Endocrine Abstracts

Multiple Endocrine Neoplasia Type 1(MEN1) syndrome is commonly associated with the three ’P’s-pituitary, parathyroid and pancreatic lesions. However, increasingly, thoracic neuroendocrine tumours (NETs) are being recognised with the syndrome. We present a case of MEN1 syndrome who primarily presented with a lung carcinoid tumour. A 31-year-old lady with without a significant past medical history presented with 2-month history of a persistent cough. ...

Introduction: The global impact of COVID-19 has been unprecedented. Specific recommendations for the management of neuroendocrine disorders in the pandemic were rapidly released by Endocrine experts. To comply with COVID rules, NET patients, due to attend the endocrine unit in March 2020 for Somatostatin analogue therapy, were rapidly identified. 25 vulnerable patients had urgent domiciliary administration arranged. Other patients were taught to self-inject. Postal surveys wer...

A 60-year-old South African male, presented as an emergency with a 4 week history of lethargy, polyuria, increased thirst, constipation and weight loss. Blood tests revealed hypercalcemia with CCa-4.72 mmol/l, PTH-159.3pmol/l and 25 OH Vitamin D 22mmol/l. Intensive iv hydration was followed by IV Pamidronate 60 mg stat. Calcitonin (4 units/Kg tds) was started 48 hours later which resulted in a fall in the calcium to 2.66 by day 5. Cinacalcet 30 mg od was then introduced such t...

We would like to describe a case of resistant hyponatraemia. A 65-year-old Caucasian male presented to ED with a two-day history of blurred vision and transient numbness in his right hand. He was an ex-smoker with a past medical history of a transient ischaemic event in 2019 and a myocardial infarction in 2005. He admitted to a 10kg weight loss. He had no changes to his medications in the recent past which included lansoprazole, ramipril, mirtazapine, atenolol, clopidogrel, at...

An 82-year-old lady admitted after multiple episodes of collapse and her blood sugar levels were noted to be less than 2.0 mmol/l. A supervised controlled fasting test was performed and results were consistent with Insulinoma. Imaging revealed a mass in the tail of the pancreas with metastasis to the liver. Liver biopsy confirmed the diagnosis of a poorly differentiated neuroendocrine tumour. She continued to have hypoglycaemic episodes which were difficult to manage. Dietary ...

Background: Parathyroid Carcinoma (PC) is a very rare endocrine malignancy. Unlike Parathyroid Adenoma (PA) and Parathyroid Hyperplasia which represents 80% and 15-20% cases of primary hyperparathyroidism (PHPT) respectively, PC only constitutes 1-2% of cases. Herein we present a clinical case of PC following a low-impact trauma.Clinical case: A 50-year-old Bulgarian female presented with a pathological mid-shaft fracture of her right femur following a t...

The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) occurs in 10-45% of patients and secretion of ectopic adrenocorticotrophic hormone (EAS) in 2.5% of patients with small cell lung cancer (SCLC). Simultaneous secretion of ADH and ACTH is rare with only 10 cases being reported. The varying biochemical data leads to misdiagnosis as this case demonstrates. A 67 year old male presented with a 2 week history of falls attributed to alcohol abuse. Physical signs ...

Background: Pituitary metastases are a rare occurrence, accounting for just 0.4% of intracranial metastatic tumours and are most often associated with breast and lung malignancies. The vast majority of lesions are asymptomatic and due to the predilection of metastasis to the posterior lobe of the pituitary gland, clinical presentation with anterior pituitary insufficiency is uncommon and rarely reported in literature.Case summary: A 51-year old male with...