Endocrine Abstracts

Background/objective: Published data suggest that growth hormone replacement (GHR) may be safely given to patients with hypopituitarism consequent upon a pituitary/peri-pituitary tumour. However, to date, these series have included a preponderance of patients treated with external pituitary irradiation. We have performed a retrospective study to evaluate the recurrence rate in a group of patients with pituitary/peripituitary tumours treated with GHR.Meth...

Background: Patients with neuroendocrine tumours (NETs) and acromegaly are commonly treated with somatostatin analogs (SSAs), such as octreotide and lanreotide depot formulations. The Pharmathen syringe is now available in several European countries and the USA for lanreotide depot injection. When using SSAs, confidence in and ease of use with syringes are important for decision-making in long-term therapy. The aim of the PRESTO 3 study was to compare nurses’ preference f...

Introduction: Phaeochromocytomas and paragangliomas (PPGL) are rare neuroendocrine tumours with no standardised protocol for treatment. 177Lu-DOTATATE peptide receptor radionuclide therapy (PRRT) is an emerging treatment option for patients with metastatic and/or inoperable PPGL, and with low toxicity. We present our experience with PRRT in advanced PPGL, treated in a ENETS Centre of Excellence.Materials and Methods: 165 patients with...

Introduction: Cushing’s syndrome is a rare endocrine disorder characterized by excess cortisol secretion. It can be caused by various etiologies, including ACTH-dependent and ACTH-independent forms. We report a case of a 78-year-old male who presented with severe hypertension, refractory hypokalemia, and severe hypercortisolaemia, diagnosed with ACTH-dependent Cushing’s syndrome with bilateral adrenal hyperplasia.Case Presentation: A 78-year-ol...

We present the case of a 54-year-old woman with known metastatic non-functional pancreatic NET since 2004 that developed new debilitating recurrent hypoglycemia in 2013. The patient presented in 2004 with disseminated malignancy. Radiology revealed a large pancreatic mass associated with multiple liver lesions and abdominal lymphadenopathy. Liver biopsy confirmed well differentiated NET. Initial treatment with cisplatin etoposide chemotherapy was poorly tolerated and discontin...

Primary hyperparathyroidism (PHP), usually due to multigland hyperplasia, occurs in >90% of patients with multiple endocrine neoplasia type 1 (MEN1). The literature is divided on the optimal surgical management for such patients. We report a retrospective cohort study on the long-term outcomes associated with limited, subtotal, or total parathyroidectomy as initial surgery for PHP in MEN1. The primary endpoint was recurrent PHP defined as an adjusted serum calcium >2.6 mmol/l ...

Context: Surgical intervention is advised in patients with multiple endocrine neoplasia type-1 (MEN-1) with non-functioning pancreatic neuroendocrine tumors (PanNET) and a size ≥20 mm. However, functioning PanNET such as patients with endogenous hyperinsulinemic hypoglycemia (EHH) due to (one or multiple) insulinomas should be treated surgically independent of size. Reliable preoperative localization of insulinomas is critical for surgical strategy.<p class="abstext"...

Background: Large populations of HIV and tuberculosis occur in South Africa and, amongst these patients, Addison’s disease is probably underdiagnosed. Preliminary data in 60 HIV-positive patients with a CD4 count less than 100 cells/mm3 showed that the overall prevalence of hypoadrenalism was 6.7%, with 1 patient having primary hypoadrenalism and 3 patients having central hypoadrenalism. This report describes the prevalence of hypoadrenalism and its association...

Introduction and aim: Pancreatic neuroendocrine tumours (PNETs) may occur sporadically (sPNETs) or as part of the multiple endocrine neoplasia type 1(MEN1) syndrome, which is characterised by occurrence of PNETs, parathyroid and anterior pituitary tumours. Our aim was to review the management of these patients in relation to the clinical practice MEN1 guidelines, and the ENETS and UKINETS guidelines for PNETs.Patients and methods: Patients attending with...

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 ...