Endocrine Abstracts

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...

Tissue samples from adrenal tumors provide the basis for standard diagnostic procedures such as pathological examination. In addition, these tumor samples have been an invaluable source for the discovery of novel molecular pathways involved in adrenal tumorigenesis. Information on the molecular phenotype are based on DNA mutation analysis and epigenetic changes, RNA and protein expression pattern and sub-cellular localization as well as post transcriptional protein modificatio...

Introduction: Patients with chronic primary adrenal insufficiency (PAI) depend on lifelong gluco- (GC) and mineralocorticoid (MC) replacement therapy. Reduced subjective well-being is however often described by these patients in absence of clinical or laboratory abnormalities and is thus a strong indicator of the gap between the concept of adequate hormone substitution and patients’ requirements. The aim of this study was to investigate the potential role of 23...

Primary aldosteronism (PA) describes the most frequent cause of secondary arterial hypertension. Aldosterone itself represents a BP-independent cardiovascular risk factor associated with increased rates of morbidity and mortality. Recently a worsening of lipid metabolism after treatment has been described.Objective: Our aim was to analyse changes in lipid parameters according to treatment outcome in PA patients. Data of 215 consecutive PA patients with u...

Background: We have recently introduced [123/131I]iodometomidate (IMTO) which selectively binds to the adrenocortical enzymes aldosterone synthase and 11ß-hydroxylase as SPECT tracer. IMTO has been proven to be useful for molecular adrenal imaging and radiotherapy in adrenal cancer (ACC). As IMTO is rapidly inactivated by endogenous esterases which may impair target tissue to background activity and therapeutic efficacy, >50 new IMTO derivatives have been d...

Context: Primary aldosteronism (PA) is the most common cause of secondary hypertension. Aldosterone excess can cause oxidative stress and respectively DNA damage in vitro and in vivo and increased levels of oxidative stress have been demonstrated in PA patients. Single case reports describe a coincidence of PA with renal cell carcinoma (RCC) and other tumours. However, so far no data on the prevalence of benign and malignant neoplasms in patients with PA exis...

Autoimmune Addison’s disease (AAD) results from the immune mediated selective destruction of adrenal steroid hormone-secreting cells. Autoantibodies (Abs) against 21-hydroxylase (21OH) are diagnostic present in 85–90% newly diagnosed patients. Its genetic susceptibility is conferred by human leukocyte antigen (HLA) DQ2 and DQ8. In many patients autoimmunity extends forming the autoimmune polyglandular syndrome type 2 (APS-2). The aim of this study was to test, whethe...

Objectives: Endocrine gland-derived vascular endothelial growth factor (EG-VEGF; also termed prokineticin-1) has been identified as a mitogen preferable for the endothelium of steroidogenic glands (1). EG-VEGF and its receptors (prokineticin receptors 1 and 2; PKR1 and 2) are highly expressed in the normal adrenal gland and an autocrine mitogenic loop has been proposed (2). Therefore, we investigated the expression of EG-VEGF and its receptors in adrenocortical carcinoma (ACC)...

Introduction: The role of surgery for recurrent ACC is not well defined. Therefore, we used the German ACC Registry to evaluate treatment modalities after first recurrence in patients amenable to surgery.Methods: Patients with recurrence after radical resection and follow-up data were included. Patients with extensive metastasized disease (>2 tumoral organs, peritoneal carcinomatosis) were excluded. Progression-free and overall survival (PFS/OS) were...