MENA 2024 Recordings-Round Table Discussion- Challenging Cases

Video Transcription

Video Summary

The presentation entailed a detailed discussion of three challenging cases in the field of endocrinology, primarily focusing on pituitary and adrenal disorders. The panel featured experts who each presented a case followed by group discussions.<br /><br />Dr. Suzanne Sandlin discussed cases involving prolactinomas, highlighting the complexities of managing resistant cases. She illustrated an example of a patient who, despite some tumor reduction with cabergoline treatment, still had elevated prolactin levels, necessitating consideration of surgical or radiotherapy options. The panelists discussed various treatment strategies, emphasizing the importance of individualized care.<br /><br />Dr. Irina Bankos presented a case of ectopic ACTH syndrome caused by a neuroendocrine tumor (NET) in the pancreas. Despite the presence of a pituitary adenoma, the rapid onset and severity of symptoms pointed towards ectopic secretion, which was confirmed with cross-sectional imaging and a corticotropin-releasing hormone (CRH) test. The patient underwent surgical resection of the pancreatic mass, achieving remission.<br /><br />Dr. Adriana Ikemaku discussed a 57-year-old with ACTH-independent Cushing's syndrome, likely due to adrenocortical carcinoma. The focus was on immediate, life-saving interventions to manage hypercortisolism and prevent complications such as infections and thromboembolic events. The case concluded with successful management using mitotane and osilodrostat until surgical debulking was feasible.<br /><br />The discussion underscored the critical importance of a multidisciplinary approach in managing complex endocrine disorders, utilizing a combination of surgical, medical, and targeted therapies while considering each patient's unique circumstances.

Keywords

endocrinology

pituitary disorders

adrenal disorders

prolactinomas

ectopic ACTH syndrome

neuroendocrine tumor

adrenocortical carcinoma

multidisciplinary approach

individualized care

treatment strategies