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Case Rep Endocrinol 2020 11;2020:6438352. Epub 2020 May 11.

Department of Pathology, Kanagawa Cancer Center, Yokohama, Japan.

A 75-year-old woman visited a nearby clinic with complaints of right clavicle discomfort, and she underwent diagnostic thoracoscopic lung biopsy, being diagnosed with lung metastasis and a right-upper mediastinal mass. The superior mediastinum mass was extrapulmonary and covered by the pleura, and it was not biopsied. Papillary thyroid carcinoma was diagnosed following biopsy of the lung metastasis. Read More

Case Rep Endocrinol 2020 4;2020:4768281. Epub 2020 May 4.

Endocrinology Service, UIM Enfermedades Endocrinas, Hospital de Especialidades, Centro Médico Nacional, S.XXI, Instituto Mexicano del Seguro Social, Av Cuauhtemoc 330, Col. Doctores, CP 06720, Mexico City, Mexico.

Objective: To report the immunohistochemical and molecular evaluation of a patient with ectopic ACTH syndrome (EAS) from a MCAT which has single cells with features of both 96 medullary and cortical differentiation. . A 16-year-old woman presented with severe EAS and a large right MCAT composed of ACTH-secreting cells resembling pheochromocytoma and another lineage similar to adrenal carcinoma. Read More

Case Rep Endocrinol 2020 10;2020:4249067. Epub 2020 Apr 10.

Department of Surgery, Yokohama City University School of Medicine, Yokohama, Japan.

Occult thyroid carcinoma preceded by clinical manifestations and findings from extrathyroidal tumors is rare. The lack of malignant findings in the thyroid during the preoperative examination makes diagnosis difficult. We encountered a 71-year-old man with a primary ectopic thyroid carcinoma causing superior vena cava syndrome. Read More

Case Rep Endocrinol 2020 3;2020:4510910. Epub 2020 Apr 3.

Division of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Petersgraben 4, 4053 Basel, Switzerland.

Severe cases of postprandial hypoglycaemia after bariatric surgery can be a diagnostic and therapeutic challenge. The diagnostic role of Ga-DOTA-Exendin-4 PET/CT in postbariatric hypoglycaemia for further treatment decisions is unclear. We present a case of a 50-year-old woman with frequent and severe postprandial hypoglycaemic (≤2. Read More

Case Rep Endocrinol 2020 31;2020:2128093. Epub 2020 Mar 31.

Department of Pathology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Sección XVI, Tlalpan, México City 14000, Mexico.

Synchronous parathyroid and papillary thyroid carcinoma are extremely rare. To our knowledge, only 15 cases have been reported in the last four decades. We describe a 50-year-old female without significant past medical or family history and no previous trauma presented with left heel pain that prompted her to seek medical attention. Read More

Case Rep Endocrinol 2020 27;2020:1865489. Epub 2020 Mar 27.

Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Background: Among many causes of hypertriglyceridemia (HTG), familial chylomicronemia syndrome (FCS) is a rare monogenic disorder that manifests as severe HTG and acute pancreatitis. Among the known causal genes for FCS, mutations in only account for <2% of cases. Medical nutrition therapy is critical for FCS because usual triglyceride- (TG-) lowering medications are ineffective. Read More

Case Rep Endocrinol 2020 16;2020:9298147. Epub 2020 Mar 16.

Endocrinology Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.

Background: Primary hyperparathyroidism usually occurs secondary to parathyroid adenoma, multiglandular hyperplasia, or parathyroid carcinoma. The patients usually present with incidentally discovered high calcium level and systemic or skeletal manifestations. In young patients with primary hyperparathyroidism, familial syndromes including multiple endocrine neoplasia types 1, 2, and 4 and hyperparathyroidism jaw tumor syndrome should be considered. Read More

Case Rep Endocrinol 2020 19;2020:7986581. Epub 2020 Mar 19.

Reading Hospital, Wyomissing, USA.

Thyrotoxicosis is a constellation of symptoms including palpitations, tremors, agitation, and heat intolerance, caused by excess thyroid hormone. It can be life-threatening in its most serious form. We present a rare case of thyrotoxicosis provoked by mechanical trauma to the neck via strangulation in a young female with a history of self-resolving postpartum symptoms of hyperthyroidism one year prior, but no formal diagnosis of thyroid dysfunction. Read More

Case Rep Endocrinol 2020 17;2020:6284764. Epub 2020 Mar 17.

Department of Endocrinology, Charles Nicolle Hospital, Tunis, Tunisia.

Langerhans cell histiocytosis (LCH) is a rare sporadic proliferative disorder of Langerhans cells. LCH rarely involves the thyroid gland. We report herein a case of a disseminated chronic form of LCH with a diagnosis established by histological examination of the thyroid gland. Read More

Case Rep Endocrinol 2020 17;2020:2521046. Epub 2020 Mar 17.

Development, Ageing and Pathology Research Group, Vrije Universiteit Brussel, Brussels, Belgium.

Takotsubo syndrome is a rare but emerging form of acute reversible myocardial injury characterized by transient systolic LV dysfunction, often related to emotional or physical stress. Pheochromocytoma is increasingly recognised as another possible trigger. Pheochromocytoma is a rare catecholamine-secreting tumour arising from chromaffin cells within the adrenal medulla or extra-adrenal paraganglia. Read More

Case Rep Endocrinol 2020 10;2020:7641940. Epub 2020 Mar 10.

Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Houston Methodist Hospital, Houston, TX, USA.

We report the case of a woman with a sporadic medullary thyroid carcinoma. Genomic analysis found that her tumor did not contain any common mutations but did harbor a V600E mutation. Only one other well-confirmed example of the BRAF V600E mutation has been reported in an MTC patient. Read More

Case Rep Endocrinol 2020 12;2020:2946868. Epub 2020 Mar 12.

Division of Endocrinology and Metabolism, Department of Medicine, and Hormonal and Metabolic Research Unit, Excellence Center in Diabetes, Hormone and Metabolism, Faculty of Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Patumwan, Bangkok 10330, Thailand.

The most common subtype of endogenous Cushing's syndrome (CS) is Cushing's disease (CD), with higher proportions of adrenal CS reported from Asia, compared to other continents. However, little was known about CS in this territory. This study was to investigate the distribution, clinical characteristics, and treatment outcomes of CS in a single tertiary hospital in Thailand. Read More

Case Rep Endocrinol 2020 12;2020:2039649. Epub 2020 Mar 12.

Al-Assad University Hospital, Damascus University, Damascus, Syria.

Pituitary stalk interruption syndrome (PSIS) is an extremely rare cause of growth failure and delayed puberty. It can be diagnosed by magnetic resonance imaging (MRI) of the hypothalamus and pituitary gland, showing an ectopic or absent posterior pituitary, an absent or interrupted pituitary stalk, or small anterior pituitary, in combination with growth hormone or other pituitary hormone deficiencies. The exact etiology of PSIS is unknown. Read More

Case Rep Endocrinol 2020 9;2020:2025631. Epub 2020 Mar 9.

Diabetes and Endocrinology Unit of National Hospital of Sri Lanka, Colombo 10, Sri Lanka.

. Adrenocortical carcinomas (ACCs) are infrequently reported to present with severe hypoglycemia syndrome resulting from the secretion of insulin-like growth factor II (IGF-II) by tumor cells. Adrenocorticotropic hormone- (ACTH) independent hypercortisolism is the norm of hormonally active ACCs, but aberrant ACTH production by tumor cells can theoretically cause ACTH-dependent hypercortisolism. Read More

Case Rep Endocrinol 2020 27;2020:8452564. Epub 2020 Feb 27.

Division of Endocrinology, Diabetes and Clinical Nutrition, Luzerner Kantonsspital, Luzern 6000, Switzerland.

In congenital analbuminemia (CAA), mutations in the albumin gene result in a severe deficiency or absence of plasma albumin. Only about 90 cases have been reported to date, but the specific features of glucose and lipid metabolism in congenital analbuminemia have only been studied in a rat model of analbuminemia. We report the case of a female patient hospitalized for a streptococcal skin infection who showed recurrent hypoglycemia. Read More

Case Rep Endocrinol 2020 26;2020:4869467. Epub 2020 Feb 26.

Department of Medicine, Department of Endocrinology, San Antonio Military Medical Center, 3551 Roger Brooke Drive, JBSA Fort Sam Houston, San Antonio, TX 78234, USA.

. Pheochromocytomas are rare neuroendocrine tumors that arise from sympathetic adrenomedullary chromaffin tissue. Depending on the amount of catecholamines they secrete, they have variable presentations. Read More

Case Rep Endocrinol 2020 24;2020:2808101. Epub 2020 Feb 24.

Departments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital Tokyo, Tokyo, Japan.

A 47-year-old woman with a history of diabetes mellitus (DM) and obesity was admitted to our hospital for glucose control. She was detected to have hypertension (HT) and diagnosed with primary aldosteronism (PA) based on the high level of aldosterone to renin ratio and the results of the upright furosemide-loading test according to the criteria of the Japanese Society of Hypertension (JSH) guidelines. Computed tomography revealed left renal tumor and adrenocortical adenoma. Read More

Case Rep Endocrinol 2020 14;2020:6724504. Epub 2020 Feb 14.

Department of Medicine, Icahn School of Medicine at Mount Sinai, NYC Health and Hospitals/Queens, Jamaica, NY 11432, USA.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are increasingly used as add-on therapy in patients with poorly controlled type 2 diabetes mellitus (T2DM). Although pancreatitis is not a known side effect of SGLT-2 inhibitors, there have been case reports of SGLT-2 inhibitor use being associated with pancreatitis. . Read More

Case Rep Endocrinol 2020 12;2020:1728423. Epub 2020 Feb 12.

Department of Medicine, Division of Endocrinology and Metabolism, University of Connecticut, School of Medicine, Farmington, CT, USA.

We describe a case of worsening Graves' orbitopathy due to immune reconstitution inflammatory syndrome (IRIS) in a 38-year-old HIV-infected male after beginning ART (antiretroviral therapy). Two years after initiation of ART, the patient developed symptoms of hyperthyroidism and thyroid eye disease (TED) or Graves' orbitopathy (GO). Thyroid iodine uptake scan was consistent with Graves' disease. Read More

Case Rep Endocrinol 2020 12;2020:1283464. Epub 2020 Feb 12.

Department of Pediatric Endocrinology, Children's Mercy Hospital, 3101 Broadway Blvd., Kansas City, MO 64111, USA.

Lithium therapy has been associated with several endocrine disorders including thyroid dysfunction, diabetes insipidus, and hyperparathyroidism. While its suppressive effect on thyroid function is well known, it is very rare to observe lithium-induced hyperthyroidism especially in the pediatric population. Here, we describe a case of lithium-induced hyperthyroidism in an adolescent female with bipolar disorder. Read More

Case Rep Endocrinol 2020 30;2020:8020761. Epub 2020 Jan 30.

Department of Endocrinology, Military Hospital, Jeddah, Saudi Arabia.

Schwannoma is a benign neurogenic tumor originating from the neural sheath of Schwann cells. It is an extremely rare cause of adrenal adenoma which is very difficult to diagnose preoperatively. We report the case of a right adrenal schwannoma discovered incidentally in a 62-year-old woman during evaluation of right flank pain. Read More

Case Rep Endocrinol 2020 30;2020:6827109. Epub 2020 Jan 30.

Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez (INNN) Neuroendocrinology, Mexico City, Mexico.

. Pheochromocytomas (Pheo) and paragangliomas (PGL) are rare neuroendocrine tumors arising from chromaffin cells of the adrenal medulla and from the extra-adrenal autonomic paraganglia, respectively. Only 1-3% of head and neck PGL (HNPGL) show elevated catecholamines, and at least 30% of Pheo and PGL (PCPG) are associated with genetic syndromes caused by germline mutations in tumor suppressor genes and proto-oncogenes. Read More

Case Rep Endocrinol 2020 31;2020:4239679. Epub 2020 Jan 31.

Department of Medico-Surgical Sciences and Biotechnologies, Internal Medicine Unit, ICOT Hospital, "Sapienza" University of Rome, Via Franco Faggiana 1668, Latina 04100, Italy.

Insulinoma is an insulin-producing pancreatic neuroendocrine tumor that can be malignant in about 10% of cases. Locoregional invasion, lymph node metastases, or remote metastases are the main criteria of malignant insulinoma. Its incidence in patients with pre-existing diabetes mellitus (DM) is exceptionally rare. Read More

Case Rep Endocrinol 2020 28;2020:1547170. Epub 2020 Jan 28.

Department of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania.

. Rickets is softening of bones caused by defective mineralization of the cartilage in the epiphyseal growth plate, causing widening of the ends of long bones, growth retardation, and skeletal deformities in children. It can be classified into calciopenic and phosphopenic, each type with various subclasses. Read More

Case Rep Endocrinol 2020 24;2020:9519621. Epub 2020 Jan 24.

Department of Endocrinology, Changi General Hospital, 2 Simei Street, Singapore 529889.

Despite being a tropical country, vitamin D deficiency is common in Singapore. All young Singaporean males between the age of 18 and 21 years have to undergo mandatory military service. Stress fractures occur in military recruits, and risk factors include a sudden increase in physical activity and vitamin D deficiency. Read More

Case Rep Endocrinol 2019 28;2019:4291486. Epub 2019 Dec 28.

Sección de Endocrinología y Nutrición, Hospital General Universitario de Alicante, ISABIAL-FISABIO, Valencia, Spain.

Amyloid goiter (AG) is characterized by the presence of deposits of amyloid protein in the thyroid tissue in sufficient amounts to produce enlargement of the gland, accompanied by fat deposition or thyrolipomatosis. It can be seen in long-standing inflammatory disorders, with the common characteristic of amyloidotic renal failure. In daily practice, practitioners should pay attention to the differential diagnosis in patients with suggestive co-morbidities for amyloidosis. Read More

Case Rep Endocrinol 2019 19;2019:5863569. Epub 2019 Dec 19.

David Geffen School of Medicine at UCLA, Larry L. Hillblom Islet Research Center, Los Angeles, CA, USA.

There is unexplained deficit in size and function of the exocrine pancreas in type 1 diabetes (T1D). We obtained pancreas from an individual with pre-T1D obtained at surgery and addressed the question, what is the relative inflammation in the exocrine and endocrine pancreas in pre-T1D in the absence of the potential confounding changes at autopsy or in brain dead organ donors. Pancreas was removed surgically from a 36 year woman for benign neuroendocrine tumors (NET). Read More

Case Rep Endocrinol 2019 25;2019:5028534. Epub 2019 Dec 25.

Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan.

We are presenting a case of falsely elevated T3 levels in a patient due to interference from monoclonal immunoglobulins. A 56-year-old, clinically euthyroid man referred to the endocrinology clinic of the Aga Khan university, Karachi Pakistan, for possible T3 thyrotoxicosis after thyroid function tests revealed total T3 >12.32 nmol/L (reference range 0. Read More

Case Rep Endocrinol 2019 26;2019:2941501. Epub 2019 Dec 26.

Department of Endocrinology, Diabetes and Metabolism, University of Kentucky, Lexington, KY, USA.

Context: Gestational trophoblastic disease (GTD) is a rare complication of pregnancy, ranging from molar pregnancy to choriocarcinoma. Twin pregnancies with GTD and coexisting normal fetus are extremely rare with an estimated incidence of 1 case per 22,000-100,000 pregnancies. Molecular mimicry between human chorionic gonadotrophin (hCG) and thyroid-stimulating hormone (TSH) leads to gestational trophoblastic hyperthyroidism (GTH) which is further associated with increased maternal and fetal complications. Read More

Case Rep Endocrinol 2019 9;2019:5130106. Epub 2019 Dec 9.

Internal Medicine Unit - Department of Endocrinology, Fundación Valle del Lili, Cra 98 #18-49, Cali 760032, Colombia.

Riedel's thyroiditis is a rare entity consisting of a fibrotic process of the thyroid which can generate gland destruction, infiltration of cervical structures and even airway obstruction. It has been associated with systemic fibrotic disorders, autoimmune diseases, and more recently with spectrum of diseases related to excess of Immunoglobulin G type 4 (IgG4). Two cases of Riedel's thyroiditis by IgG4, confirmed by immunohistochemistry and was managed surgically with favorable results during the follow-up time, are presented. Read More

Case Rep Endocrinol 2019 14;2019:2397638. Epub 2019 Dec 14.

The Wright Center for Graduate Medical Education, 111 N Washington Ave, Scranton, PA 18503, USA.

Pheochromocytoma is a rare adrenal tumor that is classically associated with the triad of paroxysmal tachycardia, diaphoresis, and headaches. However, it can have myriad manifestations. We present a case of a 31-year-old male who presented with abdominal pain, hypertensive emergency, and renal failure. Read More

Case Rep Endocrinol 2019 12;2019:8919457. Epub 2019 Dec 12.

Division of Endocrinology, Diabetes and Metabolism, Jaber Al-Ahmad Hospital, Kuwait.

Insulin autoimmune syndrome (IAS) is a disease characterized by hyperinsulinaemic hypoglycaemia associated with autoantibodies against endogenous insulin. We have described a case of a 25-year-old, previously healthy Kuwaiti man who was admitted to the Mubarak Al-Kabeer hospital with a history of recurrent hypoglycaemia. The patient revealed that he had taken several different injectable anabolic steroids and growth hormone with oral amino acids and other tablets (fat burners) for bodybuilding in the last two months. Read More

Case Rep Endocrinol 2019 12;2019:4174259. Epub 2019 Dec 12.

Department of Intensive Care, Western Health, Melbourne, VIC, Australia.

We report a case of a previously well 58-year-old man, who presented with delirium and low GCS, and was found to have extreme hypernatraemia (Na = 191 mmol/L) and hyperglycaemia (glucose = 31 mmol/L). This resulted in a corrected serum sodium of 202 mmol/L. He was treated with fluid and electrolyte replacement in the intensive care unit, and had returned to essentially normal function by hospital discharge. Read More

Case Rep Endocrinol 2019 26;2019:9095753. Epub 2019 Nov 26.

AZ Turnhout, Department of Pulmonology/Respiratory Oncology, Turnhout, Belgium.

Anaplastic thyroid carcinoma (ATC) is a deadly disease with very limited therapeutic options. There is an urgent need for new and efficacious drugs. Unfortunately accrual in clinical trials is problematic because of the rarity of the disease and often poor performance status at diagnosis. Read More

Case Rep Endocrinol 2019 8;2019:6414921. Epub 2019 Dec 8.

Decatur Morgan Hospital, Department of Internal Medicine, 1201 7th St. SE, Decatur, AL 35601, USA.

Medullary thyroid cancer (MTC) is a rare form of neoplasm affecting the thyroid gland. This neuroendocrine tumor is capable of releasing active substances causing systemic manifestation in the form of flushing, diarrhea, and uncommonly, Ectopic Cushing's syndrome (ECS). MTC can be hereditary as a part of multiple endocrine neoplasm type 2 syndrome (MEN2) or arise sporadically. Read More

Case Rep Endocrinol 2019 23;2019:4807081. Epub 2019 Oct 23.

Division of Endocrinology, Metabolism, and Nutrition, Department of Medicine, Rutgers University-Robert Wood Johnson Medical School, New Jersey, NJ 08903, USA.

Primary hyperparathyroidism (PHPT) predominantly affects older adults, and parathyroidectomy can achieve definitive cure in symptomatic PHPT and asymptomatic meeting surgical criteria. As the population continues to age, the treatment of PHPT in octogenarians and nonagenarians presents a clinical conundrum. This case series presents the management of eight patients 85 years of age and older diagnosed with PHPT. Read More

Case Rep Endocrinol 2019 3;2019:4210431. Epub 2019 Dec 3.

Hospitalist, Internal Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY, USA.

Hypothyroidism is characterized by decreased hormone production, which results in various clinical manifestations in different organ systems. Muscular symptoms are common in patents with clinical hypothyroidism which includes muscle cramps, myalgia, and mild to moderate elevation of creatinine kinase less than five times the upper limit of normal. However, rhabdomyolysis due to hypothyroidism is rare and in most of the reported cases a precipitating factor has been found. Read More

Case Rep Endocrinol 2019 11;2019:4189525. Epub 2019 Dec 11.

Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA.

Central diabetes insipidus (CDI) is an uncommon condition resulting from lack of vasopressin secretion from the posterior pituitary gland typically caused by some form of destruction of the gland. Here we present a case of transient CDI after discontinuation of vasopressin used for septic shock without evidence of overt pituitary damage. Serum sodium concentration peaked at 160 mmol/L in the setting of polyuria within days of vasopressin discontinuation without identified alternative etiologies. Read More

Case Rep Endocrinol 2019 17;2019:9616125. Epub 2019 Nov 17.

Department of Endocrinology, Metabolism and Nuclear Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

We report the case of a 45-year-old man with a history of Klinefelter syndrome undergoing testosterone replacement therapy, and with type 2 diabetes treated with metformin with poor metabolic control. When vildagliptin was added to his treatment, he presented hypoglycemia after the testosterone injection. We highlight this not widely reported drug interaction between hypoglycemic agents and testosterone. Read More

Case Rep Endocrinol 2019 16;2019:8562546. Epub 2019 Nov 16.

Division of Endocrinology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.

We report the case of a 56 year-old Hispanic male with a 10-year history of type 2 diabetes who presented with abrupt onset of hyperglycemia resistant to escalating doses of intravenous insulin infusion (>2500 units daily). He was diagnosed with antibody-mediated insulin resistance given the presence of hyperglycemia despite receiving >200 units insulin/day, a lack of identifiable precipitants for diabetic ketoacidosis or hyperosmolar hyperglycemic state, and elevated insulin antibodies. He underwent pre-immunomodulatory therapy screening for infections, rheumatologic disorders, and malignancy, which uncovered a new diagnosis of latent tuberculosis. Read More

Case Rep Endocrinol 2019 12;2019:3503651. Epub 2019 Nov 12.

Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Calcium alkali syndrome (CAS), a relatively unusual etiology of hypercalcemia, is characterized by a classical triad of hypercalcemia, azotemia, and metabolic alkalosis. This condition has been described in patients who have taken an excess dose of calcium with an alkali or with a volume-depletion status. To diagnose CAS it requires a high index of suspicion and a detailed history of medication/supplement intake specifically for calcium-containing drugs and a history of all possible ingested alkali. Read More

Case Rep Endocrinol 2019 27;2019:2502174. Epub 2019 Oct 27.

Division of Endocrinology, University Clinical Hospital of Santiago de Compostela, Spain.

Phaeochromocytomas and paragangliomas are rare catecholamine-secreting tumours arising from the adrenal medulla or sympathetic paraganglia. It is known that 20-30% of all cases occur as a result of germline variants in several well known genes. The gene was recently identified as a new phaeochromocytoma susceptibility gene. Read More

Case Rep Endocrinol 2019 27;2019:9674245. Epub 2019 Oct 27.

Department of Pulmonary and Critical Care Medicine, NYU Winthrop, USA.

The ketogenic diet, a diet high in fat and extremely low in carbohydrates, has recently gained momentum and is increasingly employed by patients in order to lose weight. We report a case of an otherwise healthy 47-year-old male who developed seizures and hypoglycemia shortly after initiating this diet. Biochemical testing confirmed hyperinsulinemic hypoglycemia and a subsequent abdomen MRI showed a pancreatic mass. Read More

Case Rep Endocrinol 2019 27;2019:9237459. Epub 2019 Oct 27.

Department of Chemical Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.

We describe a case of a 24-year-old overweight woman who presented with hirsutism, secondary amenorrhea, clitoromegaly, and symptoms of diabetes mellitus (DM). While a diagnosis of polycystic ovary syndrome (PCOS) with its associated metabolic disturbances was initially considered, serum total testosterone, androstenedione, and 17-hydroxyprogesterone (17-OHP) measured by liquid chromatography tandem mass spectrometry (LC-MS/MS) were significantly increased. As 17-OHP did not increase upon ACTH (Synacthen) stimulation and the urinary steroid profile (USP) was compatible with an ovarian source of 17-OHP excess rather than adrenal, non classical congenital adrenal hyperplasia (NCCAH) was unlikely and an androgen-secreting tumor was suspected. Read More

Case Rep Endocrinol 2019 17;2019:8641267. Epub 2019 Oct 17.

Department of General Surgery, Changi General Hospital, 2 Simei Street 3, Singapore 529889.

Primary squamous cell carcinoma of the thyroid gland (PSCCTh) and anaplastic thyroid carcinoma with extensive squamous differentiation are rare entities which pose a diagnostic challenge in determining the primary site when presented as metastases. The difficulty in confirming a thyroid primary is further compounded by the aggressive nature of these tumours which frequently present at advanced stages. We present a case in which the patient presented with a thyroid mass and a lung mass simultaneously. Read More

Case Rep Endocrinol 2019 17;2019:2314032. Epub 2019 Oct 17.

Department of Urology, Federation of National Public Service Personnel Mutual Aid Associations Tachikawa Hospital, 4-2-22 Nishikicho, Tachikawa, Tokyo 190-8531, Japan.

Immune checkpoint inhibitors, such as anti-programmed cell death-1 (anti-PD-1), have been widely used in the treatment of malignancies. However, these drugs can cause immune-related adverse events resembling autoimmune diseases. There are some reports of Graves' disease (GD) induced by anti-cytotoxic T-lymphocyte-associated antigen 4 antibodies, but reports which discussed GD induced by anti-PD-1 antibodies are very rare. Read More

Case Rep Endocrinol 2019 16;2019:5913194. Epub 2019 Oct 16.

Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Thyrotoxic periodic paralysis is an unusual neurological manifestation of thyrotoxicosis, and even rarer when it occurs in thyrotropin-secreting pituitary adenoma, only 6 cases having been previously reported. We describe a case of pituitary microadenoma with clinical syndromes of thyrotoxicosis complicated with hypokalemic periodic paralysis. Clinical manifestations and proposed management are discussed. Read More

Case Rep Endocrinol 2019 13;2019:4601484. Epub 2019 Oct 13.

Department of Gastroenterology and Liver Diseases, Los Angeles County Hospital/University of Southern California, USA.

Tumor-induced hypoglycemia (TIH) associated with hepatocellular carcinoma (HCC) results from tumor production of insulin-like growth factor 2 (IGF-2), resulting in recurrent hypoglycemia. Serum levels of insulin-like growth factor 1 (IGF-1), insulin-like growth factor 2 (IGF-2), or pro-insulin-like growth factor 2 (pro-IGF-2) are required for the diagnosis. However, due to the limited availability of testing in many laboratories, this condition is often overlooked. Read More

Case Rep Endocrinol 2019 15;2019:3196283. Epub 2019 Oct 15.

Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João (CHSJ), Porto, Portugal.

Introduction: Adrenocorticotropic hormone (ACTH) ectopic production is a rare cause of Cushing syndrome (CS). The most commonly associated tumours are small-cell lung carcinoma along with bronchial and thymic carcinoids. To date, only 5 cases have been published in the literature featuring ectopic ACTH secretion from metastatic acinic cell carcinoma (ACC) of the parotid gland. Read More

Case Rep Endocrinol 2019 13;2019:2986312. Epub 2019 Oct 13.

Department of Medicine, Kuala Lumpur Hospital, 50586, Malaysia.

Approach to patients who manifest with features of Cushing's syndrome often begin with exclusion of exposure to excessive exogenous source of glucocorticoids (GC). Most guidelines advocate no further assessment if excessive exogenous GC use is present. We present a case of a 66-year-old lady who was noted to have typical features of Cushing's syndrome. Read More