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Endocrine Tumors: Diagnosis, Treatment, and Management
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Endocrine Tumors: Diagnosis, Treatment, and Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Endocrinology & Metabolism".

Deadline for manuscript submissions: 25 September 2025 | Viewed by 8544

Special Issue Editors

Dr. Jules T. Zhang-Yin

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Guest Editor
Department of Nuclear Medicine, Clinique Sud Luxembourg, Vivalia, B-6700 Arlon, Belgium
Interests: radiation therapy; nuclear medicine; cancer treatment
Dr. Francesco Dondi

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Guest Editor
Nuclear Medicine Department of Asst Spedali Civili Di Brescia, Università Degli Studi Di Brescia, 25123 Brescia, Italy
Interests: PET/CT; oncology
Special Issues, Collections and Topics in MDPI journals
Dr. Emmanouil Panagiotidis

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Guest Editor
Cancer Hospital of Thessaloniki ‘Theagenio’, 54639 Thessaloniki, Greece
Interests: PET/CT; radionuclide therapy; nuclear cardiology

Special Issue Information

Dear Colleagues,

This Special Issue aims to provide a comprehensive platform for researchers, clinicians, and experts in the field of endocrinology to share their latest findings and advancements in the diagnosis, treatment, and management of endocrine tumors.

The Special Issue welcomes original research articles, reviews, and clinical studies that focus on various aspects of endocrine tumors, including but not limited to diagnostic techniques, therapeutic approaches, and long-term management strategies. We encourage submissions that highlight novel insights, innovative methodologies, and significant contributions to the understanding and treatment of endocrine tumors.

Please note that this Special Issue will not consider mini-reviews or case reports. Instead, we aim to publish high-quality articles that present substantial research outcomes, critical analyses, and evidence-based recommendations. All submissions will undergo a rigorous peer-review process to ensure scientific rigor and integrity.

We invite researchers and experts in the field to contribute their valuable work to this Special Issue. By bringing together diverse perspectives and cutting-edge research, we aim to foster collaboration and advance knowledge in the field of endocrine tumor research.

Dr. Jules T. Zhang-Yin
Dr. Francesco Dondi
Dr. Emmanouil Panagiotidis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • neuroendocrine tumors
  • thyroid cancer
  • adrenal gland tumors
  • pituitary adenomas
  • parathyroid tumors
  • pancreatic neuroendocrine tumors
  • surgical management
  • radiotherapy

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Published Papers (8 papers)

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Research

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20 pages, 4613 KiB  
Article
Osilodrostat Safety Profile: Findings from Real-World Data in the FAERS Database
by Ioana Rada Popa Ilie, Anca Butuca, Calin Homorodean, Carmen Maximiliana Dobrea, Claudiu Morgovan, Adina Frum and Steliana Ghibu
J. Clin. Med. 2025, 14(10), 3518; https://doi.org/10.3390/jcm14103518 - 17 May 2025
Viewed by 276
Abstract
Background/Objectives: Cushing’s syndrome (CS), including Cushing’s disease (CD)—the most common type—has a substantial negative impact on morbidity, mortality, and patients’ quality of life. Medical management of CS is essential for controlling hypercortisolism as part of preoperative preparation for definitive surgical treatment and for [...] Read more.
Background/Objectives: Cushing’s syndrome (CS), including Cushing’s disease (CD)—the most common type—has a substantial negative impact on morbidity, mortality, and patients’ quality of life. Medical management of CS is essential for controlling hypercortisolism as part of preoperative preparation for definitive surgical treatment and for managing residual or relapsed hypercortisolism post-surgery. Osilodrostat, a dual inhibitor of glucocorticoid and mineralocorticoid biosynthetic pathways, has been approved for the medical treatment of CS since early 2020. However, real-world data on its adverse effects remain limited. We mined the FAERS database and analyzed the reports associated with osilodrostat up to 1 October 2024. Methods: Descriptive and disproportionality methods based on Relative Odds Ratio (ROR), Chi-square (χ2), and Proportional Reporting Ratio (PRR), were used to discern potential safety signals and assess the significance of osilodrostat-associated adverse events. Results: This study identified 782 reports in which osilodrostat was the primary suspected drug, containing 593 preferred terms (PTs) and 2481 occurrences. The most frequently registered events belonged to the following SOCs: “General disorders and administration site conditions” (n = 457, 18.4%), “Injury, poisoning and procedural complications” (n = 311, 12.5%), “Gastrointestinal disorders” (n = 278, 11.2%), “Investigations” (n = 260, 10.5%), and “Nervous system disorders” (n = 184, 7.4%). Among PTs, off-label use was the most commonly reported, aligning with the fact that the vast majority of cases originated from the U.S. (84%), where osilodrostat is officially approved only for the treatment of CD. Disproportionality analysis confirmed previously known and new potential adverse drug reactions associated with osilodrostat treatment, including reports of cardiac flutter (n: 4; PRR: 19.42; χ2: 49.57), ventricular extrasystoles (n: 4; PRR: 11.85; χ2: 29.62), muscular weakness (n: 8; PRR: 2.25; χ2: 4.38), rib fracture (n: 4; PRR: 6.66; χ2: 13.99), spinal fracture (n: 3; PRR: 4.66; χ2: 5.35), sepsis (n: 9; PRR: 2.63; χ2: 7.56), fungal infections (n: 4; PRR: 3.67; χ2: 5.33), and COVID-19 (n: 32; PRR: 5.07; χ2: 101.16). Conclusions: This study highlights new risks and offers valuable insights into osilodrostat use; however, further research and validation are necessary, particularly for adverse reactions not yet explicitly documented in the summary of product characteristics. Full article
(This article belongs to the Special Issue Endocrine Tumors: Diagnosis, Treatment, and Management)
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10 pages, 204 KiB  
Article
Diagnostic and Therapeutic Challenges in Parathyroid Cancers: 15 Years’ Experience in a Tertiary Center and an Endocrine Surgery Referral Hospital
by Razvan Simescu, Andra Piciu, Valentin Muntean, Alexandru Mester and Doina Piciu
J. Clin. Med. 2025, 14(6), 1932; https://doi.org/10.3390/jcm14061932 - 13 Mar 2025
Viewed by 584
Abstract
Background: Parathyroid cancers are rare endocrine malignancies that pose diagnostic and therapeutic challenges, particularly when discovered incidentally or in the presence of multiple endocrine disorders. This study aims to provide clinical, biochemical and pathological insights into these malignancies through a retrospective case series. [...] Read more.
Background: Parathyroid cancers are rare endocrine malignancies that pose diagnostic and therapeutic challenges, particularly when discovered incidentally or in the presence of multiple endocrine disorders. This study aims to provide clinical, biochemical and pathological insights into these malignancies through a retrospective case series. Methods: We analyzed retrospectively, from a tertiary and an endocrine surgery referral center, 13 cases of parathyroid cancers, where 4 cases were associated with thyroid cancers, including demographic data, clinical presentation, biochemical markers, imaging, surgical interventions, histopathological findings and follow-up outcomes. Descriptive statistics were used to summarize patient characteristics. Results: The median age of the cohort was 64 (range: 40–81 years), with a female-to-male ratio of 8:5. More than half of the cases (61.53%) were diagnosed incidentally, with common biochemical findings including elevated parathyroid hormone (PTH) levels (median: 430 pg/mL) and hypercalcemia in 80% of the patients. All patients underwent surgery, with parathyroid resections with concomitant total thyroidectomy (62%) or lobectomy (23%) as the most common interventions. Histopathological analysis confirmed parathyroid carcinoma in all cases, with coexisting thyroid malignancies observed in 31%. An immunohistochemical profile performed in about half of the patients was in accordance with previously published data. Postoperative normalization of PTH levels was achieved in 77% of patients, and no recurrence or metastasis was observed in 85% of cases during follow-up. Conclusions: Despite the exceptional rarity of the disease, this case series highlights the importance of preoperative biochemical and imaging evaluation and the efficacy of surgical management. Long-term outcomes remain favorable with early diagnosis and diligent postoperative monitoring. Further research into molecular biomarkers and targeted therapies is warranted to improve the management of advanced or recurrent disease. Full article
(This article belongs to the Special Issue Endocrine Tumors: Diagnosis, Treatment, and Management)
19 pages, 1712 KiB  
Article
Analysis of Clinical and Biochemical Parameters and the Effectiveness of Surgical Treatment in Patients with Primary Hyperparathyroidism: A Single-Center Study
by Jakub Migoń, Michał Miciak, Dominika Pupka, Szymon Biernat, Łukasz Nowak and Krzysztof Kaliszewski
J. Clin. Med. 2025, 14(3), 996; https://doi.org/10.3390/jcm14030996 - 4 Feb 2025
Viewed by 1071
Abstract
Background: Primary hyperparathyroidism (PHPT) causes an imbalance of calcium-phosphate metabolism in the form of hypercalcemia and hypophosphatemia, leading to dysfunction in various organs. The main cause is a benign tumor of the parathyroid gland (adenoma), leading to excessive and uncontrolled secretion of [...] Read more.
Background: Primary hyperparathyroidism (PHPT) causes an imbalance of calcium-phosphate metabolism in the form of hypercalcemia and hypophosphatemia, leading to dysfunction in various organs. The main cause is a benign tumor of the parathyroid gland (adenoma), leading to excessive and uncontrolled secretion of parathyroid hormone (PTH). Difficulties in diagnosing PTHP are also compounded by the possibility of asymptomatic course at the early disease stages. The gold standard treatment involves removing the pathological gland, while pharmacological options are reserved for candidates ineligible for surgery. Methods: In our study, we assessed the effectiveness of surgical treatment and the factors influencing outcomes and complications by analyzing the records of 125 patients with PHPT who underwent parathyroidectomy at the University Centre of General and Oncological Surgery of the Wroclaw Medical University from 2008 to 2017. We considered sociodemographics, laboratory results, comorbidities, complications, procedure details, and outcomes. The procedures included 93 open minimally invasive parathyroidectomies (OMIPs), 11 unilateral neck explorations, and 21 bilateral neck explorations. Results: Single-gland pathology was common (101 patients), while 24 had involvement of two glands. The left inferior parathyroid gland was the most frequently affected (n = 65; 43.6%). Histopathological examination consistently indicated the presence of parathyroid adenoma in all patients. Complications following parathyroidectomy were observed in 11 (8.8%) patients. Calcium normalization after six months was observed in 119 patients (95.2%). The surgical technique, the location of the adenoma, and the sex and age of the patient did not appear to affect the effectiveness of treatment. Conclusions: Parathyroidectomy is highly effective in treating PHPT, irrespective of patient age, sex, or gland location. It leads to decreased serum PTH and total calcium levels while increasing the inorganic phosphate concentration. Full article
(This article belongs to the Special Issue Endocrine Tumors: Diagnosis, Treatment, and Management)
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13 pages, 805 KiB  
Article
Risk Factors for Malignancy of Thyroid Nodules in Patients Undergoing Thyroid Resection
by Anna Krzentowska, Filip Gołkowski, Elżbieta Broniatowska, Aleksander Konturek and Marcin Barczyński
J. Clin. Med. 2024, 13(24), 7559; https://doi.org/10.3390/jcm13247559 - 12 Dec 2024
Viewed by 878
Abstract
Background: An accurate diagnosis of thyroid nodules is crucial for avoiding unnecessary surgical procedures and making timely treatment possible. The objective of the present study was to evaluate the diagnostic accuracy of fine-needle aspiration biopsy (FNAB) using histopathological findings as the reference standard. [...] Read more.
Background: An accurate diagnosis of thyroid nodules is crucial for avoiding unnecessary surgical procedures and making timely treatment possible. The objective of the present study was to evaluate the diagnostic accuracy of fine-needle aspiration biopsy (FNAB) using histopathological findings as the reference standard. Patients with the diagnostic categories (DCs) III, IV, and V were subjected to special analysis. In addition, the authors assessed whether other factors, including age, gender, body mass index (BMI), obesity, and histopathologically confirmed lymphocytic thyroiditis, had an impact on the occurrence of malignant tumors. Methods: We performed a retrospective analysis of 535 patients (with a mean age of 52.3) who underwent thyroid surgery between October 2022 and September 2023 at the Department of Endocrine Surgery at the University Hospital in Krakow. To assess the reliability of FNAB, the results obtained using the Bethesda classification were compared with the histopathological results. Results: The risk of malignancy (ROM) values for DCs I–VI were 38.1%, 15.6%, 29.8%, 18.6%, 91.0%, and 93.2%, respectively. DC V (OR 62.34, p < 0.0001) and an age ≤ 50 (OR = 2.31, p < 0.006) had statistically significant effects on the risk of thyroid cancer. DCs III and IV were not statistically significantly associated with the risk of malignancy (OR = 1.68, p = 0.16; OR = 1.51, p = 0.3, respectively). There were no statistically significant differences in sex, BMI, or obesity between the patients with benign and malignant lesions. Conclusions: DC V is associated with a high likelihood of malignancy, especially in patients under 50 years of age, and, therefore, surgery is indicated in this category of subjects. In DCs III and IV, the risk of malignancy is lower, and conservative management with active clinical and ultrasound surveillance can be considered. In patients < 50 years of age, with Bethesda categories III and IV, surgical treatment should be considered. Full article
(This article belongs to the Special Issue Endocrine Tumors: Diagnosis, Treatment, and Management)
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11 pages, 254 KiB  
Article
Acromegaly: The Relationship between Hemodynamic Profiles Assessed via Impedance Cardiography and Left Ventricular Systolic Function Assessed via Echocardiography
by Agnieszka Włochacz, Paweł Krzesiński, Beata Uziębło-Życzkowska, Przemysław Witek, Grzegorz Zieliński, Anna Kazimierczak, Robert Wierzbowski, Małgorzata Banak and Grzegorz Gielerak
J. Clin. Med. 2024, 13(18), 5630; https://doi.org/10.3390/jcm13185630 - 23 Sep 2024
Viewed by 928
Abstract
Background/Objectives: Acromegaly-induced prolonged exposure to growth hormone and insulin-like growth factor 1 may have significant cardiovascular effects. The purpose of this study was to assess the relationship between hemodynamic parameters measured via impedance cardiography (ICG) and parameters of systolic left ventricular function [...] Read more.
Background/Objectives: Acromegaly-induced prolonged exposure to growth hormone and insulin-like growth factor 1 may have significant cardiovascular effects. The purpose of this study was to assess the relationship between hemodynamic parameters measured via impedance cardiography (ICG) and parameters of systolic left ventricular function measured via echocardiography in patients with acromegaly. Methods: The observational cohort study included 33 patients with newly diagnosed acromegaly, with a mean age of 47 years and without significant comorbidities. Correlation analysis (Spearman’s rank correlation coefficient R) was performed on parameters obtained by ICG and left ventricular systolic function parameters obtained by echocardiography. ICG assessment included indices of (1) cardiac function as a pump: stroke volume index (SI), cardiac index (CI), Heather index (HI), velocity index (VI), and acceleration index (ACI); (2) afterload: systemic vascular resistance index (SVRI) and total arterial compliance index (TACI); and (3) thoracic fluid content (TFC). Echocardiographic examinations evaluated left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS). Results: A lower LVEF was associated with a lower SI (R = 0.38; p = 0.03) and a higher SVRI (R = −0.35; p = 0.046), whereas lower GLS was associated with lower SI (R = 0.43; p = 0.02), CI (R = 0.62; p < 0.001), VI (R = 0.59; p < 0.001), ACI (R = 0.38; p = 0.048), HI (R = 0.59; p < 0.001), and TACI (R = 0.50; p = 0.006) and a higher SVRI (R = −0.59; p < 0.001). No significant correlation was observed between either LVEF or GLS and TFC. Conclusions: In patients with acromegaly, poorer echocardiographic parameters of left ventricular systolic function are associated with impaired function of the heart as a pump and higher afterload as assessed via ICG. Full article
(This article belongs to the Special Issue Endocrine Tumors: Diagnosis, Treatment, and Management)
21 pages, 2171 KiB  
Article
The Clinicopathological Characteristics and Surgical Treatment of Gastrointestinal Neuroendocrine Neoplasm—A 10-Year Single-Center Experience
by Michał Serafin, Beata Jabłońska, Emila Senderek, Karolina Majewska and Sławomir Mrowiec
J. Clin. Med. 2024, 13(16), 4892; https://doi.org/10.3390/jcm13164892 - 19 Aug 2024
Viewed by 1093
Abstract
Background: Gastrointestinal neuroendocrine neoplasms (GI-NENs) represent a diverse group of tumors, with surgical resection being the gold standard for treatment. Materials and Methods: A retrospective analysis was conducted on 63 patients (32 women, 31 men) who underwent surgery for GI-NENs at the Department [...] Read more.
Background: Gastrointestinal neuroendocrine neoplasms (GI-NENs) represent a diverse group of tumors, with surgical resection being the gold standard for treatment. Materials and Methods: A retrospective analysis was conducted on 63 patients (32 women, 31 men) who underwent surgery for GI-NENs at the Department of Digestive Tract Surgery from January 2013 to June 2023. Tumors were classified by stage (localized, regionally advanced, metastatic). Results: Clinical symptoms were reported by 42 (66.7%) patients, with abdominal pain being the most common symptom, affecting 28 (44.4%) patients. The majority of tumors (44, 69.8%) originated in the midgut. The most frequently performed surgery was right hemicolectomy, carried out on 33 (52.4%) patients. Radical tumor resection was performed in 35 (55.6%) patients. Postoperative complications occurred in 12 (19%) patients, with male gender identified as an independent predictive factor for complications (p = 0.04). Non-functioning tumors were more common (33, 52.4%), and most tumors were classified as grade 1 histopathologically (49, 77.8%). Distant metastases were present in 29 (46%) patients. The overall two-year survival rate was 94.9%, with a five-year survival rate also estimated at 94.9%. Conclusions: GI-NENs are often diagnosed at advanced stages, frequently with distant or lymph node metastases, and predominantly arise in the midgut. Despite low postoperative morbidity and mortality, male gender may be a predictor of postoperative complications. Overall, the prognosis for GI-NENs is favorable, reflected in high overall survival rates. Full article
(This article belongs to the Special Issue Endocrine Tumors: Diagnosis, Treatment, and Management)
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Review

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19 pages, 1426 KiB  
Review
The Role of Positron Emission Tomography/Computed Tomography in the Management of Differentiated Thyroid Cancer: Current Applications and Future Perspectives
by Emmanouil Panagiotidis and Jules Tianyu Zhang-Yin
J. Clin. Med. 2024, 13(22), 6918; https://doi.org/10.3390/jcm13226918 - 17 Nov 2024
Viewed by 1216
Abstract
Differentiated thyroid cancer (DTC), comprising papillary and follicular thyroid carcinoma, is the most common thyroid malignancy and typically has a favourable prognosis when detected early. Positron emission tomography/computed tomography (PET/CT) has emerged as a valuable imaging modality, integrating metabolic and anatomical data. Although [...] Read more.
Differentiated thyroid cancer (DTC), comprising papillary and follicular thyroid carcinoma, is the most common thyroid malignancy and typically has a favourable prognosis when detected early. Positron emission tomography/computed tomography (PET/CT) has emerged as a valuable imaging modality, integrating metabolic and anatomical data. Although PET/CT is not usually part of the initial diagnostic process due to DTC’s indolent nature and low metabolic activity, it plays an essential role in selected clinical scenarios. This includes identifying recurrence in patients with elevated thyroglobulin (Tg) levels and negative radioactive iodine (RAI) scans, evaluating metastatic disease, and guiding treatment in advanced cases. As the use of PET/CT evolves in oncology, this review explores its application in regard to staging, detection of recurrence, and follow-up in terms of managing DTC while also evaluating potential challenges that may occur in the future. The review also considers emerging radiotracers and the theragnostic potential of PET/CT. Full article
(This article belongs to the Special Issue Endocrine Tumors: Diagnosis, Treatment, and Management)
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20 pages, 509 KiB  
Review
Aggressive Types of Malignant Thyroid Neoplasms
by Maria Boudina, Eleana Zisimopoulou, Persefoni Xirou and Alexandra Chrisoulidou
J. Clin. Med. 2024, 13(20), 6119; https://doi.org/10.3390/jcm13206119 - 14 Oct 2024
Viewed by 1558
Abstract
Differentiated thyroid cancer (DTC) includes many subtypes, which demonstrate favorable to aggressive behavior. During the past decades, efforts have been made to describe aggressive thyroid cancers. Within DTC, aggressive variants constitute rare entities with unique histopathological features and compromised survival, as local and [...] Read more.
Differentiated thyroid cancer (DTC) includes many subtypes, which demonstrate favorable to aggressive behavior. During the past decades, efforts have been made to describe aggressive thyroid cancers. Within DTC, aggressive variants constitute rare entities with unique histopathological features and compromised survival, as local and distant metastatic disease is frequent. In recent years, the distinct category of poorly differentiated thyroid cancer was introduced in 2004 and the type of differentiated high-grade thyroid carcinoma was recently added in the 2022 WHO classification of thyroid neoplasms. Finally, anaplastic thyroid cancer exhibits a rapid, resistant to therapy, progression and confers the shortest survival. In this review, we will present the characteristics of these thyroid cancer types and also discuss the treatment, management, and follow-up of these difficult cases. Emphasis was given to recent bibliography of the last decade. Full article
(This article belongs to the Special Issue Endocrine Tumors: Diagnosis, Treatment, and Management)
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