Background: The primary endpoint was to analyze the preoperatory inflammatory markers and platelet indices in papillary thyroid cancer (PTC) patients compared with patients with benign thyroid pathology. The secondary endpoints were to analyze the relationship between these markers and the pathological features of PTC and to compare their pre- and postoperative levels in PTC patients. Methods: In this retrospective case-control study, we analyzed the files of 1183 patients submitted to thyroidectomy between January 2012 and December 2018. A total of 234 patients with PTC (mean age 51.54 ± 13.10 years, 84.6% females) were compared with an age-, gender- and BMI-matched control group of 108 patients with histologic benign thyroid disorders. Results: PTC patients had higher platelet count (PLT) (p = 0.011), plateletcrit (PCT) (p = 0.006), neutrophil (p = 0.022) and fibrinogen (p = 0.005) levels. Subgroup analysis showed that PTC females had higher PLT (p = 0.006), PCT (p < 0.001) and erythrocyte sedimentation rate (ESR) (p = 0.005), while males had higher neutrophil (p = 0.040) levels. Papillary thyroid cancer patients under 55 years had higher PLT (p < 0.001) and PCT (p = 0.010), while patients over 55 years had higher mean platelet volume (p = 0.032), neutrophil-to-lymphocyte ratio (p = 0.013), ESR (p = 0.005) and fibrinogen (p = 0.019) levels. Preoperative values for platelet indices and inflammatory markers were similar to the postoperative determinations in PTC patients. Fibrinogen (AUROC = 0.602, p = 0.02; cut-off = 327.5 mg/dL, Se = 53.8%, Sp = 62.9%) and PLT (AUROC = 0.584, p = 0.012; cut-off = 223.5 × 10³/mm³, Se = 73.1%, Sp = 42.6%) were independent predictors of the presence of PTC. Conclusions: Our data show that fibrinogen and platelet count could be promising, inexpensive, independent predictors for the presence of PTC when compared with benign thyroid disorders.

Background and Objectives: The literature suggests that physiological menopause (MP) seems linked with increased adiposity with a preference for intra-abdominal fat accumulation, greater than what can be attributed only by aging, which could magnify this period’s increased cardiovascular risk. Materials and Methods: We retrospectively analyzed two age and body mass index (BMI) propensity-matched subgroups each formed of 90 clinically healthy, 40–60-year-old postmenopausal women, within the first 5 and 5–10 years of MP. The 10-year ASCVD risk was assessed using medical history, anthropometric data, and lipid profile blood tests. The android-to-gynoid (A/G) ratio was computed using Lunar osteodensitometry lumbar spine and hip scans. Results: The A/G ratio was significantly higher for the subgroup evaluated in years 5–10 of MP than in the first 5 years of MP, even after controlling for BMI (1.05 vs. 0.99, p = 0.005). While displaying a significant negative correlation with HDL cholesterol (r = 0.406), the A/G ratio also had positive correlations with systolic blood pressure (BP) values (r = 0.273), triglycerides (r = 0.367), and 10-year ASCVD risk (r = 0.277). After adjusting for smoking, hypertension treatment, and type 2 diabetes, the 10-year ASCVD risk became significantly different for women in the first 5 years (3.28%) compared to those in years 5–10 of MP (3.74%), p = 0.047. Conclusions: In women with similar age and BMI, the A/G ratio appears to vary based on the number of years since menopause onset and correlates with either independent cardiovascular risk parameters like BP, triglycerides, and HDL cholesterol or with composite scores, such as 10-year ASCVD risk.

Background: The primary endpoint was to assess the nutritional status in patients diagnosed with prostate cancer (PCa) in Romania. The secondary endpoint was to analyze the impact of obesity on mortality and disease recurrence. Methods: In this retrospective cohort study, we analyzed the files of 354 patients diagnosed with PCa between August 2001 and May 2022 and referred to the Medical Oncology Department of Neolife Medical Center. A total of 257 patients fulfilled the inclusion criteria and were the subject of this study. Results: Excess weight was seen in 190 (73.9%) patients, with 119 (46.3%) being overweight and 71 (27.6%) having obesity. Subgroup analysis showed that at diagnosis, patients with obesity (PwO) were younger (p = 0.022), had lower PSA (p = 0.016), and had lower 10-year all-cause mortality rates (p = 0.04) than patients without obesity. Patients with metastases had lower weight (p = 0.001) and BMI (p = 0.033), higher PSA (p < 0.001), Gleason scores (p = 0.002), ISUP grade group (p < 0.001), and 10-year all-cause mortality rate (p < 0.001) than patients without metastases. Weight (AUROC = 0.637, 95% CI: 0.557–0.717, p = 0.001; cut-off = 77.5 kg, Se = 52.5%, Sp = 71.2%) and BMI (AUROC = 0.591, 95% CI: 0.507–0.676, p = 0.033; cut-off = 23.5 kg/m², Se = 25.4%, Sp = 91.9%) were independent predictors of the presence of metastases at diagnosis. In the androgen deprivation therapy (ADT) group, PwO had a shorter time to castration resistance than patients without obesity (Log Rank test: χ2 = 4.395, p = 0.036). Conclusions: Weight and BMI are accessible tools that could be useful in determining the presence of metastatic disease. PwO on ADT may develop castration resistant PCa faster than patients without obesity.

Introduction: Primary adrenal lymphoma is a rare cause of adrenal insufficiency, with most cases being of B-cell lymphoma. Case report: We present the case of a 51 yo man with a 1.5-month history of recurrent fever, nausea, vomiting, anorexia, weight loss of 12 kg, fatigue, polyarthalgia, hypotensive episodes (70/40 mmHg) and singultus. Before admission in our clinic he had a thoracic CT scan, which showed a 5.5 cm right adrenal mass and hyperplasia of the left adrenal, followed by plasmatic measurement of cortisol and ACTH, consistent with primary adrenal insufficiency: plasmatic cortisol=22.6 nmol/l (172-497), ACTH=729.5 pg/ml (7.2-63.3). Consequently, 3 days prior to admission in our clinic, his GP recommended daily 4 mg Dexamethasone iv treatment, with significant improvement of symptoms. On physical examination he had hyperpigmentation of the palmar creases, buccal mucosa and gums. Further work-up revealed mild leukocytosis [11.14 *103/μl (4.9-10.2)] with lymphocytosis [4.12 *103/μl (0.6-3.4)], elevated inflammatory markers [ESr=71 mm/h (0-15), CRP=19.9 mg/dl (<10)], mild hypercalcemia [10.6 mg/dl (8.4-10.2)] with low-normal PTH [15.8 pg/ml (15-65)]. An infectious cause of the fever was excluded by performing cardiac ultrasound, urine culture, nasal, rectal, inguinal swabs, respiratory pathogens panel test, blood cultures. Abdomen CT scan revealed an inhomogenous right adrenal gland of 7/3.3/4.7 cm and a left adrenal adenoma of 1.5/1 cm. Screening for primary hyperaldosteronism and pheochromocytoma was negative. We started glucocorticoid and mineralocorticoid replacement therapy and referred the patient to the Surgery department where tumor debulking was performed. Histopathological report described undifferentiated malignant tumor and immunohistochemistry analysis was consistent with anaplastic large cell lymphoma, ALK-negative, an aggressive neoplasm of T-cell lineage. Conclusions: Primary adrenal T-cell lymphoma is an extremely rare cause of adrenal insufficiency. Our patient is currently receiving glucocorticoid and mineralocorticoid replacement therapy and combination chemotherapy (epirubicin + etoposide).