Endocrine Abstracts

IntroductionAdrenocortical carcinoma is a rare neoplasm with local development, rarely metastatic in the spine. We report a case of metastatic dorsal spinal cord compression due to adrenocortical carcinoma.ObservationA 38-year-old lady with no notable medical history, complained of generalised weakness, severe abdominal pain and spasms. Abdominal computed tomography showed a large right adrenal renal mass mea...

BackgroundPatients with Subclinical Cushing’s Syndrome (SCS) share many similarities with those of metabolic syndrome. Several studies have shown variable prevalence of SCS in patients with diabetes and obesity of up to 9% suggesting that it may be more common in these patients. Our study aims to explore the prevalence of SCS in Malaysians with metabolic syndrome and examine any possible predicting factors.Methods<p class=...

IntroductionPrimary adrenal lymphoma (PAL) are rare extranodal lymphomas and account for<1% of all non-Hodgkin lymphomas, with characteristic clinical features including high incidence of bilateral involvement, predominantly diffuse large B-cell histology, and low incidence of extra-adrenal disease at diagnosis. We report a case of 50-year-old patient affected by bilateral B-cell adrenal lymphoma.Case presentation<p class="...

Objective11-Beta Hydroxylase deficiency (11ß0HD) is a rare form of congenital adrenal hyperplasia, resulting in glucocorticoid deficiency, virilization and hypertension. In the literature, there are rare case reports of successful pregnancy in a patient with genetically confirmed classic 11ß0HD.CaseOur patient, now age 31, was diagnosed at birth with ambiguous genitalia. There was no family history ...

Acquired Hypoaldosteronism may be caused by low circulating aldosterone levels (AD), resistance to mineralocorticoid action (MR), or a combination of both (CB). We describe the clinical/biochemical characteristics of these three types of hypoaldosteronism. Methods Retrospective review of a series of 177 patients with acquired hypoaldosteronism assessed by the Endocrinology Department of a tertiary teaching hospital from 2012 to 201...

Primary adrenal insufficiency, Addison’s disease, is a rare endocrine disorder. Early diagnosis is often difficult and the presentation is commonly only recognised after a life threatening adrenal crisis. Fortunately, with appropriate early treatment further complications are uncommon in the acute setting. This case concerns a 19-year-old man who presented with lethargy, dyspnoea on exertion and a one month history of hyperpigmentation. He had a history of nocturnal enure...

IntroductionRecent studies in patients with Addison’s disease (AD) have shown that this condition, even if treated, is fraught with significant morbidity. In this context, we report a retrospective study which concerned 32 patients with AD in order to determine the deleterious effects of long-term glucocorticoid substitution, mainly on the occurrence of type 2 diabetes.ResultsIn the 32 patients followed ...

IntroductionThe malignancy risk of an adrenal nodule is based on clinical symptoms (rapid onset of hypercortisolism and hyperandrogenism; mass symptoms) and imaging characteristics. These suspicious criteria include boundary irregularities, heterogeneity, dimension>6 cm and density>20 HU (CT). However, these are not absolute criteria.Case reportWe report the case of a 43 years-old female patient with a histor...

BackgroundParaganglioma of the urinary bladder is rarely encountered. Its clinical signs and symptoms are usually nonspecific.Case presentationWe report a case of a 48-year-old woman who presented with recurrent hematuria for last 2 months with a recently detected hypertension. Computed tomography (CT) revealed a lobulated mass arising from the posterior wall of the urinary bladder and protruding into the ves...

IntroductionAdrenal tumors represent an increasingly common problem in modern endocrine practice. The diagnostic approach can be challenging and occasionally reveals surprising features like mixed hormonal secretion: aldosterone-and-cortisol producing adenoma. This rare situation can also impact on the therapy and the post-operative management. In this context, we report 5 patients who are followed in the Endocrinology department in Hedi Chaker hospital,...

BackgroundAdrenocortical carcinoma is a rare endocrine malignancy, with an unfavorable prognosis. Radical adrenalectomy is the gold standard for localized disease.Case presentationWe report a case of a 47-year-old male with left abdominal pain and sensation of discomfort. Our patient didn’t present classical tumor symptoms, such as cachexia or night sweats. Computed tomography revealed a left heterogeneo...

BackgroundThe term adrenal incidentaloma (AI) refers to the existence of an asymptomatic adrenal mass that was detected at random in an imaging test performed not in order to evaluate the adrenal glands. In recent years, the use of imaging tests has increased, and the resolution of the imaging studies has been improved. This trend may affect the characteristics of AIs at the time of diagnosis.ObjectiveInvesti...

IntroductionPheochromocytoma(PHEO) occurs in pregnancy with an estimated incidence of 0.007%. Its rarity and overlapping presentation with other pregnancy-related hypertensive disorders make the diagnosis really challenging. If left unrecognized, may result in increased maternal and fetal mortality. There are no guidelines on approaching PHEO during pregnancy. This case highlights the difficulties encountered in managing this condition in pregnancy.<...

IntroductionSevere hemorrhage is a rare and potentially lethal manifestation of adrenal gland nor usually associated with primary aldosteronism.Material and methodsReview of the patient’s clinical record and of the relevant literature.Case reportA 47-year-old male with personal history of asthma, untreated stage II hypertension, obesity, dysphagia associated ...

Bariatric surgery is increasingly deployed world-wide in patients with significant weight excess in order to mitigate the deleterious effects of associated metabolic and cardiovascular comorbidities. Pre-operative evaluation systematically investigates for possible causes of secondary obesity due to endocrine pathologies. In our hospital a standard blood test panel comprising the anterior hypophysis, the adrenal and the thyroid is requested as well as an endocrinological evalu...

IntroductionParagangliomas (PGs) are rare tumors arising from sympathetic and parasympathetic paraganglia with an incidence of 15–20%. We report a case of a pre-operative diagnosis of retroperitoneal PGs evoked on anatomic imaging confirmed by biochemical evaluation.ObservationA 55-year-old female was referred to the endocrinology department for investigation of a paroxistic hypertension. For her persona...

Pheochromocytoma is a rare neuroendocrine tumour usually formed in the adrenal medulla. Percutaneous biopsy has been associated with life-threatening haemorrhage, hypertensive crisis, capsular disruption with tumour implantation and death. We present a case of a 63 years old woman with non-specific clinical signs which included high blood pressure, headache, tachycardia and abdominal pain. She was treated for rheumatoid arthritis. Bilateral expansion of adrenal gland with dela...

Adrenal incidentaloma (AI) is an adrenal mass discovered accidentally during abdominal or chest imaging techniques not aimed to adrenal gland assessment. Guidelines suggested confirming the benignity of AI radiologically and excluding hormonal dysfunctions. This study was designed to evaluate the clinical, endocrinological and histological characteristics of adrenal incidentalomas (AI).MethodsRetrospective study of patient addresse...

IntroductionThere is no consensus about the necessity of dehydroepiandrosterone (DHEA) replacement in women with adrenal insufficiency (AI).MethodsThe woman aged 44 with medical compensation of autoimmune 1-AI, 1-hypogonadism, osteoporosis took DHEA (tablets of 50 mg in every morning) during 4 months. Concomitant therapy: hydrocortisone, fludrocortisone, drospirenone+estradiol, colecalciferol, calcium car...

Hypokalemia is a common and potentially fatal electrolyte disturbance, especially in hospitalised patients. Therefore, prompt assessment and management is vital to avoid serious complications. We report a case of 77 Year old gentleman with a background of Alzheimer’s presenting with abdominal distension, intermittent diarrhoea and shortness of breath. He had normal blood pressure with no signs of Cushing syndrome but was found to have hypokalaemia. Plain imaging revealed ...

A man presented at age 32 with clinical features of Cushing’s syndrome and biochemical investigations were consistent with ectopic ACTH. The only potential source on imaging was a 5 mm right lung nodule on chest CT but which was too small to biopsy. Medical therapy was not successful at controlling his Cushing’s features so he was referred for thoracotomy. Following lobectomy, the lung nodule was found to be a carcinoid tumour. Post operatively, the patient’s sy...