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Catharina Olivius, Kerstin Landin-Wilhelmsen, Daniel S Olsson, Gudmundur Johannsson, Åsa Tivesten
PURPOSE: Women with hypopituitarism have increased morbidity and mortality, and hypogonadism has been suggested to be a contributing mechanism. The purpose of this study was to investigate the prevalence of central hypogonadism and hypoandrogenism in women with hypopituitarism at a single Swedish center. METHODS: All consecutive women (n = 184) who commenced growth hormone (GH) replacement therapy at Sahlgrenska University Hospital in Gothenburg between 1995 and 2015 were included...
May 22, 2018: Pituitary
Leonie H A Broersen, Nienke R Biermasz, Wouter R van Furth, Friso de Vries, Marco J T Verstegen, Olaf M Dekkers, Alberto M Pereira
PURPOSE: Systematic review and meta-analysis comparing endoscopic and microscopic transsphenoidal surgery for Cushing's disease regarding surgical outcomes (remission, recurrence, and mortality) and complication rates. To stratify the results by tumor size. METHODS: Nine electronic databases were searched in February 2017 to identify potentially relevant articles. Cohort studies assessing surgical outcomes or complication rates after endoscopic or microscopic transsphenoidal surgery for Cushing's disease were eligible...
May 16, 2018: Pituitary
Marta Araujo Castro, Mónica Marazuela Azpiroz
BACKGROUND: Two types of ectopic Cushing syndrome (ECS) are described: ECS associated with aggressive neoplasms, and ECS with indolent and occult tumors, however, there is a lack of studies that thoroughly review their characteristics. METHODS: A systematic review was carried out on PUBMED of all the papers about the ECS, in order to better define the types of this subcategory of Cushing's syndrome, highlighting the differential aspects between these subgroups. RESULTS: It was found that in 50% of cases the prototypic "aggressive" ECS is caused by small cell lung carcinomas (SCLC)...
May 15, 2018: Pituitary
Tommaso Tartaglione, Sabrina Chiloiro, Maria Elena Laino, Antonella Giampietro, Simona Gaudino, Angelo Zoli, Antonio Bianchi, Alfredo Pontecorvi, Cesare Colosimo, Laura De Marinis
Primary autoimmune hypophysitis (PAH) is considered an underdiagnosed disease, due to the difficulty in reaching a definitive diagnosis. PAH clinical diagnosis remains an exclusion diagnosis. We aimed to correlate PAH neuro-radiological signs to endocrine features and evaluate their prognostic role. 24 PAH cases were enrolled and classified according to neuro-radiological signs: in 12 adeno-hypophysitis (AHs), 8 infundibulo-neuro-hypophysitis (INHs) and 4 pan-hypophysitis (PHs). Secondary hypogonadism developed more frequently in INHs as compared to AHs (54...
May 11, 2018: Pituitary
Amit Akirov, Yona Greenman, Benjamin Glaser, Irena S'chigol, Yossi Mansiterski, Yoav Eizenberg, Ilana Shraga-Slutzky, Ilan Shimon
OBJECTIVE: Hyperprolactinemia is common in acromegaly and in these patients, insulin-like growth factor (IGF)-1 level may decrease with dopamine agonist. We report a series of patients with prolactinoma and a paradoxical increase of IGF-1 levels during cabergoline treatment. METHODS: Clinical characteristics and response to treatment of patients with prolactinomas, in whom normal or slightly elevated baseline IGF-1 levels increased with cabergoline. RESULTS: The cohort consisted of ten prolactinoma patients (nine males, mean age 48 ± 14 years)...
May 4, 2018: Pituitary
Ruth Prieto, José M Pascual
BACKGROUND: The growing interest in the molecular and genetic alterations of craniopharyngiomas (CPs) is embodied in recent studies revealing insights into the CP tumorigenesis and identifying novel molecular pathways amenable of targeted therapies. The actual impact of this new information, however, remains inconclusive. METHODS: We present a comprehensive review of the accumulated knowledge on molecular biology of CPs and a critical analysis on the strengths and weaknesses of the studies focused on CP molecular/genetic alterations published to date...
April 26, 2018: Pituitary
José M Pascual, Ruth Prieto, Maria Rosdolsky, Sewan Strauss, Inés Castro-Dufourny, Verena Hofecker, Eduard Winter, Rodrigo Carrasco, Walter Ulrich
A heterogeneous group of epithelial cystic tumors developed at the infundibulum and the third ventricle disconcerted pathologists at the dawn of the twentieth century. Very little was known at that time about the physiological role played by the pituitary gland, and there was almost complete ignorance regarding the function of the hypothalamus. Acromegaly, or enlargement of acral body parts, described in 1886 by Pierre Marie, was the only disease linked to primary hypertrophies of the pituitary gland, known as "pituitary strumas"...
April 21, 2018: Pituitary
Afif Nakhleh, Naim Shehadeh, Irit Hochberg, Moshe Zloczower, Sagit Zolotov, Riad Taher, Deeb Daoud Naccache
INTRODUCTION: Cystic prolactinoma is a variant of prolactin-secreting pituitary adenoma. The strategies for the management of cystic prolactinoma have not been addressed thoroughly in clinical guidelines. METHODS: A literature search was performed using Pubmed to review the current approaches to the treatment of cystic prolactinoma. RESULTS: Transsphenoidal resection is an effective and relatively safe approach for the treatment of cystic prolactinoma, however, morbidity of surgery is dependent on the skill of the surgeon...
April 13, 2018: Pituitary
R W J Kruis, A Y N Schouten-van Meeteren, M J J Finken, W Oostdijk, A S P van Trotsenburg, A M Boot, H L Claahsen-van der Grinten, E J van Lindert, K S Han, E W Hoving, E M C Michiels, H M van Santen
PURPOSE: Severe fluctuations in plasma sodium concentration and plasma osmolarity, including central diabetes insipidus (CDI), may have significant influence on postoperative morbidity and mortality after pediatric brain tumor surgery.The aim of this study was to describe the frequency, severity and neurological consequences of these fluctuations in pediatric brain tumor survivors. METHODS: A retrospective, multi-institutional chart review was conducted among all children who underwent brain tumor surgery in the sellar or suprasellar region in seven university hospitals in the Netherlands between January 2004 and December 2013...
April 5, 2018: Pituitary
Michiel J van Esdonk, Eline J M van Zutphen, Ferdinand Roelfsema, Alberto M Pereira, Piet H van der Graaf, Nienke R Biermasz, Jasper Stevens, Jacobus Burggraaf
OBJECTIVE: In rare disease research, most randomized prospective clinical trials can only use limited number of patients and are comprised of highly heterogeneous populations. Therefore, it is crucial to report the results in such a manner that it allows for comparison of treatment effectiveness and biochemical control between studies. The aim of this review was to investigate the current methods that are being applied to measure and report growth hormone (GH) and insulin-like growth factor-1 (IGF-1) as markers for drug effectiveness in clinical acromegaly research...
March 31, 2018: Pituitary
Peihua Lin, Xueyong Liu, Shu Wang, Xiaoling Li, Yankun Song, Lianhuang Li, Shanshan Cai, Xingfu Wang, Jianxin Chen
PURPOSE: If we can find a new method that can achieve rapid diagnosis of adenoma during operation, it will help surgeon shorten the operation time and enhance the treatment efficacy. This study discusses the feasibility of multiphoton microscopy (MPM) in diagnosing pituitary adenoma. METHOD: MPM, based on two-photon excited fluorescence (TPEF) and second harmonic generation (SHG) is performed for the diagnosis of pituitary adenoma in unstained sections. RESULTS: Our results show that MPM can reveal the variation of reticulin fiber by SHG signals of collagen, combined with the measurement of area of acinus, thickness of collagen fiber and collagen percentage...
March 29, 2018: Pituitary
Verena Klyn, Sven Dekeyzer, Ruth Van Eetvelde, Pieter Roels, Ortwin Vergauwen, Pieter Devolder, Martin Wiesmann, Eric Achten, Omid Nikoubashman
PURPOSE: To describe the prevalence of the posterior pituitary bright spot (PPBS) in the general population on 1.5 and 3T MRI examinations and on 2D-T1 spin-echo (SE) and 3D-T1 gradient-echo (GE) sequences. MATERIALS AND METHODS: 1017 subjects who received an MRI of the brain for aspecific neurological complaints were included. MRI was performed on 1.5T in 64.5% and on 3T in 35.5% of subjects. Presence of the PPBS was evaluated on sagittal 2D T1-SE echo images with slice thickness 3 mm in 67...
March 28, 2018: Pituitary
Hermann L Müller, Julia Reichel, Svenja Boekhoff, Monika Warmuth-Metz, Maria Eveslage, Junxiang Peng, Jörg Flitsch
BACKGROUND: Assessment of presurgical hypothalamic involvement (psHI) and treatment-related hypothalamic damage (trHD) is relevant for the decision on risk-adapted treatment and rehabilitation strategies in craniopharyngioma. PATIENTS AND METHODS: 129 surgical reports of childhood-onset craniopharyngioma patients recruited 2007-2014 in KRANIOPHARYNGEOM 2007 were analyzed. Data on psHI were available based on surgeon's (63%), reference neuroradiologist's (95%), and local radiologist's (23%) assessment...
March 27, 2018: Pituitary
Isabella P P Grande, Paulo V G H Amorim, Ane Caroline Thé B Freire, Raquel S Jallad, Nina R Musolino, Valter A Cescato, Gilberto O da Silva, Marcello D Bronstein, Ericka B Trarbach
Sirtuins 1-7 (SIRT) are a highly conserved family of histone deacetylases involved in the regulation of longevity that have a considerable impact in transcription, DNA repair regulation, telomeric stability, cell senescence and apoptosis. In the present study, SIRT1-7 mRNA levels were evaluated in 37 somatotropinomas and 31 nonfunctioning pituitary adenomas (NFPAs) using qPCR and relation to tumor size, invasiveness and Ki-67 proliferative index was made. Overexpression of SIRT1 was observed in 86.5% of somatotropinomas versus 41...
March 21, 2018: Pituitary
Lia Silvia Kunzler, Luciana Ansaneli Naves, Luiz Augusto Casulari
BACKGROUND: The delayed diagnosis, altered body image, and clinical complications associated with acromegaly impair quality of life. PURPOSE: To assess the efficacy of the cognitive-behavioral therapy (CBT) technique "Think Healthy" to increase the quality of life of patients with acromegaly. METHODS: This non-randomized clinical trial examined ten patients with acromegaly (nine women and one man; mean age, 55.5 ± 8.4 years) from a convenience sample who received CBT...
June 2018: Pituitary
Sabrina Chiloiro, Gherardo Mazziotti, Antonella Giampietro, Antonio Bianchi, Stefano Frara, Marilda Mormando, Alfredo Pontecorvi, Andrea Giustina, Laura De Marinis
The original version of the article contained an error in the results section of the Abstract. The vertebral fractures (VFs) odds ratio is incorrectly published as 61.0 and the correct value is 6.10.
June 2018: Pituitary
Maria Fleseriu, Niki Karavitaki
No abstract text is available yet for this article.
April 2018: Pituitary
Maria Chiara Zatelli
The pathogenesis of non functioning pituitary adenomas (NFPA) is a complex process involving several factors, from molecular to genetic and epigenetic modifications, where tumor suppressor genes, oncogenes, cell cycle derangements have been demonstrated to play an important role. MicroRNAs (miRNAs) have also been identified as possible players in NFPA tumorigenesis and pituitary stem cells have been investigated for their potential role in pituitary tumor initiation. However, a critical role for paracrine signalling has also been highlighted...
April 2018: Pituitary
Luiz Eduardo Wildemberg, Andrea Glezer, Marcello D Bronstein, Mônica R Gadelha
Pituitary apoplexy is an uncommon event, occurring due to the infarction and/or haemorrhage usually of a previously unknown pituitary adenoma. It can occur in all adenoma subtypes but is more common in nonfunctioning pituitary adenomas. The physiopathology is not completely clear, and precipitating factors, such as major surgeries, anticoagulant use or pituitary dynamic tests, can be found in up to 40% of patients. The clinical presentation is characterized by a rapid onset with a headache as the main symptom, but visual disturbances can also be present as well as meningism and intracranial hypertension...
April 2018: Pituitary
Giuseppe Minniti, John Flickinger, Barbara Tolu, Sergio Paolini
External beam radiotherapy (RT) is an essential part of the management of intracranial tumors and has been used in treating pituitary adenomas for more than five decades. It has been demonstrated that conventional RT for postoperative residual or progressive nonfunctioning pituitary adenomas (NFAs) present an excellent long-term local tumor control, although its use has been limited because of the potential late toxicity related to radiation treatments. Recent advances in radiation techniques have led to more accurate treatments, rendering obsolete many commonly held views of the "old" radiotherapy...
April 2018: Pituitary
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