Endocrine Abstracts

Introduction: In 2009 the Endocrine Society’s clinical practice guidelines for management of hypoglycemic disorders, confirming previous suggestions, have stated that the new cut-off of insulin for the diagnosis of insulinoma should be lowed to 3 μU/mL in presence of hypoglycemia (serum glucose ≤55 mg/dL). Moreover hypoglycemia in post-prandial status has been reported in insulinoma, alone or associated with fasting hypoglycemia. Finally preexisting diabetes me...

Background: Sleep apnea syndrome (SAS) is a common disease in acromegaly and it can persist during remission in up to 58% of the patients. Data regarding long term outcome of SAS in acromegalic patients are lacking. Moreover it is still unknown which component, either craniofacial deformation or soft tissue hypertrophy of the palate and upper airways, may play the major role in the pathogenesis of this complication.Aim: To assess the presence of SAS in a...

Background: Mitotane (o,p’DDD) is the reference therapy for adrenocortical carcinoma (ACC) and should undergo metabolization in o,p’DDE and o,p’DDA to exert its anti-proliferative activity. We have previously shown that there is a link between RRM1 gene expression and o,p’DDD activity in an adjuvant setting. Aim of this study was to assess whether RRM1 gene expression is correlated to the bioavailability and cytotoxic activity of o,p’DDD and its metabo...

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...

Mitotane, used in the treatment of adrenocortical cancer (ACC), is able to inhibit multiple enzymatic steps of adrenocortical steroid biosynthesis, potentially causing adrenal insufficiency (AI). Recent studies in vitro have also documented a direct inhibitory effect of mitotane at the pituitary level.The aim of the study was to assess the hypothalamic pituitary adrenal (HPA) axis in patients receiving mitotane as adjuvant treatment after radica...

We have demonstrated that adjuvant mitotane prolong recurrence free survival (RFS) in patients with radically resected ACC. Aim of the present study was to correlate mitotane levels with patient outcome in an adjuvant setting in 3 different referral centres in Europe. There were 120 patients (45 W, 75 M, median age 44 years, range 16–76) radically resected for ACC who were treated adjuvantly with mitotane from 1996 to 2010. ACC was stage I in 10 cases, II in 73, III in 31...

The optimal treatment of recurrent adrenocortical cancer (ACC) remains to be established since there are discrepant opinions on the value of repeat surgery. We did a retrospective analysis of the outcome of patients who were referred to our units from 1988 to 2006 for a recurrence of ACC, which occurred 2–83 years after radical removal of the tumor. In that period, the treatment policy of ACC recurrence differed among our units, since oncologists were more accustomed to u...

The long-term risk of carcinogenic and genetic damage following the treatment with 131I for differentiated thyroid cancer (DTC) is quite low. The hypothyroid status (HS), at the time of 131I administration, decreases the renal clearance of 131I and increases the whole-body, blood and bone marrow irradiation, unlike the euthyroid status (ES). Chromosome aberrations (CA) in peripheral lymphocytes reflect blood cells exposure to irradiation. This ...

Adrenocortical carcinoma (ACC) is a rare tumor with poor prognosis and the only approved drug for advanced disease is mitotane. The cytochromes P450 (CYP) 2W1 and 2B6 are proposed predicting markers of sensitivity to mitotane treatment. Aim of the study was to evaluate the relationship between CYP2W1 and/or CYP2B6 polymorphisms and response to mitotane in ACC.Methods: We performed a multicentric retrospective study including 182 ACC patients (F/M=121/61)...

Introduction: Available literature on series of patients affected by ectopic Cushing’s syndrome (ECS) deriving from neuroendocrine tumours (NETs) is relatively scarce. This is the first Italian multicentre study regarding clinicopathologic features, modalities of treatment, and survival of patients with NETs and ECS.Patients and methods: Retrospective analysis of data from patients with ECS from NETs collected in 14 centres between 1986 and 2014, ob...