Endocrine Abstracts

Introduction: Pituitary and adrenal Cushing’s may be managed by pharmacological-inhibition of adrenal steroidogenesis, using metyrapone and/or ketoconazole. Assessment of biochemical control is challenging owing to cross-reactivity in immunoassays (e.g. cortisol and 11-deoxycortisol) leading to over/under-treatment. Off-target effects can also result, e.g. hyperandrogenism/mineralocorticoid hypertension (increased 11-deoxycorticosterone/DOC). LC-MS/MS analysis is free fro...

Background: Lack of expression of MGMT (O-6-methylguanine-DNA methyltransferase) is associated with a better tumour response to temozolomide. There are no systematic studies of MGMT expression in pituitary tumour series.Aim: We introduced MGMT immunohistochemistry for all pituitary adenoma specimens in 2011. In this study we investigated the immunohistochemical expression of MGMT in a large series of pituitary adenomas, in order to determine (1) the over...

Inpatients with hyponatraemia have a high mortality and longer length of stay. We instituted a system of automatic referral to the endocrinology team where any inpatient with a serum (Na+) ≤125 mmol/l was referred automatically from their biochemical results.Aims: We evaluated the diagnosis, management, and outcome of the patients referred with hyponatraemia over 6 months.Methods: Data were prospectively captured e...

Introduction: Pituitary inflammation (Hypophysitis) is rare in paediatric population and usually results in pituitary enlargement and hypopituitarism. Hypophysitis can be either primary (most commonly lymphocytic, granulomatous or xanthomatous disease) or secondary (consequent to systemic diseases, immunotherapy or alternative sella-based pathologies). We describe the clinical presentation and management of apparent primary lymphocytic hypophysitis in an adolescent girl. Case ...

Background: It is generally accepted that a post-operative cortisol of <50 nmol/l is a good predictor of long-term remission following trans-sphenoidal surgery (TSS).Aim: We wished to determine the rate of late recurrence and need for consequent intervention in patients who had initial biochemical remission after TSS for pituitary dependent Cushing’s.Methods: We performed a retrospective analysis of our patients who underw...

There is limited research into the impact of active brown adipose tissue (aBAT) in patients with phaeochromocytomas and paragangliomas (PPGLs). A small body of evidence has shown that patients with PPGL patients can exhibit a high prevalence for aBAT recognized as ranging between 8 - 28% without specific correlation to germline mutations. Furthermore, it has been suggested that aBAT may be linked to increased mortality. Systematic searches of the Medical Literature Analysis an...

Adrenocortical carcinoma (ACC) is a rare malignancy, but accounts for up to 11% of adrenal masses investigated in referral centres. Diagnosis remains a challenge. Up to two thirds are biochemically inactive, resulting from de facto enzyme deficiencies in the steroid hormone biosynthetic pathways, as shown by urine steroid profiling by gas chromatography-mass spectrometry. Increased metabolites of pathway intermediates in ACC discriminate it from benign adrenal lesions...

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 ...

Objective: To describe the clinical presentation, management and treatment outcomes of prolactinomas diagnosed in childhood and adolescence in a consecutive series.Design and Methods: A retrospective review of medical records of patients with prolactinoma less than 20 years at diagnosis, referred to a tertiary paediatric endocrine service between 1996 and 2018.Results: Twenty-three patients (14 females) were identified; median age ...

Introduction: In 2017 the term ‘Atypical adenoma’ was removed from the WHO classification, and ‘High-risk adenomas’ was introduced as a term to classify those with rapid growth, radiological invasion, and a high Ki-67 proliferation index. In this retrospective cohort study we have sought to identify the clinical and histological characteristics which are associated with worse outcomes.Methods: Data: We created a dataset of 1793 pa...