Endocrine Abstracts

Background: Benign adrenal incidentalomas (AI) are found in 3-5% of adults. All patients should undergo a 1 mg -overnight dexamethasone suppression test (1 mg -DST) to exclude cortisol excess (non-functioning adrenal tumours, NFAT; serum cortisol ≤50 nmol/l) or diagnose possible mild autonomous cortisol secretion (MACS; serum cortisol >50 nmol/l). Current guidelines discourage repeating hormonal work-up in patients with benign AI. However, data underpinning this reco...

Background: Primary adrenal insufficiency (PAI) can be of autoimmune origin (Addison’s disease, AD) or due to inborn disorders of steroidogenesis (congenital adrenal hyperplasia, CAH). Prognosis of patients with PAI has improved considerably after glucocorticoid replacement therapy became available. However, even in recent years, an increased risk of death has been described in both AD and CAH patients. Moreover, even with the current state-of-the-art replacement therapy,...

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...

Introduction: Differentiated thyroid cancer (DTC) is the most frequent endocrine cancer. After surgery followed, if any, by 131I radio remnant ablation (RRA), follow-up monitoring consists of neck ultrasonography (US) and measurements of thyroglobulin (Tg) levels and anti-Tg antibodies (Ac-Tg) both on levothyroxine (L-T4) therapy and after recombinant TSH (rTSH). The aim of our study is to define a cut-off of Tg before RRA (RRA-Tg) during <...

Background: Patients with primary adrenal insufficiency (PAI) carry an increased risk of infections which can precipitate adrenal crises. They are thought to be more likely to contract COVID-19 and develop severe disease; however, little is known about the true impact of COVID-19 on these patients.Objectives: To assess the response of a large single-centre cohort of PAI patients to COVID-19, focusing on morbidity and health promotion attitudes.<p cla...

Background: The last American Thyroid Association guidelines (ATA-2015) defined the risk of structural recurrence in patients with DTC cured after initial treatment and according to the initial histology. However, these data resulted from several studies including different patients with different kinds of treatment. We retrospectively evaluated a large population of patients with DTC, treated and followed in a tertiary referral center, with the aim to characterize the rate of...

Introduction: Virtually all familial cases of Medullary Thyroid Carcinoma (MTC) have a RET germline mutation. Subjects harboring RET germline mutation without unaware of their condition are defined gene carriers (GC). Thyroid surgery timing is decided upon RET mutation and calcitonin levels (both basal, bCT, and stimulated, sCT). However, bCT and sCT thresholds for planning thyroid surgery have not been established, yet.Methods...

Background: Standard treatment for advanced adrenocortical carcinoma (ACC) is mitotane in monotherapy or combined with etoposide, doxorubicin and cisplatin (EDP), yet biomarkers predictive of treatment response are lacking. Inflammation-based scores were proposed as predictors for gemcitabine+capecitabine efficacy, used as second-line in progressive ACC. We investigated the role of inflammation-based scores in predicting response to first-line treatment in advanced ACC.<p ...

Background: The detection of phaeochromocytomas evolved from autopsy finding to presentation in symptomatic/hypertensive, and genetically-predisposed individuals. Increasingly, phaeochromocytomas are diagnosed in incidental adrenal masses and the impact on the clinical, biochemical, and radiological features is unclear.Methods: Retrospective review of patients with phaeochromocytomas seen at a large tertiary referral centre between January 2010 and May 2...

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±...