cells and the PA-derived cytokine network.<p class="abste...

While pituitary adenomas (PA) usually occur as a sporadic disease, an increasing number of patients are recognised with a family member also suffering from a PA. If no other syndromic features are present, these families are categorised as FIPA. In published studies, 20% of the FIPA families, 20% of sporadic childhood and 13% of sporadic young-onset (≤30 years) acromegaly patients carry a germline AIP mutation. As familial disease is more aggressive, family scre...

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...

We have previously shown that the orexigenic and peripheral adipogenic effects of ghrelin are mediated by its effect on the metabolic enzyme AMPK. As the cannabinoid (CB1)-antagonist rimonabant inhibits the orexigenic effect of ghrelin, we suggest that there is an interaction between cannabinoids and ghrelin.To study the involvement of CB1 in the effects of ghrelin, wild-type (WT) and CB1-knockout mice were treated with ghrelin and rimonabant.<p clas...

The 250 mg short synacthen test (SST) is the most commonly used tool to assess the integrity of hypothalamic-pituitary-adrenal (HPA) axis. There are many instances when compromise to HPA-axis function is potentially reversible (including the use of suppressive dose of prescribed glucocorticoids), but currently there are no data to guide clinicians as to the frequency of repeat testing or to the likelihood of HPA-axis recovery. We performed an observational, retrospective, anal...

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 ...

We report a retrospective, single centre observational study to determine the characteristics and outcomes of pancreatic insulinoma. Interrogation of the Oxford NET database, a departmental database of new NET MDT referrals since 2011 (n = 1059), revealed 23/1059 (2.1%) patients with insulinoma diagnosed and treated between 2011 and 2018. Patient records were reviewed and data was captured on demographics, presentation, investigations, treatments and outcomes: 15/23 (...

Neuroendocrine tumours (NETs) presenting as metastatic cancer of unknown primary site (CUP) are suspected to confer poorer prognosis compared to metastatic NETs of known primary site. We performed a retrospective, single centre study to determine the prognostic indicators in CUP-NETs compared to metastatic small intestinal NET (SiNET), before and after adjusting for factors known to affect overall survival. Subjects were selected from a departmental database of 1050 NET patien...