Yutaro Fuse, Kazuhito Takeuchi, Hiroshi Nishiwaki, Takahiro Imaizumi, Yuichi Nagata, Kinji Ohno, Ryuta Saito
PURPOSE: Delayed hyponatremia (DHN), a unique complication, is the leading cause of unexpected readmission after pituitary surgery. Therefore, this study aimed to develop tools for predicting postoperative DHN in patients undergoing endoscopic transsphenoidal surgery (eTSS) for pituitary neuroendocrine tumors (PitNETs). METHODS: This was a single-center, retrospective study involving 193 patients with PitNETs who underwent eTSS. The objective variable was DHN, defined as serum sodium levels < 135 mmol/L at ≥ 1 time between post operative days 3 and 9...
March 30, 2023: Pituitary
J MacFarlane, K A Huynh, A S Powlson, A G Kolias, R J Mannion, D J Scoffings, I A Mendichovszky, H K Cheow, W A Bashari, J Jones, D Gillett, O Koulouri, Mark Gurnell
Accurate localization of the site(s) of active disease is key to informing decision-making in the management of refractory pituitary adenomas when autonomous hormone secretion and/or continued tumor growth challenge conventional therapeutic approaches. In this context, the use of non-standard MR sequences, alternative post-acquisition image processing, or molecular (functional) imaging may provide valuable additional information to inform patient management.
March 27, 2023: Pituitary
Anders Jensen Kolnes, Kristin Astrid Berland Øystese, Evelina Sjöstedt, Nicoleta Cristina Olarescu, Ansgar Heck, Jens Pahnke, Daniel Dahlberg, Jon Berg-Johnsen, Geir Ringstad, Olivera Casar-Borota, Jens Bollerslev, Anders Palmstrøm Jørgensen
PURPOSE: Transforming growth factor-beta receptor 3-like (TGFBR3L) is a pituitary enriched membrane protein selectively detected in gonadotroph cells. TGFBR3L is named after transforming growth factor-beta receptor 3 (TGFBR3), an inhibin A co-receptor in mice, due to sequence identity to the C-terminal region. We aimed to characterize TGFBR3L detection in a well-characterized, prospectively collected cohort of non-functioning pituitary neuroendocrine tumours (NF-PitNETs) and correlate it to clinical data...
March 23, 2023: Pituitary
Anamil Khiyami, Neha Mehrotra, Sharini Venugopal, Hussain Mahmud, Georgios A Zenonos, Paul A Gardner, Pouneh K Fazeli
PURPOSE: Acromegaly is a disorder characterized by IGF-1 excess due to autonomous GH secretion. In individuals without acromegaly, IGF-1 is not only influenced by GH secretion but is also sensitive to other factors including nutritional status, as evidenced by the inverted U-shaped association between BMI and IGF-1; in low-weight individuals (BMI < 18.5 kg/m2 ) and those who are obese, IGF-1 levels may be frankly low. It is not known if this same relationship between BMI and IGF-1 is also observed in acromegaly...
March 17, 2023: Pituitary
Sandrine A Urwyler, Niki Karavitaki
A small subset of lactotroph adenomas is resistant to dopamine agonists (DA) and can also demonstrate aggressive or even malignant behavior. The implicated mechanisms are not clearly defined. Management can be challenging and requires a multidisciplinary approach. In DA resistant prolactinomas, switching to another DA could be the first option to consider. Further strategies include surgery and radiotherapy used alone or in combination. In cases of aggressive or malignant prolactinomas, temozolomide could be offered...
March 16, 2023: Pituitary
Amit K S Sumal, Dongyun Zhang, Anthony P Heaney
The majority of corticotroph adenomas are benign but some are locally invasive, demonstrate high rates of recurrence, and exhibit a relatively poor response to often repeated surgical, medical, and radiation treatment. Herein, we summarize the currently known somatic and genetic mutations and other molecular factors that influence the pathogenesis of these tumors and discuss currently available therapies. Although recent molecular studies have advanced our understanding of the pathogenesis and behavior of these refractory corticotroph adenomas, these insights do not reliably guide treatment choices at present...
March 14, 2023: Pituitary
Anat Ben-Shlomo
PURPOSE: Treatment-refractory pituitary tumors demonstrate characteristics resembling those of highly aggressive tumors, in which the local tumor microenvironment (TME) plays a dominant role in promoting aggressiveness and refractoriness. However, role of the TME in pituitary tumors is not well studied. METHODS: Literature on the TME and development of refractory pituitary tumors was reviewed RESULTS: TME harbors tumorigenic immune cells, cancer-associated fibroblasts (CAF), extracellular matrix, and other factors that have been shown to affect behavior of tumor tissue...
March 4, 2023: Pituitary
Kai Li, Zhiwei Xiong, Mingfeng Zhou, Yichao Ou, Weizhao Li, Guangsen Wu, Mengjie Che, Haodong Gong, Xingqin Wang, Junjie Peng, Xiaoxuan Zheng, Jiahui Li, Zhanpeng Feng, Junxiang Peng
PURPOSE: The histopathological study of brain tissue is a common method in neuroscience. However, efficient procedures to preserve the intact hypothalamic-pituitary brain specimens are not available in mice for histopathological study. METHOD: We describe a detailed procedure for obtaining mouse brain with pituitary-hypothalamus continuity. Unlike the traditional methods, we collect the brain via a ventral approach. We cut the intraoccipital synchondrosis, transection the endocranium of pituitary, broke the spheno-occipital synchondrosis, expose the posterior edge of pituitary, separate the trigeminal nerve, then the intact pituitary gland was preserved...
March 2, 2023: Pituitary
Hugo Layard Horsfall, Alistair Lawrence, Ashwin Venkatesh, Ryan T S Loh, Ronie Jayapalan, Olympia Koulouri, Rishi Sharma, Thomas Santarius, Mark Gurnell, Neil Dorward, Richard Mannion, Hani J Marcus, Angelos G Kolias
PURPOSE: Transsphenoidal surgery is an established treatment for pituitary adenomas. We examined outcomes and time points following transsphenoidal surgery for pituitary adenoma to identify reporting heterogeneity within the literature. METHODS: A systematic review of studies that reported outcomes for transsphenoidal surgery for pituitary adenoma 1990-2021 were examined. The protocol was registered a priori and adhered to the PRISMA statement. Studies in English with > 10 patients (prospective) or > 500 patients (retrospective) were included...
March 2, 2023: Pituitary
Giorgio Fiore, Giulio Andrea Bertani, Giorgio Conte, Emanuele Ferrante, Leonardo Tariciotti, Elisabetta Kuhn, Letterio Runza, Mauro Pluderi, Stefano Borsa, Manuela Caroli, Elisa Sala, Giulia Platania, Karin Kremenova, Stefano Ferrero, Fabio Maria Triulzi, Giovanna Mantovani, Marco Locatelli
PURPOSE: To (1) identify a radiological parameter to predict non-functioning pituitary tumor (NFPT) consistency, (2) examine the relationship between NFPT consistency and extent of resection (EOR), (3) investigate if tumor consistency predictors can anticipate EOR. METHODS: The ratio (T2SIR) between the T2 min signal intensity (SI) of the tumor and the T2 mean SI of the CSF was the main radiological parameter, being determined through a radiomic-voxel analysis and calculated using the following formula: T2SIR = [(T2 tumor mean SI - SD)/T2 CSF SI]...
February 20, 2023: Pituitary
Roman O Kowalchuk, Daniel M Trifiletti, Paul D Brown, Jason P Sheehan
The pituitary gland is a potential site for a range of pathologies, for which treatment can involve resection and/or ionizing radiation. Modern stereotactic radiosurgery (SRS) involves highly conformal radiation, allowing for the delivery of high doses to the tumor while simultaneously sparing nearby healthy structures. SRS has become a standard treatment option for residual or recurrent pituitary adenomas. It has been used for both functioning and nonfunctioning pituitary adenomas, with reported local tumor control over 90% and moderate rates of endocrine remission in functioning adenomas...
February 17, 2023: Pituitary
Tamara Kolitz, Yona Greenman
Non-functioning pituitary adenomas (NFPAs) comprise silent tumors of different pituitary lineages that tend to escape early detection and present as invasive macroadenomas with symptoms of mass effect. Incomplete surgical resection is common and may be followed by significant rates of subsequent remnant progression. Pituitary tumors are defined as refractory when resistance to optimal standard therapies including surgery, radiotherapy, and medical treatment is documented. In the absence of approved medications for the treatment of NFPAs, the last criterion to classify these tumors as refractory is ill defined...
February 14, 2023: Pituitary
Agnieszka Grzywotz, Yan Li, Nicole Unger, Cordula Kiewert, Witold X Chmielewski, Ulrich Sure, Anne Uerschels, Karsten Wrede, Ilonka Kreitschmann-Andermahr
OBJECTIVE: Childhood hydrocephalus patients treated by ventriculo-peritoneal (v.-p.) shunting are sometimes referred years after this therapy for evaluation of suspicious pituitary enlargement. Since pituitary size has been shown to depend on cerebrospinal fluid (CSF) pressure, we assume this phenomenon to be caused by shunt overdrainage. Therefore, we studied pituitary size and morphology in shunted hydrocephalus patients with radiological signs of high CSF drainage. PATIENTS AND METHODS: Retrospective study of pituitary size and morphology in 15 shunted patients with non-tumoral hydrocephalus and 7 shunted hydrocephalus patients due to childhood brain tumor compared to a population mean...
January 18, 2023: Pituitary
Nanna Thurmann Jørgensen, Trine Møller Erichsen, Morten Buus Jørgensen, Thomas Idorn, Bo Feldt-Rasmussen, Jens J Holst, Ulla Feldt-Rasmussen, Marianne Klose
PURPOSE: Active acromegaly is associated with impaired glucose metabolism, which improves upon treatment. Treatment options include surgery, medical therapy with somatostatin analogues (SSA) and Pegvisomant (PEG), and irradiation. The objective of the study was to describe the differential effect of various treatment regimens on the secretion of glucose, insulin, glucagon, glucagon-like peptide-1 (GLP-1), and glucose-dependent insulinotropic polypeptide (GIP) in patients with acromegaly...
January 6, 2023: Pituitary
Xiaoyu Ji, Jiajia Fu, Xiaozhe Li, Kun Yuan, Xuebo Sun, Qiaoling Yao
PURPOSE: In the past few decades, acromegaly and colonic polyps have been associated with an increased risk of colorectal cancer. Previous studies highlighted the importance of serum biomarkers of colonic polyps in patients with acromegaly. METHODS: We reviewed studies on serum biomarkers of colonic polyps in patients with acromegaly, published on PubMed, Embase, Cochrane Library, Medline, and Chinese databases from January 1, 1966, to May 8, 2022. Meta-analysis and systematic review were conducted using Stata MP 14...
February 2023: Pituitary
Amit Akirov, Laura Dery, Maria Fleseriu, Yaron Rudman, Ilan Shimon, Yossi Manisterski, Nirit Aviran-Barak, Varda Nadler, Sandra Alboim, Tzipora Shochat, Gloria Tsvetov, Dania Hirsch
OBJECTIVE: To evaluate the clinical presentation, biochemical profile, and etiology of Cushing's syndrome (CS) in women stratified by age. METHODS: Retrospective study of patients with CS, treated at Rabin Medical Center from 2000 to 2020, or Maccabi Healthcare Services in Israel from 2005 to 2017. Disease etiology, presentation and biochemical profile were compared according to age at diagnosis: ≤ 45, 46-64, or ≥ 65 years. Study was approved by the Ethics Review Boards of both facilities with waiver of consent...
February 2023: Pituitary
Dorothee Cäcilia Spille, Elena Vorona, Michael P Catalino, Gilles Reuter, Albert Beckers, Markus Holling, Arianna Fava, Walter Stummer, Edward R Laws, Eric Suero-Molina
PURPOSE: Endonasal resection is the first-line treatment for patients harboring growth hormone (GH)-secreting pituitary adenomas. The complexity of the parasellar neurovascular structures makes pre-operative diagnostic imaging essential to understanding the anatomy of this region. We aimed to describe vascular anomalies in acromegalic patients and emphasize their relevance for surgery and preoperative planning. METHODS: A systematic review following the PRISMA statement was performed in July 2021...
February 2023: Pituitary
Chloe Dumot, David Schlesinger, Georgios Mantziaris, Sam Dayawansa, Zhiyuan Xu, Jason P Sheehan
PURPOSE: Stereotactic radiosurgery (SRS) can be used in acromegaly patients to achieve endocrine remission. In this study we evaluate the biological effective dose (BED) as a predictor of SRS outcomes for acromegaly. METHOD: This retrospective, single-center study included patients treated with single-fraction SRS with growth hormone secreting pituitary adenomas and available endocrine follow-up. Kaplan-Meier analysis was used to study endocrine remission, new pituitary deficit, and tumor control...
December 5, 2022: Pituitary
Fatos Alkan, Betul Ersoy, Deniz Ozalp Kızılay, Beyhan Cengız Ozyurt, Senol Coskun
PURPOSE: To evaluate cardiac structure, exercise capacity and electrocardiography (ECG) parameters of children with complete and partial growth hormone (GH) deficiency (GHD) and the effect of 12 months GH treatment on these. METHODS: M-mode echocardiography, ECG and exercise test expressed as metabolic equivalent (MET) were performed in children with GHD, aged 9-14 years, divided into those with a peak GH response < 7 µg/L (complete GHD; n = 30) and 7-10 µg/L (partial GHD; n = 17) after two GH stimulation tests, at baseline and 12 months after GH initiation...
December 4, 2022: Pituitary
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