Journal Articles

Aggressive silent corticotroph adenoma progressing to pituitary carcinoma. The role of temozolomide therapy

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Olga Moshkin, Luis V. Syro, Bernd W. Scheithauer, Leon D. Ortiz, Camilo E. Fadul, Humberto Uribe, Ricardo Gonzalez, Michael Cusimano, Eva Horvath, Fabio Rotondo, Kalman Kovacs

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Temozolomide (TMZ) has recently been recommended as a novel approach in the management of aggressive pituitary tumors. Herein, we present the case of a 43-year-old man with a 20-year history of silent subtype 2 pituitary corticotroph adenoma. Nine surgical resections and radiotherapy had failed to provide a cure. Morphological evaluation of the tumor revealed …

Thyroid hemiagenesis, Graves’ disease and differentiated thyroid cancer: a very rare association: case report and review of literature

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Alfredo Campennì, Salvatore Giovinazzo, Lorenzo Curtò, Ernesto Giordano, Maria Trovato, Rosaria M. Ruggeri, Sergio Baldari

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OBJECTIVE: Thyroid hemiagenesis is a rare congenital disorder characterized by the absence of a lobe and/or of isthmus. Studies on the association between thyroid hemiagenesis, Graves’ disease and differentiated thyroid cancer are rare …

Baubo: a Case of Ambiguous Genitalia in the Eleusinian Mysteries

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Neoklis A. Georgopoulos, George A. Vagenakis, Apostolos L. Pierris

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In an Orphic account of the constitutive mythology of the Eleusinian Mysteries, there occurs the relation of a remarkable tale of sacred obscenity. The Baubo affair is pivotal for a more in-depth understanding of the symbolism involved in the most awesome mysteric cult of the ancient Greek world …

Hypokalemic paralysis following administration of intravenous methylprednisolone in a patient with Graves’ thyrotoxicosis and ophthalmopathy

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Stelios Tigas, Petros Papachilleos, Nikolaos Ligkros, Maria Andrikoula, Agathocles Tsatsoulis

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Glucocorticoids are commonly used in the treatment of patients with thyroid disorders, in particular Graves’ ophthalmopathy. Thyrotoxic hypokalemic periodic paralysis (TPP) is an infrequent but potentially serious condition characterised by recurrent episodes of weakness associated with hypokalemia …

The growth endocrine axis and inflammatory responses after laparoscopic cholecystectomy

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Themistoklis Floros, Anastassios Philippou, Dimitrios Bardakostas, Dimitrios Mantas, Michael Koutsilieris

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OBJECTIVE: It is well known that conventional surgery leads to detrimental immune and catabolic responses, thus there is growing interest in the effect of minimally invasive techniques on postoperative endocrine and immune function. The aim of this prospective study was to evaluate the growth hormone (GH)/insulin-like growth factor-1 (IGF-1)/IGF binding protein-3 (IGFBP-3) axis and acute phase (interleukin-6, IL-6, and C-reactive protein, CRP) responses in patients who underwent laparoscopic cholecystectomy …

Familial paraganglioma: A novel presentation of a case and response to therapy with radiolabelled MIBG

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Justin K. Lawrence, Eamonn R. Maher, Richard Sheaves, Ashley B. Grossman

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Phaeochromocytomas (PC) and paragangliomas are disorders of the sympatho-adrenomedullary system. They are chromaffin-containing neuroendocrine tumors of neural crest origin that contain catecholamine-secreting granules: they arise from either the adrenal medulla (phaeochromocytomas) or from extra-adrenal neural crest derivatives e.g. the sympathetic chain (paragangliomas)…

Non tumoral hyperserotoninaemia responsive to octreotide due to dual polymorphism in UGT1A1 and UGT1A6

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Anna Maladaki, Maria P. Yavropoulou, Kalliopi Kotsa, Theoni Tranga, Stelios Ventis, John G. Yovos

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Gilbert’s syndrome is a common inherited metabolic disorder, caused by genetic aberration in the enzyme UDP-glucuronosyl-transferase 1A1 that leads to reduced glucuronidation of bilirubin. Recent advances in molecular genetics have frequently reported the concurrence of dual genetic …

Which is the best predictor of thyroid cancer: thyrotropin, thyroglobulin or their ratio?

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Pinar Yazici, Mehmet Mihmanli, Emre Bozkurt, Feyza Yener Ozturk, Mehmet Uludag

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OBJECTIVE: Since documented incidence of thyroid cancer has been rising over time, in part due to incidental small papillary cancer, several studies have been carried out to investigate the role of possible serum markers of thyroid cancer prior to surgery. DESIGN: Prospective cohort study. AIM: To investigate the role of thyroglobulin (Tg), thyrotropin (TSH) and the TSH:Tg, Tg:TSH ratio in the preoperative diagnosis of thyroid cancer …

The Hippocratic Spirit

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George K. Daikos

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The Hippocratic medical school (the medical school of Kos) was not an isolated phenomenon but the evolution and consequence of previous ideas and practices derived from many older sources. Hippocratic medicine1-3 replaced the theurgical and hieratic medicine, succeeding to and evolving from the medicine of the Minoan civilization of Crete …

Rare presentation of occult medullary carcinoma of the thyroid as a mediastinal mass

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Vasiliki Daraki, Sofia Koukouraki, George Velegrakis, Evangelia Mamalaki, Vrettos T. Haniotis, George Kalikakis, Maria I. Stathaki, Nikos Karkavitsas, Stathis S. Papavasiliou

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OBJECTIVE: To describe a rare case of occult (<1cm in diameter) medullary thyroid carcinoma (MTC) in a 45-year-old woman, presenting as an asymptomatic mediastinal mass. DESIGN: The diagnostic methodology included laboratory measurements of relevant biochemical and hormonal parameters ...

A novel truncating AIP mutation, p.W279*, in a familial isolated pituitary adenoma (FIPA) kindred

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Güven Barış Cansu, Bengür Taşkıran, Giampaolo Trivellin, Fabio R. Faucz, Constantine A. Stratakis

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Familial isolated pituitary adenomas (FIPA) constitute 2-3% of pituitary tumours. AIP is the most commonly mutated gene in FIPA. We herein report a novel germline mutation of the AIP gene in a family with FIPA. We present two patients, a father and his 12-year-old daughter, diagnosed clinically and using laboratory measures with acromegaly-gigantism …

Hermaphroditism in Greek and Roman antiquity

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George Androutsos

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Since antiquity hermaphrodites have fascinated the mind and excited the imagination. In this paper, such subjects are discussed as legends about the nativity of Hermaphroditus, son of Hermes and Aphrodite, the social status of these bisexual beings, and their fate in Greek-Roman antiquity…

Parathyroid carcinoma as a challenging diagnosis: Report of three cases

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Alfredo Campennì, Rosaria Maddalena Ruggeri, Alessandro Sindoni, Salvatore Giovinazzo, Letterio Calbo, Antonio Ieni, Maurizio Monaco, Giovanni Tuccari, Salvatore Benvenga, Sergio Baldari

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Parathyroid carcinoma (PC) is a rare malignancy with an indolent but progressive course. This rare tumour is often difficult to diagnose preoperatively, thus limiting the efficacy of surgery. As long-term survival is largely dependent on the extent of the primary surgical resection …

A novel splicing mutation in exon 4 (456G>A) of the GH1 gene in a patient with congenital isolated growth hormone deficiency

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Olga V. Fofanova, Oleg V. Evgrafov, Alexander V. Polyakov, Valentina A. Peterkova, Ivan I. Dedov

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Isolated Growth Hormone Deficiency (IGHD) due to GH1 gene defects has a variable inheritance pattern: autosomal recessive, autosomal dominant, and X-linked. the autosomal dominantly inherited form, IGHD II, is mainly caused by heterozygous mutations of splicing around the exon 3/IVs3 boundary region of the GH1 gene resulting in exon 3 skipping of transcripts …

Case Report: Primary pituitary non-Hodgkin’s lymphoma developed following surgery and radiation of a pituitary macroadenoma

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Labrini Papanastasiou, Theodora Pappa, Aikaterini Dasou, Efi Kyrodimou, George Kontogeorgos, Christianna Samara, Panagiotis Bacaracos, Athanasios Galanopoulos, George Piaditis

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OBJECTIVE: Primary central nervous system (CNS) non-Hodgkin’s lymphoma is a rarely encountered clinical entity. Here we present a case of a primary CNS diffuse large B-cell non-Hodgkin’s lymphoma developed on a previously operated and irradiated pituitary macroadenoma. DESIGN-RESULTS: A 60-year-old woman presented with muscle weakness …

The impact of thyroid autoimmunity (TPOAb) on bone density and fracture risk in postmenopausal women

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Snezana P. Polovina, Dragana Miljic, Sladjana Zivojinovic, Natasa Milic, Dragan Micic, Vera Popovic Brkic

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OBJECTIVE: Skeletal development, linear growth, cartilage biology and bone turnover are highly dependent on the activity of thyroid hormones. Thyroid dysfunction affects the skeleton, and autoimmune thyroid disease, manifesting as a chronic inflammatory condition, may be an important contributing factor to impaired bone quality in these patients. MATERIALS AND METHODS: Measurement of TSH, FT4, TPOAb and bone mineral density and FRAX score calculations were performed …

Thyroid tuberculosis

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Konstantinos Terzidis, Panagoula Tourli, Erasmia Kiapekou, Maria Alevizaki

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Although the association of thyroid disorders with tuberculosis has been known for a long time, the diagnosis of thyroid tuberculosis is rare. Differential diagnosis can be very difficult without fine needle aspiration. The clinical course of the disease may resemble toxic goiter or acute thyroiditis or may follow a subacute or chronic pattern without specific symptomatology…

PROP-1 gene mutations in a 63-year-old woman presenting with osteoporosis and hyperlipidaemia

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Maria Andrikoula, Amalia Sertedaki, Sofia Andrikoula, Catherine Dacou-Voutetakis, Agathocles Tsatsoulis

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PROP-1 gene mutations have been reported as a cause of combined pituitary hormone deficiency. Physical and hormonal phenotypes of affected individuals are variable. We report a 63-year-old female who presented with osteoporosis

PTH and PTHR1 in osteocytes. New insights into old partners

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Maria P. Yavropoulou, Alexandros Michopoulos, John G. Yovos

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Parathyroid hormone receptors are present in bone cells and play a crucial role in the maintenance of skeletal integrity, bone homeostasis and regulation of calcium and phosphate metabolism. Although the function of these receptors has long being recognized in the cells of the osteoblastic lineage regulating directly osteoblast differentiation and function and indirectly osteoclastogenesis …

Growth hormone deficiency in a patient with autoimmune polyendocrinopathy type 2

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Asteroula Papathanasiou, Eleni Kousta, Vasiliki Skarpa, Petros Papachileos, Vasilios Petrou, Charalambos Hadjiathanasiou

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Autoimmune polyglandular syndrome (APs) type 2 is characterized by the presence of Addison’s disease, in association with autoimmune thyroid disease and/or type 1 diabetes mellitus and is rare in children. A 12.5yr old prepubertal boy presented with symptoms related to Addison’s disease and a large goiter. He was euthyroid with positive thyroid antibodies, low cortisol, aldosterone and very high adrenocorticotropin …

A thymic carcinoid tumour causing Zollinger-Ellison and Cushing’s syndromes due to ectopic ACTH and gastrin secretion

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Noel P. Somasundaram, Chaminda Garusinghe, Dan Berney, Ashley B. Grossman

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Cushings’s syndrome due to ectopic adrenocorticotrophin (ACTH) secretion was first described nearly a century ago by Hurst Brown. Bronchial carcinomas, usually bronchial carcinoids, were the first to be described and continue to be the leading cause of the ectopic ACTH syndrome …

Adiponectin levels may help assess the clinical repercussions of obesity irrespective of body mass index

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Eirini Dermitzaki, Pavlina D. Avgoustinaki, Eirini C. Spyridaki, Panagiotis Simos, Niki Malliaraki, Maria Venihaki, Christos Tsatsanis, Andrew N. Margioris

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OBJECTIVE: Adiponectin is the major product of adipose tissue. The aim of this study was to associate adiponectin levels with adipose tissue and metabolic indices. DESIGN: Plasma samples of 274 non-diabetic volunteers were collected to evaluate for adiponectin, inflammatory markers, insulin and lipid parameters. Body fat composition was measured by DEXA. RESULTS: As expected, adiponectin levels correlated with body mass index (BMI) …

A female infant with Silver Russell Syndrome, mesocardia and enlargement of the clitoris

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Assimina Galli-Tsinopoulou, Eleftheria Emmanouilidou, Paraskevi Karagianni, Maria Grigoriadou, John Kirkos, George S. Varlamis

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Silver Russell Syndrome (SRS) is a rare condition (1/3000 – 1/100,000 newborns). We present a female infant with SRS, cardiac malposition and asymmetric enlargement of the clitoris. She is the first child of Greek nonconsanguinous parents, born at 38 weeks gestation …

Sequential treatment with teriparatide and strontium ranelate in a postmenopausal woman with atypical femoral fractures after long-term bisphosphonate administration

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Kalliopi Lampropoulou-Adamidou, Symeon Tournis, Alexia Balanika, Ioulia Antoniou, Ioannis P. Stathopoulos, Christos Baltas, Ioannis K. Triantafillopoulos, Nikolaos A. Papaioannou

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OBJECTIVE: Despite the existence of numerous case series, no evidenced-based medical management for atypical fractures associated with bisphosphonate (BP) treatment has been established. DESIGN: We report the outcome of teriparatide (TRP) administration followed …