Rodríguez-Gutiérrez R, Zapata-Rivera MA, Rodriguez-Velver KV, Montes-Villarreal J and Villarreal-Perez JZ. OPEN Giant Cystic Prolactinoma in a Woman: Do not Forget the Hook Effect. SM J Endocrinol Metab. 2015;1(1):1001.

Extracellular signal-regulated kinase-1/2 (ERK1/2) activation and expression and proliferating cell nuclear antigen (PCNA) content in normal tissues, benign and malignant (metastatic and not metastatic) human thyroid tumors were studied. In malignant tumors and follicular adenoma tissue increased PCNA expression was observed, and the amount of antigen in tumor tissue, except for follicular carcinoma, exceeded the amount in the conditionally normal tissue. Importantly, in encapsulated papillary carcinomas this excess was 85%, while in nonencapsulated, metastatic tumors PCNA content was on average more than 3 times above normal, and in the cases of most aggressive tumors with metastases in lungs – even 4 times. Total ERK content was significantly lower in tumors compared to normal tissue, except goiter. Activation of the ERK was almost completely suppressed in tumors but not in normal tissue. Thus, ERK activation is not associated with proliferative processes in thyroid tumor tissue. PCNA amount in thyroid tissue could serve as one of diagnostic and prognostic markers, and development of effective antigen inhibitors may be a promising trend in thyroid cancer treatment.

Hypothyroidism can present with variety of clinical features. But bleeding manifestations as a sole atypical presentation of hypothyroidism is extremely rare. Hemostatic disorder may be a manifestation of several underlying etiology. Here we have reported a case where a 14 yr old girl who initially presented with bleeding diathesis without any other symptoms suggestive of thyroid dysfunction but later found to be suffering from severe hypothyroidism after investigations.

Turner syndrome (TS) involves 45XO monosomy while TS variants are mostly 45XO/46XY or 45XO/46XX (with phenotype varying from female to male).

Orbitopathy is an inflammatory disorder affecting orbital and per orbital tissue. It can manifest itself with proptosis. The main cause of proptosis in adults is Graves’ Orbitopathy (GO). Recognition of GO does not exclude other causes of exophthalmos and differential diagnosis is sometimes required. The case presents the patient with Graves Disease (GD), admitted to the Department of Endocrinology due to the symptoms of active orbitopathy. The patient had significant proptosis (right eye-30mm, left eye29mm). Computed tomography showed thickening of oculomotor muscles in both eyes but also a mucous cyst localized in the right frontal sinus. The patient underwent endoscopic, intranasal removal of the lesion. Due to active, moderate to severe orbitopathy, he underwent treatment with 12 weekly pulses of intravenous methylprednisolone, followed by a 3-month prednisone therapy and orbital radiotherapy. The case describes the patient with two coexisting pathologies. Each of them could manifest itself with proptosis. The main cause of proptosis is GO. Physicians must bear in mind that in case of atypical course of GO and lack of improvement, or worsening during corticosteroid treatment, differential diagnosis should be considered. It is worth emphasizing that one of the reasons of proptosis may be a mucocoele (mucous retention cyst).