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Lukas Andereggen, Janine Frey, Robert H Andres, Marwan El-Koussy, Jürgen Beck, Rolf W Seiler, Emanuel Christ
OBJECTIVE: In men with prolactinomas, an impaired bone density is the principle consequence of hyperprolactinemia-induced hypogonadism. While dopamine (DA-) agonists are the first-line approach in prolactinomas, surgery can be considered in selected cases. In the present study, we aimed to investigate on the long-term control of hyperprolactinemia, hypogonadism and bone health comparing primary medical and surgical therapy in men who had not had prior DA-agonist treatment. METHODS: Retrospective case-note study of 44 consecutive men with prolactinomas and no prior DA-agonists managed in a single tertiary referral center...
October 20, 2016: World Neurosurgery
K Wolinski, A Stangierski, K Dyrda, K Nowicka, M Pelka, A Iqbal, A Car, M Lazizi, N Bednarek, A Czarnywojtek, E Gurgul, M Ruchala
PURPOSE: Acromegaly is a chronic disease resulting from pathological oversecretion of growth hormone and subsequently insulin growth factor-1. Several complications of the disease have been reported, including cardiovascular diseases, respiratory disorders but also increased risk of benign and malignant neoplasms. The aim of the study was to evaluate the risk of malignant neoplasms in the patients with acromegaly in comparison with the control group. PATIENTS AND METHODS: Medical documentation of acromegalic patients treated in one medical center between 2005 and 2016 has been analyzed...
October 21, 2016: Journal of Endocrinological Investigation
Toshihiro Ogiwara, Tetsuyoshi Horiuchi, Alhusain Nagm, Tetsuya Goto, Kazuhiro Hongo
PURPOSE: It is generally accepted that dopamine agonists (DA) represent the first-line treatment for most patients with prolactinoma, and patients become candidates for surgical intervention when DA is contraindicated. Surgical indication for cystic prolactinoma remains controversial. This study was performed to investigate the significance of surgery for cystic prolactinoma. METHODS: A total of 28 patients that underwent transsphenoidal resection of prolactinoma between February 2004 and May 2016 were reviewed...
October 18, 2016: Pituitary
Karolína Drbalová, Kateřina Herdová, Petr Krejčí, Monika Nývltová, Svatopluk Solař, Lenka Vedralová, Pavel Záruba, David Netuka, Petr Bavor
Multiple Endocrine Neoplasia (MEN) is a condition in which several endocrine organs of an individual are affected by adenoma, hyperplasia and less often carcinoma, either simultaneously or at different stages of life. Two existing syndromes, MEN1 and MEN2 (2A, 2B), in literature is also mentioned MEN4, are associated also with other non-endocrine disorders. MEN1 (Wermer syndrome) affects the pituitary, parathyroid, and pancreatic area. 95 % of patients show very early manifestation of hyperparathyroidism, often before 40 years of age...
2016: Vnitr̆ní Lékar̆ství
A Krishna Murthy, G Vasavilatha, Srinivas Rao, Pranoy G
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Thierry Brue, Frederic Castinetti
Secreting pituitary adenomas that cause acromegaly and Cushing's disease, as well as prolactinomas and thyrotroph adenomas, are uncommon, usually benign, slow-growing tumours. The rarity of these conditions means that their diagnosis is not familiar to most non-specialist physicians. Consequently, pituitary adenomas may be overlooked and remain untreated, and affected individuals may develop serious comorbidities that reduce their quality of life and life expectancy. Because many signs and symptoms of pituitary adenomas overlap with those of other, more common disorders, general practitioners and non-endocrinology specialists need to be aware of the "red flags" suggestive of these conditions...
October 6, 2016: Orphanet Journal of Rare Diseases
Khalid S Aljabri, Samia A Bokhari, Faisal Y Assiri, Muneera A Alshareef, Patan M Khan
BACKGROUND: Data on pituitary adenoma (PA) prevalence in Saudi Arabia are scarce. OBJECTIVE: To estimate the epidemiology of PA in a well-defined population. DESIGN: Retrospective analysis. SETTING: Departments of Endocrinology and Radiology at King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. PATIENTS AND METHODS: Radiological and hormonal data of patients with pituitary adenoma by MRI were reviewed for the period January 2008 to December 2015...
September 2016: Annals of Saudi Medicine
Laurent Vroonen, Patrizio Lancellotti, Monica Tomé Garcia, Raluca Dulgheru, Matilde Almanza, Ibrahima Maiga, Julien Magne, Patrick Petrossians, Renata Auriemma, Adrian F Daly, Albert Beckers
Since the 1990's cabergoline has been the treatment of choice in prolactinoma, as it permits rapid and effective hormonal and tumor control in most cases. Evidence of cardiac valvulopathy was demonstrated in Parkinson's disease patients treated with dopamine agonists. Retrospective studies in prolactinoma patients treated with cabergoline at lower doses did not show such an effect. However, few prospective data with long-term follow-up are available. The aim of this study was to assess the safety of cabergoline regarding cardiac valvular status during prospective follow-up in patients treated for prolactinoma or idiopathic hyperprolactinemia...
October 5, 2016: Endocrine
Paula Andujar-Plata, Rocio Villar-Taibo, Maria Dolores Ballesteros-Pomar, Alfonso Vidal-Casariego, Begoña Pérez-Corral, Jose Manuel Cabezas-Agrícola, Paula Álvarez-Vázquez, Ramón Serramito, Ignacio Bernabeu
Giant prolactinomas are rare tumors characterized by their large size, compressive symptoms, and extremely high prolactin secretion. The aim of this study is to describe our experience with a series of 16 giant prolactinomas cases in terms of clinical presentation, therapeutic decisions, and final outcomes. Retrospective analysis of adult patients diagnosed with giant prolactinomas at the endocrine departments of three university tertiary hospitals. We included 16 patients (43.7 % women); mean age at diagnosis: 42...
October 4, 2016: Endocrine
Nicolás Triantafilo, Victoria Castro-Gutiérrez, Gabriel Rada
Cabergoline and bromocriptine are among the most commonly used drugs to treat prolactinoma. Cabergoline is a long-acting dopamine receptor agonist which might offer advantages over bromocriptine. However, it is not clear if this translates into clinical benefits. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified two systematic reviews including 12 studies addressing the question of this article, including five randomized controlled trials. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach...
2016: Medwave
Lukas Andereggen, Janine Frey, Robert H Andres, Marwan El-Koussy, Jürgen Beck, Rolf W Seiler, Emanuel Christ
While dopamine-agonists are the first-line approach in treating prolactinomas, surgery can be considered in selected cases besides non-responders or patients with dopamine-agonist intolerance. The aim of the present study was to compare the long-term outcome in women with prolactinomas treated primarily either surgically or medically who had not had prior dopamine-agonist treatment. Retrospective case-note study of all consecutive women with prolactinomas primarily managed with medical therapy or surgery in a tertiary referral centre...
September 29, 2016: Endocrine
Diane Donegan, John L D Atkinson, Mark Jentoft, Neena Natt, Tod B Nippoldt, Bradley Erickson, Fredric Meyer, Dana Erickson
OBJECT: Prolactinomas are primarily treated with medical therapy. Given the efficacy of Dopamine agonists (DA), surgery has remained a second line treatment option. Despite medical therapy, some tumors display resistance and or patients maybe intolerant of DA requiring alternative treatment options. We examined the indications, efficacy and safety of pituitary surgery for the treatment of prolactinomas. METHODS: We performed a retrospective analysis of all patients who had surgery for a prolactinoma at our institution from January 1993 to October 2014...
September 28, 2016: Endocrine Practice
Hasan A Zaidi, David J Cote, Joseph P Castlen, William T Burke, Yong-Hui Liu, Timothy R Smith, Edward R Laws
BACKGROUND: Primary lactotroph disinhibition, or stalk effect, occurs when mechanical compression of the pituitary stalk disrupts the tonic inhibition by dopamine released by the hypothalamus. The resolution of pituitary stalk effect-related hyperprolactinemia post-operatively has not been studied in a large cohort of patients. We performed a retrospective review to investigate the time course of recovery of lactotroph disinhibition after transsphenoidal surgery. METHODS: Medical records were retrospectively reviewed for all patients undergoing transsphenoidal surgery with the senior author from April 2008 to November 2014...
September 23, 2016: World Neurosurgery
Stavroula Α Paschou, Andromachi Vryonidou, Dimitrios G Goulis
Pituitary incidentalomas are lesions which are detected incidentally in the pituitary gland during imaging procedures for unrelated causes, such as headache, trauma or symptoms involving the neck or central nervous system. The wide application of sensitive brain imaging techniques (CT, MRI) has led to an increasing recognition of such lesions. Although the etiology of pituitary incidentalomas covers a wide range of pathologies, most of them (∼90%) are benign adenomas; nonetheless, they may result in visual and/or neurologic abnormalities...
October 2016: Maturitas
Sunita M C De Sousa, Ian M Chapman, Henrik Falhammar, David J Torpy
Dopamine agonists are the first line of therapy for prolactinomas, with high rates of biochemical control and tumour shrinkage. Toxicity is considered to be low and manageable by switching of agents and dose reduction. Dopamine agonist-induced impulse control disorders are well described in the neurology setting, but further data are required regarding this toxicity in prolactinoma patients. We performed a multicenter retrospective cohort study of eight men with prolactinomas and associated central hypogonadism...
September 6, 2016: Endocrine
Alina Livshits, Jelena Kravarusic, Ellie Chuang, Mark E Molitch
PURPOSE: The objective of this case report is to demonstrate that the simple expedient of measuring periodic prolactin levels in patients with MEN1 who have modest hyperprolactinemia and normal pituitary MRI scans is insufficient to monitor for the development of pituitary adenomas. METHODS: Review of relevant literature and chart review. RESULTS: A 25 year old man with known MEN1 manifested by hyperparathyroidism and a gastrin-producing neuroendocrine tumor was found to have a prolactin [PRL] level of 20...
September 6, 2016: Pituitary
Mei-Ting Chen, Wei Lian, Bing Xing, Yong Yao, Ming Feng, Ren-Zhi Wang
Objective To analyze the predictive factor of surgical efficacy in male patients with prolactinoma. Method The clinical data of 184 male patients with prolactinoma who had undergone surgery were retrospectively analyzed.Results Before the surgery,the serum prolactin level from 150 to 204 952 ng/ml,the tumors sized 6 to 70 mm. Macroadenoma was seen in 152 cases (82.6%) and suprasellar adenoma with visual deficitsin 75 cases (40.7%). Complete resection was achieved in 149 patients. After surgical therapy,postoperative immediate prolactin level declined in 182 patients (98...
August 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
Alejandro Ibañez-Costa, Esther Rivero-Cortés, M Carmen Vázquez-Borrego, Manuel D Gahete, Luis Jimenez-Reina, Eva Venegas, Andrés de la Riva, Miguel Ángel Arráez, Inmaculada González-Molero, Herbert A Schmid, Silvia Maraver-Selfa, Inmaculada Gavilán-Villarejo, Juan A Garcia-Arnes, Miguel Ángel Japón, Alfonso Soto, Maria Angeles Galvez, Raul M Luque Huertas, Justo P Castaño
Somatostatin analogs (SSA) are the mainstay of pharmacological treatment for pituitary adenomas. However, some patients escape from therapy with octreotide, a somatostatin receptor 2 (sst2)-preferring SSA, and pasireotide, a novel multi-sst-preferring SSA, may help to overcome this problem. It has been proposed that correspondence between sst1-sst5 expression pattern and SSA binding profile could predict patient's response. To explore the cellular/molecular features associated to octreotide/pasireotide response, we performed a parallel comparison of their in vitro effects, evaluating sst1-5 expression, intracellular Ca2+ signaling ([Ca2+]i), hormone secretion and cell viability, in a series of 85 pituitary samples...
September 1, 2016: Journal of Endocrinology
Carmel Halevy, Benjamin C Whitelaw
Temozolomide (TMZ) has been shown as an effective treatment option in aggressive pituitary adenomas and carcinomas. This review analyses the published case series and demonstrates 42 % of patents show a radiological response and 27 % experience stable disease following TMZ. Prolactinomas and corticotroph tumours respond best to TMZ, showing approximately a 50 % response rate, with non-functioning tumours responding only half as frequently. Other factors that may predict the tumour's TMZ response include MGMT and MSH status, but neither is sufficiently robust to determine treatment decisions...
August 31, 2016: Pituitary
Ryo Okada, Tatsuo Shimura, Shigeyuki Tsukida, Jin Ando, Yasuhide Kofunato, Tomoyuki Momma, Rei Yashima, Yoshihisa Koyama, Shinichi Suzuki, Seiichi Takenoshita
BACKGROUND: Multiple endocrine neoplasia type 1 (MEN1) is an autosomal-dominant inherited disorder that is classically characterized by the presence of neoplastic lesions of the parathyroid glands, the anterior pituitary gland, and the pancreas. However, MEN1 with concomitant pheochromocytoma is extremely rare. CASE REPORT: We report a case of MEN1 concomitant with pheochromocytoma. A 44-year-old Japanese man, who had undergone total parathyroidectomy due to primary hyperparathyroidism at the age of 18, was referred to our hospital with a complaint of a large abdominal tumor...
December 2016: Surgical Case Reports
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