Endocrine Abstracts

Introduction: Pharmacological treatments are still not ideal in ACTH-microadenomas and transnasal-trans-sphenoidal surgery (TSS) is first choice in the treatment of Cushing’s disease (CD). The question is how can a nearly 100% remission rate be achieved with minimally invasive diagnostic testing and TSS. In the discussion of the main lecture from an expert from the USA in ECE13, it became clear that in many European centres, like ours, the procedures are less invasive. Th...

Introduction: Pharmacological treatments are available for all functioning pituitary adenomas, but found to be only ideal in prolactinomas. Therefore, at least in ACTH- and GH-microadenomas we have to strive to achieve 100% remission with transnasal surgery. Our question is, which combination of an increasing arsenal of pre- and peri-operative methods will bring the pituitary surgeons to this result without increasing complications.Materials and methods:...

Introduction: In this present study, we assessed the effects of the last preoperative medical treatment (dopamine-agonists, somatostatin-analogous and GH receptor antagonists) on the proliferation parameters Ki-67 and Topoisomerase-IIα in pituitary adenomas of patients with acromegaly.Material and methods:: We retrospectively studied the clinical characteristics, neuroimaging, histology and immuno-histochemistry (Ki-67 and topoisomerase-IIα lab...

We present the case of a 67-year-old man who presented to the outpatient clinic for endocrinological evaluation after partial resection of an atypical pituitary adenoma (APA). Pathohistological assessment of two independent and experienced neuropathologists resulted in a diagnosis of APA with unusually high proliferation indices (Ki67 10–20%/p53 30%) and immunoreactivity for LH, FSH and the alpha-subunit. Clinical examination as well as laboratory testing revealed no sign...

Introduction: Trans-sphenoidal surgery (TSS) with minimally invasive techniques is the first choice in the treatment of paediatric Cushing’s disease (CD). The question is how can high remission rates be achieved with less invasive investigations and TSS. The developments in our centre treating 100 pediatric Cushing patients with long-term follow-up may add some helpful ideas.Material and methods: Data from our first series 1 (n=55) will be ...

Introduction: Pituicytoma is a rare neoplasm of the sellar region, believed to originate from neurohypophyseal cells. Tumor resection is the primary treatment option, but may remain incomplete due to excessive bleeding of the well vascluarized tumor stroma. Therefore the search for alternative or additional treatment regimens is necessary. In a previous publication in 2012 the presence of VEGF-R was shown in one tumor sample, potentially opening the door for modern treatment o...

Objective: Despite a wide variety of differential diagnosis, modern MRI imaging usually enables a good preoperative evaluation of the aetiology in most cases with scull base and sellar lesions. However, in some cases MRI visualization alone may also be misleading with a consecutive need to adapt intraoperative strategies.Clinical presentation: The case of a 67-year-old male patient with the history of a bacterial meningitis, visual deterioration and the ...

Autonomy of ACTH secretion has been described in patients with chronic dysinhibition of ACTH secretion. We here present the very unusual case of a 31-year old female patient who had congenital adrenal hyperplasia and developed Cushing’s disease, including clinical examinations, laboratory data, endocrine function tests, histological and genetic analyses.The affected patient had clinical signs and a typical history of hypercortisolism. Endocrine func...

For somatostatin, five receptor subtypes (sst1-5) have been identified that are widely distributed in various endocrine tissues and tumors. Potent somatostatin analogs like octreotide, lanreotide and the new multiligand SOM230 – with different binding properties to the receptor subtypes - have been developed. We examined somatostatin receptor protein expression in 134 pituitary tumors of various etiologies. Immunostaining was performed with specific polyclonal anti...

Recently, somatic, heterozygous mutations in the gene encoding the deubiquitinase USP8 have been identified in 30–60% of corticotroph tumors. These mutations were found to hinder binding of 14-3-3 proteins, increasing its deubiquitinating activity. One substrate is Epidermal Growth Factor Receptor (EGFR), USP8 triggering EGFR recycling and increased EGFR signaling. However, tumors harboring mutations in USP8 are smaller than WT tumors, raising the debate if EGFR, as a pot...