Endocrine Abstracts

Introduction: Current medical treatment of adrenocortical carcinoma (ACC) is based on mitotane alone or in combination with cytotoxic chemotherapy. However, very little is known about the pharmacokinetic properties of mitotane and dosing schedules are based on clinical experience only. The aim of this study was to investigate the relationship between mitotane dose and plasma concentration comparing two pre-defined treatment regimens. Secondary objectives were to evaluate safet...

Background: No randomized trials have been conducted in adrenocortical carcinoma (ACC) patients. Treatment recommendations for this rare but aggressive disease have been based on data from small phase II trials. We have now performed the first randomized phase III trial, comparing etoposide, doxorubicin, cisplatin, plus mitotane (EDP-M) against streptozotocin plus mitotane (Sz-M).Methods: Three-hundred and four chemotherapy-naive patients with ACC not am...

Mitotane therapy is associated with many side effects, including thyroid function perturbations mimicking central hypothyroidism, possibly due to laboratory test interference or pituitary direct effects of mitotane. Therefore, we aimed at investigating whether increasing concentrations of mitotane in the therapeutic range might interfere with thyroid hormone assays and evaluate the effects of mitotane on a mouse TSH- producing pituitary cell line. TSH, FT4 and FT<su...

Aim of this study is to present preliminary epidemiological data on a population of 1512 acromegalic patients attending 22 tertiary centers in Italy from 1980 to 2002. At our knowledge this is the first large–scale epidemiological Italian study on acromegaly. Gender was 624 (41.2%) men and 888 (58.8%) women. Mean age at diagnosis was 45±13 years, 43±13 for men and 47±13 for women. Median estimated duration of acromegaly before diagnosis was 74 months (range...

The existing follow-up studies on patients with incidentally discovered adrenal adenoma (AA) focused almost exclusively on repeat imaging and endocrine work-up on a short period.Of consecutive 152 patients with AA referred to our center from 1989 to 2003, we have assessed the risk of developing metabolic disorders and vascular complications in the 74 patients who did not underwent surgery (51 women and 23 men, median age 57, range 25–74 years) durin...

Recent guidelines recommend to use the 1-mg DST to screen for subclinical hypercortisolism assuming that a post-DST cortisol >5.0 μg/dl define this condition. However, several experts suggest a more sensitive cut-off at 1.8 μg/dl while others consider mandatory to confirm unsuppressibility with a 8-mg DST. A consecutive series of 64 patients (22 men, 42 women, aged 28–81 years) with clinically inapparent adrenal adenoma were studied between 2005 and 2007. Th...

Objective: The Antiphospholipid Syndrome (APS) is a thrombophilic disorder characterised by recurrent venous and/or arterial thromboses and increased pregnancy morbidity. There is growing evidence supporting a functional interplay between the neuroendocrine and immune system; the hypothalamic-pituitary-adreal (HPA) axis plays a pivotal role in this network. Previous studies have described normal cortisol levels in APS patients while occurrence of acute adrenal failure was repo...

Objective: Seventeen patients (9 women, 8 men aged 36 years, 22–58) radically resected for ACC were treated with adjuvant mitotane and prospectically followed from 2000 to 2006.Methods: Stage of ACC: was: 1 stage I,; 12 stage II, 4 stage III; Weiss score 6, 3–9; Ki67% 20, 4–67. Eleven patients had functional tumors. Median duration of treatment was 15 months (range:4–84) and 14 patients are currently on mitotane, 2 died, 1 discontinue...

Background and objectives: The role of adjuvant mitotane therapy after radical surgery for adrenocortical carcinoma (ACC) is still debated. The aim of our study is to assess the effects of adjuvant mitotane on recurrence free survival (RFS) and overall survival (OS) in non-metastatic ACC patients and to evaluate prognostic factors in adjuvant setting.Methods: Retrospective data were collected from 152 patients affected by ACC (stage I-III) referred to ou...

Background: Adrenocortical carcinoma (ACC) is a rare cancer associated with hereditary syndromes in 10% of cases. However, data on germline variants (GVs) in adult patients with sporadic ACC are limited.Methods: We analyzed germline DNA from 150 adult patients with sporadic ACC sequentially referred to our centers between 1998-2019. We designed a custom panel of 17 genes potentially involved in the pathogenesis of ACC: AIP, APC, ARMC5, ARNT, BRCA1, BRCA2...