Introduction: In recent years, ultrasound (US)-guided thermal ablation techniques have come to the fore as minimally invasive alternatives to surgery. The purpose of this study was to assess the effectiveness and safety of radiofrequency ablation or microwave ablation procedures in patients with benign thyroid nodules. Material and methods: This retrospective and single-centre study consisted of 55 patients and 62 benign thyroid nodules that were treated either with radiofrequency ablation (RFA) or microwave ablation (MWA) in our hospital between January 2020 and March 2022. All the patients were at high risk for surgery or with symptomatic TNs and who refused surgery. The TNs diagnosed as benign from the fine-needle aspiration biopsy were evaluated in terms of volume reduction, symptom, and cosmetic scores. In addition, these 2 treatment modalities were compared to each other. Results: Out of 55 patients, 44 (80%) were female and were aged between 24 and 97 years with a median age of 50 years. RFA was applied to 54.5% (n = 30) of the participants, and MWA was applied to 46.5% (n = 25). The volume reduction rate (VRR) after RFA and MWA at the first month was 63.4 ± 14.2 and 65.7 ± 13, respectively. No significant difference was detected between the 2 groups in terms of VRR (p = 0.51). In addition, the mean symptom and cosmetic scores decreased significantly in both procedures, and there was a significant difference due to the symptom score change in the RFA group compared to the MWA group. Of all the patients, one patient experienced haematoma in the RFA, and one patient had transient voice change in the MWA group. No life-threatening complications were noted. Conclusion: In the treatment of benign symptomatic thyroid nodules, both RFA and MWA are options worthy of consideration in terms of efficacy and safety.

Aim: The association between high levels of anti-thyroid antibodies and the extent of destruction of thyroid tissue is well documented. The aim of the present study was to analyze the relationship between anti-thyroid antibodies, thyroid hormones, and sonographic parenchymal changes. Methods: The study was designed as a case-control study. Four hundred and seventy-five patients with HT and 98 healthy subjects were included in the study. Serum levels of free thyroxine (fT4), free triiodothyronine (fT3), thyroid-stimulating hormone, and anti-thyroid antibodies (anti-thyroid peroxidase antibodies and anti-thyroglobulin antibodies) were measured. The ultrasonographic results of the patients were also recorded. Results: Serum levels of anti-TPO and anti-Tg were significantly associated with hypoechogenicity, heterogeneity, and pseudonodulation (p<0.001). There was no significant difference between the two groups in terms of cyst and nodule formation, however, a significant difference was found in terms of thyroid volume (p<0.001). Thyroid volumes were higher in the HT group. As serum anti-TPO levels increased in the HT group, parenchymal hypoechogenicity increased (p<0.001). Conclusion: Ultrasonography is a non-invasive method that provides information about the inflammatory activity of the thyroid gland. Significantly reduced echogenicity, heterogeneity, and multifocal pseudonodular infiltration were indicators of inflammatory activity and were associated with higher anti-TPO levels. Anti-TPO and ultrasonographical changes may be useful in the follow-up of Hashimoto's thyroiditis.

Objective: To evaluate the differences in thyroid volume and thyroid functions between male patients newly diagnosed with idiopathic hypogonadotropic hypogonadism (IHH) and healthy males. Material and Method: A total of 51 consecutively diagnosed male patients with IHH (mean age: 30.1 +/- 8.9 years) and 36 body mass index (BMI)- and age-matched healthy controls (mean age: 31.3 +/- 5.9 years) were included in the study. All the subjects resided in the same region where mild iodine deficiency was present. Patients with thyroid diseases were excluded. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), IGF-1, prolactin, cortisol, total testosterone, free testosterone, free T4 (fT4), free T3 (fT3), TSH, anti-TPO, and anti-TG were evaluated. Thyroid volumes (TV) were measured using a high-resolution. ultrasound operated by an experienced endocrinologist. Results: FSH, LH, total testosterone and free testosterone were lower in patients with IHH than in the control subjects (p<0.05). TSH, fT4, fT3, anti-TPQ and anti-TG were found to be similar in both groups (p>0.05). Thyroid volume of patients with IHH (mean value of TV=11, 0 +/- 6.2 mL) was significantly smaller than in the control subjects (mean value of TV=18, 6 +/- 8.1 mL) (p=0.001). Conclusion: Young males with newly diagnosed IHH have smaller thyroid volume than healthy males. Thyroid function tests were similar in both groups.

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Objective: The incidence of papillary thyroid cancer (PTC) is rising all over the world. The trace elements copper (Cu) and zinc (Zn) are essential for many physiological functions. Concurrent exposure to Cu and Zn may result in remarkable epithelial toxicity and stress. We evaluate the serum Cu and Zn concentrations as well as the Cu/Zn ratio to predict the possible malignancy of PTC in patients who underwent thyroid fine needle aspiration biopsy (FNAB) before total thyroidectomy. Material and methods: Serum Zn and Cu concentrations as well as the Cu/Zn ratio of 111 patients (23 male and 89 female) who underwent total thyroidectomy and in whom preoperative thyroid FNAB was non-diagnostic or demonstrated atypia of undetermined significance (AUS) or was suspicious for follicular neoplasm (SFN) or showed benignity were evaluated. Postoperative pathology results were classified as benign or malignant. The amount of Cu and Zn was determined using atomic absorption spectrometry. In the malignant group, preoperative serum Cu levels correlated with tumor size, localization, and focality. Results: In the malignant group, the preoperative Cu level and Cu/Zn ratio was found higher than in the benign group; also postoperative serum Cu difference and serum Cu/Zn difference showed a significant decrease when compared to the preoperative state (p = 0.001, 0.034, 0.002, 0.003, respectively). In receiver-operating characteristics (ROC) analysis, the optimal cut-off value of preoperative Cu for differentiating malignant tumor from benign tumor was found to be 158.88 mg/dL (p = 0.001; sensitivity: 48%, specificity: 84%). In subjects in whom FNAB results were non-diagnostic or revealed benignity, AUS, or SFN, preoperative Cu levels over 158.88 mu g/dL to predict malignancy were found to have a sensitivity of 24%, 67%, 54%, and 50%, respectively, and a specificity of 70%, 82%, 93%, and 100%, respectively. Conclusions: Before thyroid surgery, if FNAB was non-diagnostic or revealed indeterminate cytology like AUS and SFN, the assessment of serum Cu is considered to be a useful diagnostic tool for surgical decisions in patients with thyroid nodules and for determining PTC cases.

OBJECTIVE:This retrospective multicenter study, centrally conducted and supported by the Society of Endocrinology and Metabolism of Turkey, aimed to evaluate the impact of free RET proto-oncogene testing in medullary thyroid carcinoma (MTC) patients. Surgical timing, adequacy of the treatment, and frequency of prophylactic thyroidectomy (PTx) in mutation carriers were also assessed.METHODS:Genetic testing for MTC and pheochromocytoma was conducted between July 2008 and January 2012 in 512 patients. Application forms and RET mutation analyses of these patients whose blood samples were sent from various centers around Turkey were assessed retrospectively. An evaluation form was sent to the physicians of the eligible 319 patients who had confirmed sporadic MTC, familial MTC (FMTC), multiple endocrine neoplasia type 2 (MEN2), or who were mutation carriers. Physicians were asked to give information about the surgical history, latest calcitonin levels, morbidity, mortality, genetic screening, and PTx among family members. Twenty-five centers responded by filling in the forms of 192 patients.RESULTS:Among the 319 patients, RET mutation was detected in 71 (22.3%). Cys634Arg mutation was the most prevalent mutation (43.7%), followed by Val804Met in 18 patients (25.4%), and Cys634Tyr in 6 patients (8.5%). Among 192 MTC patients, the diagnosis was sporadic MTC in 146 (76.4%), FMTC in 14 (7.3%), MEN2A in 15 patients (7.9%), and MEN2B in one patient. The number of mutation carriers among 154 apparently sporadic MTC patients was 8 (5.2%). Ten patients were submitted to PTx out of twenty-four mutation carriers at a mean age of 35±19 years.CONCLUSION:Turkish people have a similar RET proto-oncogene mutation distribution when compared to other Mediterranean countries. Despite free RET gene testing, the number of the PTx in Turkey is limited and relatively late in the life span of the carriers. This is mainly due to patient and family incompliance and incomplete family counselling.

BACKGROUNDHyperprolactinemia is the most common endocrinologic disorder in causing menstrual irregularities. Although the correlation between hyperprolactinemia and menstrual dysfunction is widely known, the etiology of menstrual cycle disorders is not profoundly understood in patients with prolactinoma. We aimed to investigate the correlation between prolactin levels and insulin resistance and hyperandrogenism in patients with prolactinoma.METHODSSixty-four patients with microprolactinoma and 33 healthy women were enrolled. Thirty-six of these patients with prolactinoma (group 1) had an estradiol (E2) level under 30 pg/mL, and 28 (group 2) had an E2 level greater than 30 pg/mL. Blood samples were drawn to measure the levels of the following hormones: Follicle stimulating hormone (FSH), luteinizing hormone (LH), E2, prolactin (PRL), total testosterone (TT), androstenedione (AS) and dehydroepiandrostenedione sulphate (DHEAS). Body Mass Index (BMI of ≥30 kg/m2) was excluded from the study. Insulin resistance (IR) was calculated by the HOMA-IR.RESULTSBMI was higher in patients with prolactinoma than the control group (P=0.02, P=0.025, respectively). IR and glucose intolerance existence were higher in patients with prolactinoma (P=0.007, P=0.097, respectively) than the healthy women, but these differences did not exist between eugonadic and hypogonadic women with prolactinoma (P=0.020, P=0.032, respectively, Bonferroni correction). TT and AS were higher in eugonadic women with prolactinoma than the control group (P=0.004, P=0.003, Bonferroni correction, respectively).CONCLUSIONSOur study revealed that the relationship between hyperprolactinemia and IR/glucose intolerance is irrespective of gonadal status in women with prolactinoma. Also, the study concluded that hyperandrogenism may be a cause of menstrual dysfunction in eugonadic women with prolactinoma.

Purpose: Depending on improvements in immunohistochemical and ultrastructural analyses, hormonal immunoreactivity are more commonly detected in pituitary adenomas. In this study, we investigated the correlation between immunohistochemical results and clinical and laboratory findings.Material and Method: The records of 110 patients with acromegaly who were operated at our hospital were retrospectively evaluated. Of the patients, 43 were excluded because of missing data. All patients were clinically evaluated preoperatively and had pituitary hormone profile.Results: Our study population was consisted of 42 females and 25 males. While there were 30 patients with growth hormone staining alone, plurihormonal staining was determined at the remaining 37 patients. Three of 14 patients were diagnosed with thyrotropin-secreting pituitary adenoma according to clinical and findings laboratory, preoperatively. Except these cases, there were no hormone-secreting adenomas even if positive cellular immunreactivity existed.Discussion: Our data suggest that immunohistochemical results may not be correlated with the signs of hormone hypersecretion as evident by symptoms or laboratory results in patients with acromegaly.

Differentiated thyroid cancers (DTC) are the most frequently occuring endocrine malignancies and accounts for ≥ 90% of all thyroid cancers. It was suggested that after total or near total thyroidectomy, the stimulated thyroglobuline (sTg) and quantified uptake in whole body scintigraphy (WBS) are significant predictors for the successful ablation and disease-free status. We aimed to evaluate preablative thyroid stimulating hormone (TSH), sTg and anti-thyroglobulin antibodies (TgAbs) levels, after following thyroid hormone withdrawal, and compare them with diagnostic WBS (DxWBS) uptake for predict the efficacy of radioiodine (RAI) ablation therapy in DTC patients. We retrospectively investigated 100 consecutively patients which followed up for DTC in Ankara Numune Education and Research Hospital at Department of Endocrinology and Metabolism between January 2006 and June 2013. Patients had histologically confirmed DTC and underwent RAI remnant ablation therapy without clinical or radiological evidence of distant metastases. 131I was used generally from 30-200 mCi dosage in all 100 patients. (median dose, 100 mCi). Preablation TSH, preablation sTg, postablation TSH, postablation sTg, postablation TgAbs levels, tumor size and tumor multifocality did not differ between DxWBS uptake negative and positive groups, while the preablation TgAbs level was found significantly lower in DxWBS uptake negative group (p [Med-Science 2016; 5(4.000): 961-6]

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

The aim of this study was to investigate atherosclerotic risk markers in women with clinically nonfunctioning pituitary adenomas (CNFAs). Records of 47 women with CNFAs and 73 healthy women who were treated as outpatients between January 2010 and March 2014 were evaluated retrospectively. All study data were obtained from file records. Lipid parameters, mean platelet volume (MPV), total testosterone (TT), androstenedione (AS), and dehydroepiandrostenedione sulfate (DHEAS) were recorded. Insulin resistance (IR) was calculated with homeostatic model assessment-insulin resistance (HOMA-IR). Among the atherosclerotic risk markers, the HOMA-IR and AS levels were higher in patients with CNFAs than in healthy subjects (p=0.003, p=0.021, respectively). A positive correlation between AS and insulin/HOMA-IR levels was found among the metabolic parameters in the patients with CNFAs (p=0.001, r=0.550, p=0.004, r=0.498, respectively). The data showed that patients with CNFAs had high atherosclerotic risk markers such as insulin resistance and hyperandrogenemia. Insulin resistance may also cause hyperandrogenemia in patients with CNFAs.

It has been suggested that hyperprolactinemia may be associated with obesity and dyslipidemia. However it is not fully understood that dyslipidemia is occurs independently or due to obesity. The study was aimed to investigate lipid abnormalities and androgen hormone levels before and after cabergolin (CAB) treatment in non- obese premenauposal patients with prolactinoma. This study was a single-centre, prospective, case–control study, consisted of 53 patients with symptomatic prolactinoma (group 1) and 57 healty women (group 3). All subjects underwent a physical examination, anthropometric measurement and a 12 hour fasting blood sample for fasting blood glucose and lipid levels. 49 patients with prolactinoma were reevaluated for metabolic parameters after one year of cabergolin treatment (group 2). The median age was 34 (24-38) in group 1, and 33 (27-41) in group 3 (p=0.522). The initially higher body mass index (BMI) in patients with prolactinoma became similar after one year of treatment those with control group (p=0.475). While LDL-C was significanly higher in group 1 than in controls, HDL was significanly lower in group 1. Also post- treatment values of LDL-C (p=0.440) and HDL-C (p=0.612) were not different from the control group. No correlation was found between baseline prolactin levels and FSH, LH, LDL-C, HDL-C (p=0.129, p=0.658, p=0.817, p=0.760 respectively). In conclusion, beneficial metabolic changes were seen in patients with prolactinoma after treatment with cabergoline. Thus considering the metabolic profile and an appropriate treatment goal is important in the clinical management of patients with prolactinoma.

Purpose Analysis of the RET proto-oncogen is very important for diagnosis and prognosis of medullary thyroid cancer (MTC). Genotype-phenotype correlation is also well known. Here we report features of the largest known family in Turkey with the V804M-mutated RET proto-oncogene.Methods Thirty members from three generations were evaluated. A RET proto-oncogen mutation, calcitonin (Ct) measurement and thyroid ultrasound were performed on all individuals. Seventeen members had V804M mutation. Fourteen of these patients underwent total thyroidectomy and additional central lymph node dissection for five subjects.Results The mean age of patients with MTC was 46.5 (30-61) years. The mean calcitonin level of RET positive members was 13.27 pg/mL (1-49.8 pg/mL). Three had a basal Ct level above normal limits. Seven of the 14 patients were diagnosed with MTC, and two were diagnosed with papillary thyroid cancer without MTC. One patient had central neck metastasis. Hyperparathyroidism or pheochromocytoma was not detected in any case. Patients who were RET negative, had normal Ct levels and no suspected nodule on ultrasound examination.Conclusions Our study revealed a relatively good prognosis in patients with V804M mutation. Despite the surgery was performed in older age no advance disease was observed.

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)