Endocrine Abstracts

Clinical case: An incidental right sided pelvic mass measuring 6 cm×7 cm was found in a 35 year-old nulliparous lady during investigations for secondary infertility. This mass was hard, irregular and white in appearance and biopsy confirmed a carcinoid tumour with a low Ki 67 index of 2.7%. She had no symptoms of flushing, diarrhoea or local discomfort. Endocrine screen showed a non-secretory tumour with normal fasting gut hormones and negative urinary 5H1AAs. Other tumou...

Adrenocortical carcinoma (ACC) is a rare and highly malignant tumour with a poor prognosis with an incidence of 1 – 2 per million population per year. We report 2 cases of functioning ACC.Case 1: An 80 yr old with a history of hypertension, paroxysmal atrial fibrillation and cerebrovascular disease presented with leg ulcers, peripheral oedema, tiredness, weight gain, plethora and proximal myopathy. ACTH-independent Cushing’s syndrome was confir...

Clinical case: A 30-year-old Eritrean presented as an emergency to the orthopaedics surgeons with radicular back pain. Following L3/L4 spinal decompression, he was noted to be classically acromegaloid and was transferred to the Endocrine Unit, where a mild bitemporal upper quadrantinopia was noted. GH was massively elevated at 1200 mU/L, IGF1>130 nmol/L, with associated corticotroph and gonadotroph insufficiencies requiring replacement. MRI showed a large pituitary adenoma...

Between March 1998 and October 2002, 62 patients requiring trans-sphenoidal pituitary surgery (PS) and 36 patients requiring endoscopic sinus surgery (controls, C) were recruited. Patients were aged 18–65 years and had not had previous surgery or radiotherapy to the brain. The mean ages (p>0.05) and genders (p>0.05) of the two groups were similar 47 years, 41% male (PS) compared with 43 years, 39% male (C). Baseline IQ of the two groups was also similar, 101&#177...

INTRODUCTION: Hyperprolactinaemia frequently causes secondary hypogonadism through central suppression of gonadotropin secretion. Macroprolactinomas (>1cm diameter) may additionally cause more generalised hypopituitarism; a recent series finding the prevalence of TSH and ACTH deficiencies to be 35% and 9%, respectively. Recovery of the thyrotropic and/or corticotropic axes is well described following surgery to pituitary tumours, but remains poorly defined in relation to me...

Introduction: Perrault syndrome (PS), a rare autosomal recessive condition mostly reported in females, is characterized by sensorineural hearing loss (SNHL), ovarian dysgenesis manifesting as primary amenorrhoea (PA), premature ovarian insufficiency (POI) and neurological manifestations but little is known about testicular function in males.Case summary: A 34 year-old man was referred with progressively reduced libido, e...

Introduction: Proton pump inhibitors (PPIs) were until very recently perceived to be safe, effective and inexpensive. As a result they are widely prescribed empirically, beyond their core indications. However dose-dependent adverse reactions increasingly reported include diarrhoea, resistant hypomagnesaemia/hypocalcaemia and interstitial nephritis. Moreover, they are associated with increased rates of vertebral and wrist fractures, and increased C. difficile carriage rate....

We describe two unrelated men with a previously unreported combination of tumours. The first patient developed a right-sided testicular teratoma at the age of 25 years treated with orchidectomy. He went on to develop a left-sided seminoma at the age of 35 years, treated with orchidectomy followed by prophylactic para-aortic radiotherapy (30 Gy in 15 fractions). At the age of 48 years he developed a nodule in the left lobe of thyroid (AC4/Thy4 on FNA) treated with hemithyroidec...

Section 1: Case history: A 60 year-old lady presented with a 4-year history of progressively increasing virilisation on the background of right salpingo-oophorectomy for ectopic pregnancy in 1984 (no histology available).Section 2: Investigations: Testosterone 23.6 nmol/l (NR < 1.7), LH 16 IU/l (7.7–58.5), FSH 33 IU/l (25.8–134.8), androstenedione 3.2 nmol/l (NR 1.4–14.3), DHEAs 1.2 umol/l (0.5–5.6), 17-OHP 2.7 nmol/l (1–4.5)...

Objective: Clinical management of pituitary cysts remains controversial, especially if asymptomatic. We retrospectively review clinical management and outcome of these patients undergoing long-term follow-up in our pituitary clinic.Methods: All patients with MRI-based diagnosis of pituitary cyst were included. Clinical presentation, cyst size and endocrinopathies (secondary adrenal, thyroid or gonadal deficiency) were compared between surgical and observ...