Endocrine Abstracts

Background: Pituitary adenomas commonly present with palsies involving the cranial nerves in the cavernous sinus. It is unusual, however, for other cranial nerve palsies to co-present and to have biochemical results that do not fit with the clinical picture.Case: A 47 year old man was admitted with 3 days of headache, vomiting, right sided facial paraesthesia and facial droop. He had no symptoms suggestive of endocrine disturbance. Neurological examinati...

Background: A large proportion of patients who attend the Endocrine clinic have thyroid dysfunction, usually thyrotoxicosis. These patients require regular thyroid function tests (TFTs) and advice on medication dose alteration, usually through frequent clinic appointments. At our University Teaching Hospital, we have a nurse-led system whereby TFT monitoring and advice is managed virtually, with patients usually attending clinic annually for review. We call this the Thyroid Sh...

Introduction: Our knowledge of the genomic background of neuroendocrine neoplasms (NENs) is rapidly expanding with more widespread use of sequencing technologies. Although known to be mutationally quiet compared to some other malignancies, many NENs harbour somatic copy number alterations (SCNAs), however the significance of these are unclear.Aims: We sought to identify SCNAs in a cohort of patients with NENs.Methods: Whole exome s...

Introduction: Genomic testing is expected to become a part of mainstream testing in the not-too-distant future, with clinicians ordering genetics tests in the same way routine endocrine tests are requested today. Knowledge on how and what test to request needs to be gathered by a wide range of physicians. To support this, the Genomics Education Programme of NHS England is developing a resource for all endocrinologists to use in clinic as part it’s Genomic...

Case: A 69 year old man was diagnosed with poorly differentiated pancreatic adenocarcinoma with liver metastases in November 2017 and received FOLFIRINOX chemotherapy followed by Gemcitabine. This stabilised his disease and chemotherapy was stopped in March 2020. In April 2021 he presented with a 3-4 month history of tiredness; intermittent confusion, especially in the early morning; the discovery that food resolved his symptoms, albeit temporarily; and accompanying significan...

Introduction: There is a clinical need to develop better biomarkers for the monitoring of patients with neuroendocrine tumours (NETs), including for patients with multiple endocrine neoplasia (MEN). Chromogranins are widely used, as are individual hormones for specific syndromes. Neurone specific enolase (NSE), however, is measured less commonly and its utility is debatable.Aims: To assess the value of measuring NSE in the clinical management of patients...

Introduction: There is a clinical need to develop novel and better biomarkers to monitor patients with neuroendocrine neoplasms (NENs). Our aim was to identify and track plasma circulating cell free tumour derived DNA (ctDNA) in a cohort of patients using a personalised, patient specific approach.Materials and methods: 35 serial plasma samples were collected from 9 patients with metastatic NENs (6 small intestinal and 1 each of lung, ovarian, and pelvic;...

Thyroid cancer is the most common endocrine malignancy accounting for 1% of new cancer cases each year. Even after treatment, one in five patients develop recurrence eventually. Therefore, close follow up is crucial after treatment. Current tumour biomarkers are not perfect, and there is a need for a more sensitive and specific way of detecting early recurrence. Liquid biopsies have emerged as a novel marker in tumour surveillance and monitoring response to treatment. In parti...

Introduction: Meningiomas are the most common brain tumours and they express progesterone receptors. Cyproterone acetate (CPA) is a synthetic progestogen approved for use as an anti-androgen in Polycystic Ovarian Syndrome (PCOS). We report a case of meningioma probably resulting from long-term CPA treatment and a review of our PCOS cohort for further cases.Case report: A 47-year-old lady with PCOS was treated with CPA 100 mg once daily for hirsutism and ...

We present two patients with an unusual cause of primary hyperparathyroidism.A 50 year old man was referred due to incidentally noted raised serum calcium consistent with primary hyperparathyroidism (adjusted calcium 3.52 mmol/L, phosphate 0.66 mmol/L, PTH (parathyroid hormone) 99.5 pmol/L, Vitamin D 46 nmol/L). An initial neck ultrasound demonstrated a 1.2x1.7 cm left sided presumed parathyroid nodule but also a cystic 3.3x3.2x1.7...