Endocrine Abstracts

Leiomyosarcoma is a rare, malignant tumour that can arise from smooth muscle cells anywhere in the body; common sites include uterus, GI tract and retroperitoneum. We report an unusual case of a patient with an adrenal incidentaloma confirmed as a leiomyosarcoma on histology.A 61-year-old Caucasian female was investigated for chronic abdominal pain. CT scan of the abdomen and pelvis did not show any pathology other than an inci...

We report the case of an 82-year-old lady who was admitted with hypercalaemic crisis (adjusted Calcium 4.82 mmol/L) and acute kidney injury (creatinine 169 micromol/L). PTH was 295 pmol/L, raising the suspicion of an underlying parathyroid carcinoma. She had no palpable neck mass. Her ALP was 131 IU/L and Vitamin D 73 nmol/L; myeloma screen was negative and chest radiograph showed no pathology. A DEXA scan revealed osteoporosis. The hypercalcaemic crisis...

A 22-year-old female first presented in 2008 with a six-month history of galactorrhoea and irregular menses. She had hyperprolactinaemia (2401 mIU/L), a negative macroprolactin screen and her pituitary MRI scan demonstrated a 4 mm microadenoma. Her cannulated prolactin levels were >1500 mIU/L. TFTs, IGF-1, cortisol and remaining pituitary profile were within normal range.Cabergoline was commenced and gradually i...

: We report a case of a 56-year-old gentleman who presented to the endocrine clinic with erectile dysfunction. He had elevated SHBG levels, MCV, gamma GT, ferritin, iron and markedly elevated testosterone and transferrin saturation (GGT 167 IU/l, ferritin 1128 ug/l, testosterone 62.5 nmol/l). He had a marginally low platelet count (123X109/l). He denied ever taking testosterone supplements. His calculated free testosterone was normal. His full blood count was otherwise unremar...

Introduction: Glucocorticoid replacement in adrenal insufficiency may be achieved by administering thrice- daily hydrocortisone or once-daily very low dose (2-4 mg) prednisolone. Prednisolone’s longer half-life enables once-daily dosing, improving patient satisfaction and compliance. At very low doses, it has shown no difference in most markers of metabolic risk when compared with hydrocortisone. At Imperial College Healthcare NHS Trust (ICHNT), use of an eight-hour troug...

Introduction: Liberal glucocorticoid replacement therapy prevents Addisonian crises in individuals with adrenal insufficiency (AI). Prednisolone is six to eight times more potent than hydrocortisone. There is inter-individual variation in glucocorticoid metabolism wherein 5 mg prednisolone once-daily may result in over-replacement in most individuals, with subsequent long-term morbidity and mortality.Methods: Data from individuals on established predniso...

64 years old lady with history of breast cancer (post lumpectomy followed by radical mastectomy) received chemotherapy with Epirvlacin 140 mg and cyclophosphamide 600 mg 1 day prior. Past medical history included hypertension on ramipril and type 2 diabetes on diet control. Bloods on day of chemotherapy normal particularly sodium 135 mmols/l. Presented in 18 hours after 20 seconds tonic clonic seizure noted by family followed by abnormal flexion. Presented with GCS 7 which the...

38 year old woman presented with palpitations, chest tightness, dizziness and light headedness. There was no evidence of infection clinically or biochemically. She had a background of Alemtuzumab induced Graves’ thyrotoxicosis, relapsing remitting Multiple Sclerosis. Her regular medications included Carbimazole 20 mg three times a day, Amitriptyline 120 mg daily, Propranolol 40 mg four times a day, Tizanidine 2 mg daily (up to 18 mg), Tramadol 50 mg as required, Senna 7.5...

Background: Pancreatic neuroendocrine tumors (P-NETs) are a rare cancer with increasing incidences worldwide. Low-grade P-NETs are unique in that they express high levels of Somatostatin Receptor Type 2 (SSTR2), which represents a target for both tumor imaging and therapeutics. P-NET grade inversely correlates with SSTR2 tumor staining, and higher tumor grade is associated with poor patient prognosis. Unfortunately, application of SSTR2-targeted treatment options is currently ...

A 35-year-old gentleman was referred to our Endocrinology department by Moorfields Eye hospital. He reported a one-year history of visual decline in his right eye, which led to prescription glasses, and incidental finding of bilateral conjunctival nodules. He had reduced visual acuity (pinhole right eye: 6/24 and left eye 6/6) and prominent corneal nerves on slit-lamp examination. He underwent an excisional biopsy of the conjunctival nodules confirming bilateral conjunctival n...