Endocrine Abstracts

Objective: To document influences of sampling of blood under supine fasting versus seated non-fasting conditions on diagnosis of pheochromocytoma using plasma concentrations of normetanephrine, metanephrine and methoxytyramine (P-NMN/MN/MTY).Design and methods: P-NMN/MN/MTY were measured by liquid chromatography with tandem mass spectrometry in 695 patients at five centers, two of which complied with requirements for supine sampling after an overnight fa...

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...

Background: The water deprivation test (WDT) with direct or indirect measurement of plasma vasopressin (AVP) is the method of choice for the differential diagnosis of the polydipsia–polyuria syndrome. In theory, direct measurement of AVP is highly attractive but hampered by technical difficulties.Objective: To evaluate the utility of copeptin, a surrogate of AVP secretion, in the diagnostic work-up of the polyuria–polydipsia syndrome, and to co...

While bariatric surgery is the most effective treatment strategy to maintain long-term weight-loss and to improve survival, it has not been shown, that bariatric surgery is as effective in craniopharyngeoma patients with hypothalamic obesity. We retrospectively analyzed weight loss and metabolic parameters in 7 craniopharyngeoma patients and 14 controls who underwent gastric banding surgery in five centers in Germany and Austria. The last before and the first patient after the...

Introduction: Surgery is the established first line treatment in adrenocortical carcinoma (ACC). For benign adrenal tumours, laparoscopic adrenalectomy (LA) has become the treatment of choice. However, the role of LA in ACC remains highly controversial. Data from the German ACC Registry were used to evaluate the technical feasibility of LA in ACC and to compare the long-term outcome after LA with the results of open adrenalectomy (OA).Methods: Out of 521...

Objectives: No immunohistochemical marker has yet been established to reliably differentiate adrenocortical tumors from other adrenal masses (e.g. metastases). Thus, a panel of several markers like melan A and inhibin is currently used for this purpose, but suffers from limited diagnostic accuracy. We hypothesized that expression of steroidogenic factor 1 (SF-1), a nuclear transcription factor involved in adrenal development and steroidogenesis, might hold significant diagnost...

Standard treatment of adrenocortical carcinoma (ACC) comprises adrenolytic therapy with mitotane. Prolongation of bleeding time has previously been observed based on a series of 7 patients (Haak et al. 1991). As patients with ACC frequently undergo surgery for local recurrence or metastases, we have studied the effect of mitotane on coagulation in 44 patients with ACC before and/or during treatment with mitotane (total sample size n=62).Pla...

Adrenal masses are highly prevalent tumours comprising of a variety of entities. Therefore, therapeutic consequences also vary considerably. The CYP11B-specific PET-tracer [11C]metomidate has been shown to be suitable to characterize adrenal lesions. However, its availability is restricted to PET-centers with an on-site cyclotron. Also imaging is hindered by the short tracer half-life (20 min). Therefore, we have developed [123I]iodometomidate as a tracer...

Objectives: Adrenocortical carcinoma (ACC) is a rare tumor with poor prognosis and limited therapeutic options. Survivin is an anti-apoptotic molecule expressed by neoplastic and tumor-specific endothelial cells of various carcinomas, but rarely or only weakly in normal differentiated tissue. In melanoma and pancreatic cancer, preliminary results of a survivin vaccination trial (www.clinicaltrials.gov) indicated that an immunological response in patients is often paralleled by...