Endocrine Abstracts

A 62-year-old male was referred by his GP querying acromegaly. His past medical history included sleep apnoea, hypertension, dislipidaemia and gout. Serum IGF1 was elevated at 827 ug/l (normal range 100–300 ug/l). Prolonged oral glucose tolerance did not show suppression of GH with a nadir of 9.0 mu/l. A pituitary MRI demonstrated a 5x6mm microadenoma. There were no visual field defects. The patient was pre-treated with somatostatin analogues and proceeded to transphenoid...

Malignant paraganglioma causing skull metastasis is rare. We describe a 49-year-old male who gives a history of a mass on the vertex of the scalp, noticed a year before presentation and which grew rapidly from 1 cm to 5 cm. His past medical history is significant for hypertension (treated with Amlodipine), and back pain and headache on a regular basis. On MRI the mass measured 5.7 cm craniocaudal, by 7 cm AP and 6.9 cm transverse. Additionally, multiple additional focal areas ...

We present a case of a 48 year old male who presented originally with a 8mm prolactinoma. He presented with a reduced libido for 6 months, and lethargy and retro-orbital headaches for the previous 18–24 months. He had no visual disturbance. Initial investigations revealed hyperprolactinaemia with a level of over 4000 iu/L and a normal IGF1 of 184 iu/L in the presence of a pituitary macroadenoma (8 x 11mm). He responded well to Cabergoline with a noticeable improvement in ...

An 88 year old female presented with gradually worsening stridor and dysphagia. Her past medical history was complex and included included ischaemic heart disease and atrial fibrillation treated with warfarin. She had been initially referred for enlargement of her lonstanding goitre 6 years ago (2012) with investigations demonstrating a suppressed TSH and a normal FNA cytology. Respiratory function tests did not show any significant extra thoracic compression, but her CT scan ...

An association between the use of proton pump inhibitors (PPIs) and profound hypomagnesaemia has been highlighted in a number of case reports. As the prevalence of this occurrence or cause remain unknown, we undertook a review of patients with significant hypomagnesaemia in our hospital with a particular focus on use of PPIs and management.35 patients (21f; mean age (S.D.): 71.3 (14.6); median: 74 years) with significant hypomagnesaemia (d...

In 2003, a 60-year-old man presented to our unit non-specifically unwell. Thyroid function tests (TFTs) demonstrated an elevated fT4 of 50 pmol/l (reference range 10–22 pmol/l)), T3 8.8 pmol/l (reference range 3.1–6.8 pmol/l) and TSH of 10.3 mU/l (reference range 0.5–4.5 mU/l)). Following appropriate investigations, a TSHoma was confirmed. MRI of the Pituitary confirmed the finding of a macroadenoma and the patient underwent pituitary decom...

A 64-year-old man was referred with an incidental finding of multiple bilateral thyroid cysts following CT scanning for abdominal pain. He had originally presented with an acute episode of left upper quadrant pain. CT scan of the abdomen demonstrated multiple lesions in the liver compatible with simple cysts. There were also multiple bilateral renal cysts, of which the largest was 10 cm. A small amount of retroperitoneal fluid was seen, probably as a result of a ruptured cyst....

A 68 yr old male with a history of type 2 diabetes presented with myalgia and girdle weakness affecting him on a frequent but episodic basis. Investigations confirmed Cyclical Cushing's Disease. Pituitary MRI was normal. Further investigations include bilateral inferior petrosal sinus sampling (BIPSS) which can help determine the origin of ACTH-dependent Cushing’s syndrome. After CRH-stimulation, a peak central to peripheral ACTH ratio of >3 suggests a pituitary ACTH ...

We report a case of severe postradiation encephalitis presenting 6 months following pituitary radiotherapy for pituitary adenoma. Our patient (78 years old female) was diagnosed with non-functioning pituitary ademona compromising the optic chiasm in 1999 at the age of 66 years. She underwent transphenoideal decompression in 2000. Over the next 8 years there was slow re-growth of the pituitary adenoma and by 2008 it was causing optic chiasm compression. At this stage, the patie...

A 28-year-old man presented to his GP in Turkey complaining of fatigue. As part of his work up, serum PTH was assessed and was found to be markedly elevated at 29.9 pmol/l (normal range 1.6–6.8), with normal calcium, phosphate, alkaline phosphatase, renal function, 1,25- and 25-hydroxy vitamin D3 levels. A DEXA scan was normal and a Sestamibi scan did not reveal any parathyroid adenoma. Prior to any further investigations or treatment, he moved to the UK.<p class="abs...