Endocrine Abstracts

Adrenal masses are discovered in 5% of abdominal imaging scans and the diagnostic work-up has to address two major questions: does the adrenal mass overproduce hormones and, most important to the patient, does the adrenal tumour represent cancer? The reported incidence of adrenocortical carcinoma varies in reported series from 2 to 11%. However, the accuracy of currently available imaging tests to diagnose malignancy is poor. Urine steroid metabolomics is a combination of ster...

Introduction: Gas chromatography mass spectrometry (GC-MS) is the gold standard method for urinary steroid profiling. However, GC-MS requires chemical derivatisation, long run times, is labour intensive, expensive, and unsuitable for rapid multi-sample analysis, limiting its use in routine clinical practice. GC-MS urinary steroid metabolomics, the combination of steroid profiling and machine learning (Generalized Matrix Learning Vector Quantization) was shown to have superior ...

Introduction: Carney complex (CNC) is a rare multiple neoplasia syndrome characterized by pigmented lesions of the skin and mucosa in association with various endocrine and non-endocrine tumors. The disease can be inherited in an autosomal-dominant fashion or occur sporadically due to novel mutations in the PRKAR1A gene. Primary pigmented nodular adrenocortical disease (PPNAD) is a common endocrine manifestation of CNC.Case description: A 20-year-old wom...

11β-hydroxysteroid dehydrogenase type 1 (HSD-1) controls the intracellular cortisol pool that has access to cytosolic glucocorticoid and mineralocorticoid receptors. HSD-1 activity is elevated in patients with Cushing’s syndrome (CS).1 Patients with CS and constitutionally low HSD-1 activity showed no hypercortisolism-related symptoms despite very high 24-hour urine free cortisol.2, 3 A recent pilot trial of a HSD-1 inhibitor in patients with classical or mild CS sho...

Objective: We examined whether sequential enhancement patterns of pituitary microadenomas on dynamic MRI correlates with different subtypes of pituitary tumors.Materials and methods: Patients with pituitary microadenomas imaged via dynamic MRI between years 2000 and 2012 were included. The intensity of the adenoma and of normal gland at each time point in the dynamic sequence was measured by drawing a region of interest (ROI) on both the normal pituitary...

Background: Chronic opioid use may lead to adrenal insufficiency (AI) due to suppression of the hypothalamic-pituitary-adrenal axis. We aimed to determine incidence of AI and mortality in patients treated with chronic opioid therapy in a standardized geographically well-defined population.Methods: In this population-based cohort study we assessed the standardized incidence rate of first time met chronic opioid use and adrenal insufficiency in adult resid...

Introduction: Minimally invasive blood-borne circulating microRNAs might be used for the preoperative differentiation of adrenocortical carcinoma (ACC) and adrenocortical adenoma (ACA). Circulating hsa-miR-483-5p is so far the best microRNA biomarker of ACC. To the best of our knowledge, there have been no studies concerning the potential applicability of urinary has-miR-483-5p as a non-invasive biomarker of ACC and its correlation with plasma hsa-miR-483...

Introduction: Testicular leydig cell tumours (LCTs) are rare stromal tumors often associated with androgen excess. Metastatic malignant LCTs typically show resistance to radiotherapy and cytotoxic chemotherapy, calling for alternative management options. Here we describe our experience with treatment of two patients with metastatic LCTs with the adrenolytic drug Mitotane.Patients/methods: Case 1: A 51-year-old patient presented with a 6 month hi...

Objective: There is limited evidence on the diagnostic accuracy of imaging tests in patients at high risk for adrenal malignancy. Our objective was to determine the performance of computed tomography (CT) and 18FDG-PET/CT imaging in diagnosing a malignant adrenal mass in a high risk population of patients referred for CT-guided adrenal biopsy.Methods: We retrospectively reviewed the medical records of 378 patients who had percutaneous adrenal ...

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...