It Keeps Getting Bigger: A Patient With a Hypothalamic Tumor and Hyperprolactinemia DOI Open Access

Musa Kiyani,

Marvin Wei Jie Chua

Cureus, Journal Year: 2025, Volume and Issue: unknown

Published: March 18, 2025

Internists might occasionally see patients with prolactinomas and non-prolactin-secreting intracranial tumors under their care. This report presents an interesting rare case of a woman end-stage renal disease, who presented hallucinations suprasellar mass. Her symptoms prolactin levels, however, did not improve adherent, inpatient, dopamine agonist treatment. She was eventually palliated demised shortly after compassionate discharge. It is imperative that physicians maintain high index suspicion alternative diagnoses (such as metastatic disease or high-grade glioma) when hypothalamic masses raised levels do significantly decline agonism.

Language: Английский

Cushing Syndrome DOI
Martín Reincke, Maria Fleseriu

JAMA, Journal Year: 2023, Volume and Issue: 330(2), P. 170 - 170

Published: July 11, 2023

Importance Cushing syndrome is defined as a prolonged increase in plasma cortisol levels that not due to physiological etiology. Although the most frequent cause of exogenous steroid use, estimated incidence endogenous overproduction ranges from 2 8 per million people annually. associated with hyperglycemia, protein catabolism, immunosuppression, hypertension, weight gain, neurocognitive changes, and mood disorders. Observations characteristically presents skin changes such facial plethora, easy bruising, purple striae metabolic manifestations excess fat deposition face, back neck, visceral organs. disease, which corticotropin produced by benign pituitary tumor, occurs approximately 60% 70% patients production. Evaluation possible begins ruling out use. Screening for elevated performed 24-hour urinary free test or late-night salivary evaluating whether suppressed morning after an evening dexamethasone dose. Plasma can help distinguish between adrenal causes hypercortisolism (suppressed corticotropin) corticotropin-dependent forms (midnormal levels). Pituitary magnetic resonance imaging, bilateral inferior petrosal sinus sampling, whole-body imaging identify tumor sources hypercortisolism. Management surgery remove source production followed medication includes steroidogenesis inhibitors, pituitary-targeted drugs, glucocorticoid receptor blockers. For responsive medication, radiation therapy adrenalectomy may be appropriate. Conclusions Relevance The First-line causative tumor. Many will require additional treatment medications, radiation, adrenalectomy.

Language: Английский

Citations

102
Hypopituitarism DOI
Maria Fleseriu, Mirjam Christ‐Crain, Fabienne Langlois

et al.

The Lancet, Journal Year: 2024, Volume and Issue: 403(10444), P. 2632 - 2648

Published: May 9, 2024

Language: Английский

Citations

28
Endocrine Outcome and Quality of Life After Transsphenoidal Resection of Pituitary Adenoma—A Prospective Randomized Single-Blinded Study Comparing Endoscopic Versus Microscopic Resection DOI Creative Commons
Andrej Paľa,

Nadja Grübel,

Benjamin Mayer

et al.

Neurology International, Journal Year: 2025, Volume and Issue: 17(1), P. 5 - 5

Published: Jan. 10, 2025

Endoscopic pituitary surgery might yield better endocrine outcomes compared to microscopic resection. We conducted a prospective, randomized, single-blinded study compare the outcome and quality of life (QoL) patients with newly diagnosed adenoma who underwent either endoscopic or transsphenoidal (NCT03515603). Due slow recruitment, this had be stopped prematurely. Out 170 surgeries performed during period, 36 were enrolled in study. The primary endpoint was based on development new hypopituitarism. Secondary endpoints included extent resection, complications, QoL. 47.2% (n = 17). A hypopituitarism found 8.3% 3). All these cases Arginine vasopressin deficiency 2.7% 1) after Gross total resection achieved 94.4% 34). No surgical complications neurological deficits observed. QoL improved significantly surgery, as measured by EQ-VAS (p 0.003). According EQ-5D3L, remained unchanged almost all patients. significant difference between groups. technique appears offer benefits treatment adenomas, particularly terms achieving favorable outcome.

Language: Английский

Citations

1
X-linked ubiquitin-specific peptidase 11 (USP11) increases susceptibility to Cushing’s disease in women DOI Creative Commons
Tao Zhang, Yanting Liu, Fang Liu

et al.

Acta Neuropathologica Communications, Journal Year: 2025, Volume and Issue: 13(1)

Published: Feb. 5, 2025

The incidence of pituitary adrenocorticotropic hormone (ACTH)-secreting PitNETs, commonly known as ACTH is significantly higher in females; however, the underlying causes for this gender disparity remain unclear. In study, we analyzed expression deubiquitinating enzymes functioning PitNETs from both male and female subjects using RNA sequencing identified USP11 a potential susceptibility factor contributing to prevalence these females. Further investigation revealed that markedly elevated with levels than those observed normal tissue. Experimental data indicate promotes transcription proopiomelanocortin (POMC) secretion ACTH. contrast, knockdown leads substantial reduction POMC secretion, demonstrated vitro vivo models. Mechanistically, found facilitates deubiquitination key TPIT enhancing its protein stability thereby promoting secretion. Additionally, virtual screening Lomitapide Nicergoline inhibitors USP11, reducing Thus, emerges therapeutic target, drugs aimed at inhibiting function could benefit women Cushing's disease.

Language: Английский

Citations

1
American Association of Clinical Endocrinology Consensus Statement on Management of Multiple Endocrine Neoplasia Type 1 DOI
Jaydira Del Rivero,

Alexandra Gangi,

Justin P. Annes

et al.

Endocrine Practice, Journal Year: 2025, Volume and Issue: 31(4), P. 403 - 418

Published: April 1, 2025

Language: Английский

Citations

1
Pathogenesis, clinical features, and treatment of plurihormonal pituitary adenoma DOI Creative Commons

Yunjia Cai,

Siyuan Liu, Xue Zhao

et al.

Frontiers in Neuroscience, Journal Year: 2024, Volume and Issue: 17

Published: Jan. 8, 2024

Plurihormonal pituitary adenoma (PPA) is a type of tumor capable producing two or more hormones and usually presents as an aggressive, large adenoma. As yet, its pathogenesis remains unclear. This the first study to systematically summarize underlying PPA. The related plurihormonal primordial stem cells, co-transcription factors, hormone co-expression, differential gene expression, cell transdifferentiation. We conducted literature review PPA analyzed clinical characteristics. found that average age patients with was approximately 40 years, most showed only one symptom. common manifestation acromegaly. Currently, treated surgical resection. However, recent studies suggest immunotherapy may be potentially effective treatment.

Language: Английский

Citations

5
Clinical and Pathological Features of Pit1/SF1 Multilineage Pituitary Neuroendocrine Tumor DOI
Xingchao Wang, Hanlu Tang,

Zhixu Bie

et al.

Neurosurgery, Journal Year: 2024, Volume and Issue: unknown

Published: Jan. 30, 2024

BACKGROUND AND OBJECTIVES: Lineage-based classification has critical clinical implications in pituitary neuroendocrine tumor (PitNET). As the most prevalent subtype of multilineage PitNET, PitNET originating from both pituitary-specific positive transcription factor 1 (Pit1) and steroidogenic factor-1 (SF1) lineages (Pit1/SF1-adenoma) is expected to exhibit rich varied behaviors. A comprehensive understanding pathological characteristics Pit1/SF1-adenoma will provide mechanistic insight influence prognosis treatment PitNET. METHODS: retrospective study was conducted by reviewing 57 cases between 2018 2022. We also included 88 arising Pit1 cell lineage (Pit1-adenoma) 70 SF1 (SF1-adenoma) as controls. Comprehensive data, including demographic, symptom, endocrinal, radiological, surgical, pathological, prognostic information, were systematically collected. All specimens immunostained for factors (PTFs) hormones. RESULTS: The detection rate 8.0% within surgical specimens. displayed a male predominance, with mean diagnosis age falling Pit1-adenoma SF1-adenoma. endocrine activity lower than but higher had incidence cavernous sinus invasion (56.1%) (38.6%, P = .039) SF1-adenoma (27.1%, .001). Furthermore, showed more postoperative complications (29.8% vs 8.0%, Nonfunctional radiological recurrence nonfunctional (34.8% 10.9%, .021). Notably, immunostaining pattern diverse Pit1/SF1-adenoma, various combinations staining intensity PTFs 15 6 Intriguingly, no different impact on outcome Pit1/SF1-adenoma. CONCLUSION: represents unique characterized distinctive Identifying can facilitate precise management practical use Pit1/SF1 immunostaining.

Language: Английский

Citations

5
Impulse Control Disorders in Patients with Pituitary Tumors Treated with Dopamine Agonists: A Systematic Review DOI Open Access
Ross Hamblin, Niki Karavitaki

Archives of Medical Research, Journal Year: 2023, Volume and Issue: 54(8), P. 102910 - 102910

Published: Nov. 19, 2023

Language: Английский

Citations

11
Disulfiram mediated anti-tumour effect in pituitary neuroendocrine tumours by inducing cuproptosis DOI
Ning Huang, Feng Yao, Yanting Liu

et al.

International Immunopharmacology, Journal Year: 2024, Volume and Issue: 134, P. 112159 - 112159

Published: April 30, 2024

Language: Английский

Citations

4
Neuro-ophthalmic evaluation and management of pituitary disease DOI Creative Commons
Michael T.M. Wang,

Juliette A. Meyer,

Helen V. Danesh‐Meyer

et al.

Eye, Journal Year: 2024, Volume and Issue: 38(12), P. 2279 - 2288

Published: July 22, 2024

Abstract Neuro-ophthalmic evaluation is a crucial component of the diagnostic and prognostic assessment pituitary disease compressive chiasmopathy, can inform timing vision-restoring tumour resection surgery. The most common affecting with neuro-ophthalmic implications are adenomas. manifestations include decreased vision, abnormal colour vision impaired visual field or diplopia. recognition these syndromes critical to achieve early diagnosis treatment improve prognosis. pattern loss in chiasmal compression determined by anatomical relationship between lesion optic chiasm, potential defects bitemporal deficits, junctional scotomas, monocular cecocentral defects, incongruous homonymous hemianopias. Rarer ophthalmoplegia, nystagmus, obstructive hydrocephalus. There growing evidence that demonstrates strong utility optical coherence tomography (OCT) parameters detecting presence as well ability predict rate degree recovery following decompression Long-term monitoring for delayed surgery, which may represent recurrence secondary complications.

Language: Английский

Citations

4