Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement

Nature Reviews Endocrinology, Год журнала: 2023, Номер 19(12), С. 722 - 740

Опубликована: Сен. 5, 2023

Язык: Английский

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Consensus on criteria for acromegaly diagnosis and remission

Pituitary, Год журнала: 2023, Номер unknown

Опубликована: Ноя. 3, 2023

Abstract Purpose The 14th Acromegaly Consensus Conference was convened to consider biochemical criteria for acromegaly diagnosis and evaluation of therapeutic efficacy. Methods Fifty-six experts from 16 countries reviewed discussed current evidence focused on assays; the role imaging, pathology, clinical assessments; consequences diagnostic delay; remission recommendations follow up; value assessment monitoring in defining disease progression, selecting appropriate treatments, maximizing patient outcomes. Results In a with typical features, insulin-like growth factor (IGF)-I > 1.3 times upper limit normal age confirms diagnosis. Random hormone (GH) measured after overnight fasting may be useful informing prognosis, but is not required For patients equivocal results, IGF-I measurements using same validated assay can repeated, oral glucose tolerance testing might also useful. Although primary treatment outcome, findings should interpreted within context acromegaly. Follow up assessments effectiveness, imaging studies evaluating residual/recurrent adenoma mass, signs symptoms acromegaly, its complications, comorbidities. Referral multidisciplinary pituitary center considered biochemical, or at diagnosis, insufficiently responsive standard approaches. Conclusion highlight new understandings disordered GH importance expert management this rare disease.

Язык: Английский

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Clinical, surgical, and endocrine outcome following treatment of posterior pituitary tumors: a retrospective cohort study

Pituitary, Год журнала: 2025, Номер 28(2)

Опубликована: Апрель 1, 2025

Abstract Purpose This study evaluates the clinical presentation, endocrine dysfunction, surgical outcome, and long-term prognosis in patients with histologically confirmed posterior pituitary tumors (PPTs). Methods A retrospective cohort was conducted on 19 treated for PPTs at a single center between 2000 2023. Data clinical, endocrine, outcomes were collected analyzed. Results The included 3 pituicytomas (PCs), 8 granular cell (GCTs), spindle oncocytomas (SCOs) patients, female predominance (58%) mean age of 57.2 ± 13.2 years. Symptoms leading to diagnosis headache (31.6%), visual impairment (21%), sexual dysfunction (10.5%). GCT had higher preoperative BMI (34.49 5.72) compared PC (22.12 2.40) SCO (24.74 4.24) ( p < 0.01). Postoperative increased across all groups, GCTs showing steepest rise Endocrine largely persisted or worsened after surgery, limited recovery follow-up. Surgical approaches transsphenoidal (48%) transcranial (52%), achieving gross total resection 58% cases. Tumor recurrence occurred 16% requiring adjuvant radiation therapy. Tumor-specific survival 5 years 100% an overall rate 80% where non-tumor-related comorbidities accounted observed mortality. Conclusion are rare significant metabolic consequences. While management is associated favorable tumor-specific survival, persistent postoperative progressive underscore need follow-up targeted interventions. These findings contribute understanding PPT biology support development optimized strategies.

Язык: Английский

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A proposed clinical classification for pituitary neoplasms to guide therapy and prognosis

The Lancet Diabetes & Endocrinology, Год журнала: 2024, Номер 12(3), С. 209 - 214

Опубликована: Янв. 29, 2024

Язык: Английский

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Splicing diversity enhances the molecular classification of pituitary neuroendocrine tumors

Nature Communications, Год журнала: 2025, Номер 16(1)

Опубликована: Фев. 11, 2025

Pituitary neuroendocrine tumors (PitNETs) are one of the most common intracranial with diverse clinical manifestations. Current pathological classification systems rely primarily on histological hormone staining and transcription factors (TFs) expression. While effective in identifying three major lineages, molecular characteristics based hormones TFs lack sufficient resolution to fully capture complex tumor heterogeneity. Transcriptional diversity by alternative splicing (AS) offered additional insight address this challenge. Here, we perform bulk full-length single-cell RNA sequencing comprehensively investigate AS dysregulation across all PitNET lineages. We reveal pervasive dysregulations that better depict Additionally, delineate fundamental heterogeneity at resolution, confirming findings refining varying among cell types. Notably, effectively distinguish silent corticotroph subtype define a distinct TPIT lineage subtype, which is associated worse outcomes increased abnormalities driven altered ESRP1 In conclusion, our results characterize specific landscape PitNETs, enhancing understanding PitNETs subtyping. pituitary factors. authors analyze revealing subtypes abnormalities.

Язык: Английский

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Radiological and Immunohistochemical Characteristics of PitNETs in 79 Patients Undergoing Neurosurgery

Cancers, Год журнала: 2025, Номер 17(4), С. 666 - 666

Опубликована: Фев. 16, 2025

The human pituitary is a gland located within small bony box, the sella turcica, under base of brain [...]

Язык: Английский

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Predictors of testosterone recovery in male patients with nonfunctioning pituitary adenoma treated with transnasal transsphenoidal extrapseudocapsular microsurgery

Metabolism and Target Organ Damage, Год журнала: 2025, Номер 5(1)

Опубликована: Фев. 17, 2025

Aim: To investigate the predictor of hypothalamic-pituitary-gonadal (HPG) axis recovery in male pituitary adenoma patients with trans-sphenoid extrapseudocapsular microsurgery. Methods: From June 2019 to December 2021, we retrospectively analyzed clinical data gonadal hormone changes and resection degree before after surgery nonfunctioning (NFPA) who underwent microsurgical by pseudocapsule technique same treatment group at Department Neurosurgery, Tongji Hospital. We explored predictors affecting postoperative testosterone using logistics regression analysis. Results: Among 291 adenomas, mean age was 50 years. Preoperative lower than normal 127 (43.6%); total subtotal were performed 279 (95.9%) 12 (4.1%), respectively. Postoperative follicle-stimulating (FSH) elevated 224 (77.0%) patients, luteinizing (LH) 230 (79.0%) prolactin significantly decreased 259 (89.0%) patients. Seventy-one low preoperative levels recovered levels. Univariate multivariate analysis suggested that tumor size, coagulative necrotic apoplexy (CNPA), invasiveness (P < 0.05). Conclusion: For NFPA, transsphenoidal extra-pseudocapsule microsurgery can effectively restore function anterior gland promote testosterone. Tumor CNPA

Язык: Английский

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Does a Transcriptionally Active HPV Infection Affect the Invasiveness of Pituitary Neuroendocrine Tumors? A Case Series Study of 60 Patients in Krakow, Poland

Cancers, Год журнала: 2025, Номер 17(4), С. 684 - 684

Опубликована: Фев. 18, 2025

Pituitary neuroendocrine tumors (PITNETs) often show a tendency towards invasive behavior, i.e., an invasion the cavernous sinuses or destruction of sella turcica. In present study, we analyzed whether transcriptionally active HPV infection affects invasiveness pituitary tumors. Sixty patients with different phenotypes PITNETs who underwent neurosurgery were studied. The obtained postoperative material was histopathologically. For each patient, formalin-fixed paraffin-embedded blocks cut into ultra-thin slices and two to three them designated for DNA extraction, while one used histological slides. Based on isolated DNA, presence from individual types determined by real-time detection polymerase chain reaction using REALQUALITY RQ-Multi Detection reagent kit (AB ANALITICA, Italy). P16 protein expression assessed immunohistochemical staining A distinguished when overexpression detected simultaneously given tumor. group 60 PITNETs, high-risk in subset 11 (18.3%). This associated significantly lower probability tumor invasiveness, measured both Knosp (OR = 0.11, 95% CI: 0.02-0.58) Hardy scales 0.12 0.024-0.56). Further studies are needed confirm prevalence infections adenomas role these

Язык: Английский

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Clinical and prognostic implications of pituitary macroadenomas (PitNets) grading: a monocentric experience

Pituitary, Год журнала: 2025, Номер 28(2)

Опубликована: Март 13, 2025

Язык: Английский

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Pituitary Apoplexy in Patients with Pituitary Neuroendocrine Tumors (PitNET)

Biomedicines, Год журнала: 2023, Номер 11(3), С. 680 - 680

Опубликована: Фев. 23, 2023

Various complications of pituitary neuroendocrine tumors (PitNET) are reported, and an intratumor hemorrhage or infarct underlying apoplexy (PA) represents uncommon, yet potentially life-threatening, feature, thus early recognition prompt intervention important. Our purpose is to overview PA from clinical presentation management outcome. This a narrative review the English-language, PubMed-based original articles 2012 2022 concerning PA, with exception pregnancy- COVID-19-associated non-spontaneous (prior specific therapy for PitNET). We identified 194 papers including 1452 patients (926 males, 525 females, one transgender male; male-to-female ratio 1.76; mean age at diagnostic 50.52 years, youngest being 9, oldest 85). Clinical included severe headache in majority cases (but some exceptions registered, as well); neuro-ophthalmic panel nausea vomiting, meningism, cerebral ischemia; respectively, decreased visual acuity complete blindness two cases; field defects: hemianopia, cranial nerve palsies manifesting diplopia majority, followed by ptosis ophthalmoplegia (most frequent affected was oculomotor nerve, and, rarely, abducens trochlear); proptosis (N = 2 cases). Risk factors high blood pressure diabetes mellitus main elements. Qualitative analysis also pointed out infections, trauma, hematologic conditions (thrombocytopenia, polycythemia), Takotsubo cardiomyopathy, T3 thyrotoxicosis. Iatrogenic elements may be classified into three categories: medication, tests techniques, surgical procedures. The first group dominated anticoagulant antiplatelet drugs; additionally, low level statistical evidence, we mention androgen deprivation prostate cancer, chemotherapy, thyroxine therapy, oral contraceptives, phosphodiesterase 5 inhibitors. second category includes dexamethasone suppression test, clomiphene use, combined endocrine stimulation tests, regadenoson myocardial perfusion scan. third involves major surgery, laparoscopic coronary artery bypass mitral valvuloplasty, endonasal lumbar fusion surgery prone position. PitNETs still challenging condition requiring multidisciplinary team short- long-term management. Controversies involve risk adequate protocols concern neurosurgical decisions their timing versus conservative approach. present decade-based analysis, our knowledge largest so far on published cases, confirms lack unanimous approach criteria intervention, large circumstantial events, potential triggers different levels significance, addition heterogeneous picture (if any, seen subacute PA) spectrum evolution that varies spontaneous remission control PitNET-associated hormonal excess exitus. Awareness mandatory. A total 25 cohorts have been more than 10 cases/studies, whereas enrolled around 100 patients. Further studies necessary.

Язык: Английский

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