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Hai Yan Huang, Shao Jian Lin, Wei Guo Zhao, Zhe Bao Wu
The aim of this study is to compare the efficacy of bromocriptine (BRC) versus cabergoline (CAB) in patients with giant prolactinomas. We searched MEDLINE, EMBASE, CENTRAL and Clinical for studies dated before March 1st, 2016, that used BRC or CAB for the treatment of patients with giant prolactinomas. Specific eligibility criteria were set to identify articles and cases. The selected articles were reviewed, and the data were extracted for analysis. The compared outcomes included tumor shrinkage, tumor response, normalization of prolactin (PRL) level, and visual field defect (VFD) improvement...
March 15, 2018: Metabolic Brain Disease
Khaled Elshazly, Varun R Kshettry, Christopher J Farrell, Gurston Nyquist, Marc Rosen, James J Evans
BACKGROUND: Giant pituitary adenomas represent a surgical challenge. We present the results of the endoscopic endonasal approach (EEA) for giant pituitary adenomas. METHODS: We retrospectively reviewed medical records of 55 patients with giant pituitary adenomas (> 4 cm in maximum diameter) that underwent an EEA from 2008 - 2016. Factors affecting the extent of resection (EOR) were evaluated. RESULTS: Mean age was 55.5 years. All tumors were non-functional except in four patients (GH-secreting [2], ACTH-secreting [1], prolactinoma [1])...
March 12, 2018: World Neurosurgery
Adrian F Daly, Emily Castermans, Lindsey Oudijk, Mirtha A Guitelman, Pablo Beckers, Iulia Potorac, Sebastian J C M M Neggers, Nathalie Sacre, Aj Van der Lely, Vincent Bours, Wouter W de Herder, Albert Beckers
Copy number variations (CNV), an important genetic mechanism in inherited tumor genetics, can affect large genetic regions or can be limited to smaller regions within genes, such deletions of single exons. Such exon deletions can be challenging to identify and sequencing can be normal in these cases. Multiplex ligation dependent probe amplification (MLPA) can identify CNV of individual exons. Mutations in the MAX gene are associated with a risk of sporadic and hereditary pheochromocytoma. As mutations in other pheochromocytoma related genes can also cause pituitary tumors (3P-Association), we studied whether MAX exon deletions were involved in the etiology of patients with an unexplained association of multiple endocrine neoplasia including pituitary adenoma and pheochromocytoma...
March 13, 2018: Endocrine-related Cancer
Dimitrios Askitis, Damianos Tsitlakidis, Nicolle Müller, Albrecht Waschke, Gunter Wolf, Ulrich Alfons Müller, Christof Kloos
INTRODUCTION: We retrospectively evaluated all patients with pituitary tumours treated in our department from 1/1/1997 to 01/11/2014. PATIENTS AND METHODS: Two hundred and fifteen patients (124 females, 91 males, mean age 50.9 years) were treated because of pituitary tumours. All patients underwent basal hormonal analysis and when required dynamic testing in order to check for hormonal activity. Pituitary masses were divided into groups concerning their hormonal status and were further classified according to gender, age at diagnosis, tumour size, and the development of postoperative pituitary insufficiency when neurosurgical intervention was conducted...
March 12, 2018: Endocrine
Xiaohai Liu, Yang Liu, Jun Gao, Ming Feng, Xinjie Bao, Kan Deng, Yong Yao, Renzhi Wang
BACKGROUND: Prolactinomas are the most common functional pituitary adenomas, and dopamine agonists (DAs) are the primary therapy. However, some patients are resistant to DAs. Recently, metformin has been proposed as a cancer treatment. CASE DESCRIPTION: This study is a retrospective review of two cases, including one patient with prolactinoma who was resistant to bromocriptine, diagnosed with impaired glucose tolerance and administered metformin. Surprisingly, combining the patient's treatment with metformin decreased prolactin (PRL) levels to 12 ng/ml and had significantly decreased the size of the tumor after one year of combination therapy...
March 9, 2018: World Neurosurgery
Hesam Ghadirian, Mohamad Shirani, Shahab Ghazi-Mirsaeed, Saleh Mohebi, Maysam Alimohamadi
Pituitary apoplexy is a rare clinical presentation caused by infarction of the pituitary gland or adenoma with or without hemorrhage. Although pituitary apoplexy is usually spontaneous, one of the predisposing factors is treatment with dopamine agonists, especially bromocriptine. The occurrence of apoplexy during cabergoline therapy is reported much less frequently. In this article, we report a 34-year-old man with macroprolactinomas who developed sudden visual deterioration due to pituitary apoplexy 1 year after initiation of cabergoline therapy...
January 2018: Asian Journal of Neurosurgery
Martina Cappelletti, Andrea G Ruggeri, Giorgia Iacopino, Benedetta Fazzolari, Maria Fragale, Roberto Delfini
No abstract text is available yet for this article.
February 23, 2018: Journal of Neurosurgical Sciences
Valérie Bernard, Chiara Villa, Aurélie Auguste, Sophie Lamothe, Anne Guillou, Agnès Martin, Sandrine Caburet, Jacques Young, Reiner A Veitia, Nadine Binart
Lactotroph adenoma, also called prolactinoma, is the most common pituitary tumor but little is known about its pathogenesis. Mouse models of prolactinoma can be useful to better understand molecular mechanisms involved in abnormal lactotroph cell proliferation and secretion. We have previously developed a prolactin receptor deficient ( Prlr -/- ) mouse, which develops prolactinoma. The present study aims to explore the natural history of prolactinoma formation in Prlr -/- mice, using hormonal, radiological, histological and molecular analyses to uncover mechanisms involved in lactotroph adenoma development...
January 19, 2018: Oncotarget
Sema Ciftci Dogansen, Gulsah Yenidunya Yalin, Seher Tanrikulu, Sakin Tekin, Nihan Nizam, Bilge Bilgic, Serra Sencer, Sema Yarman
PURPOSE: To assess baseline T2-weighted signal intensity (T2-WSI) of functional pituitary adenomas (FPA), and to investigate the relationship of baseline T2-WSI with clinical features, histopathological granulation patterns, and response to treatment in patients with acromegaly, prolactinoma and Cushing's disease (CD). METHODS: Somatotroph adenomas (n = 87), prolactinomas (n = 78) and corticotroph adenomas (n = 29) were included in the study. Baseline T2-WSI findings (grouped as hypo-, iso- and hyperintense) were compared with hormone levels, tumor diameter, granulation patterns and response to treatment...
February 19, 2018: Pituitary
Thomas Breil, Catherine Lorz, Daniela Choukair, Janna Mittnacht, Ioana Inta, Daniela Klose, Jessica Jesser, Egbert Schulze, Markus Bettendorf
BACKGROUND: Paediatric prolactinomas are rare. The aim of this study was to investigate the clinical features and outcome of paediatric patients with prolactinomas. METHODS: In this single-centre retrospective analysis, clinical, biochemical, and radiological features of all paediatric patients with pituitary adenomas diagnosed between 2000 and 2016 were evaluated. RESULTS: Among 21 patients with pituitary adenomas, 12 patients with prolactinomas (median age 14...
February 16, 2018: Hormone Research in Pædiatrics
Mary In-Ping Huang Cobb, Rachael Mintz-Cole, Aatif M Husain, Miles Berger, David Jang, Patrick Codd
BACKGROUND: Prolactinomas are typically treated non-surgically with a dopamine agonist. However, once the tumor shrinks, adjacent eloquent structures such as the optic apparatus can become skeletonized and herniate into the dilated parasellar space. CASE DESCRIPTION: We describe here a 48-year-old man with a prolactin-secreting macroadenoma treated with cabergoline who presented with progressive bitemporal hemianopsia. MRI showed no recurrence of disease and a stretched optic chiasm herniating into an empty sella...
February 5, 2018: World Neurosurgery
Avital Perry, Christopher Salvatore Graffeo, Christopher Marcellino, Bruce E Pollock, Nicholas M Wetjen, Fredric B Meyer
Background  Pediatric pituitary adenoma is a rare skull base neoplasm, accounting for 3% of all intracranial neoplasms in children and 5% of pituitary adenomas. Compared with pituitary tumors in adults, secreting tumors predominate and longer disease trajectories are expected due to the patient age resulting in a natural history and treatment paradigm that is complex and controversial. Objectives  The aims of this study were to describe a large, single-institution series of pediatric pituitary adenomas with extensive long-term follow-up and to conduct a systematic review examining outcomes after pituitary adenoma surgery in the pediatric population...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
Yinxing Huang, Chenyu Ding, Fangfang Zhang, Deyong Xiao, Lin Zhao, Shousen Wang
The present study aimed to investigate the function of the prolactin/adenoma maximum diameter (PRL/MD) and the prolactin/adenoma volume (PRL/V) in the differential diagnosis of prolactinomas and other types of pituitary adenomas. A total of 118 patients with pituitary adenoma, hyperprolactinemia and a plasma PRL <250 µg/l were enrolled. Clinical data from these patients were retrospectively analyzed. A receiver operating characteristic curve was plotted. The function of PRL, PRL/MD and PRL/V in the differential diagnosis of prolactinomas and other types of pituitary adenomas was compared...
February 2018: Oncology Letters
Yuanyi Wei, Xia Zhou, Liying Ren, Chunxia Wang, Yuhao Li
Prolactinomas are the most prevalent functional pituitary adenomas that cause chronic pathological hyperprolactinemia. Prolactin is known to promote cell growth and inhibit apoptosis in cells. Paeoniflorin is the principal component of radix Paeoniae alba (the main ingredient in some traditional herbal formulas clinically used for hyperprolactinemia-associated disorders). Recent findings from intensive studies have suggested that paeoniflorin regulates cell proliferation and apoptosis in many cell lines. However, the effects of paeoniflorin in pituitary tumor cells remain unknown...
February 1, 2018: Journal of Cellular Biochemistry
Cheng Chen, Senlin Yin, Shizhen Zhang, Mengmeng Wang, Yu Hu, Peizhi Zhou, Shu Jiang
RATIONALE: Aggressive pituitary adenomas and pituitary carcinomas are rare and demand multiple treatment strategies. Temozolomide, an orally active alkylating chemotherapeutic agent, has recently been recommended as a salvage medication for refractory pituitary adenomas or carcinomas. PATIENT CONCERNS: A 17-year-old male presenting with aggressive prolactinoma that continued to progress despite surgery, gamma knife, and dopamine agonists. DIAGNOSES: The diagnosis of refractory aggressive prolactinoma was made on the basis of clinical findings and the lack of efficacy of conventional treatment...
November 2017: Medicine (Baltimore)
Anastasia P Athanasoulia-Kaspar, Kathrin H Popp, Gunter K Stalla
The dopaminergic treatment represents the primary treatment in prolactinomas which are the most common pituitary adenomas and account for about 40% of all pituitary tumours with an annual incidence of six to ten cases per million population. The dopaminergic treatment includes ergot and non ergot derivatives with high affinity for the dopamine receptors D1 or/and D2. Through the activation of the dopaminergic pathway on pituitary lactotrophs, the dopamine agonists inhibit the prolactin synthesis and secretion, therefore normalizing the prolactin levels and restoring eugonadism, but also lead to tumour shrinkage...
January 29, 2018: Endocrine Connections
Oluwaseun O Akinduro
INTRODUCTION: Prolactinomas may rarely present with meningitis and cerebrospinal fluid (CSF) rhinorrhea secondary to erosion of the wall of the sella turcica. It is even more un-common for this abnormal communication to be caused by an ectopic prolactinoma arising from the sphenoid sinus and eroding into the sella. This atypical growth pattern makes diagnosis very difficult, as there may be no displacement of the normal pituitary gland. The authors present the first reported case of a patient with an ectopic prolactinoma presenting primarily with meningitis, and discuss the management strategy as well as surgical and non-surgical treatment options for these patients...
January 26, 2018: World Neurosurgery
Lina Ma, Frederick A Jakobiec, Natalie Wolkow, Thaddeus P Dryja, Gary E Borodic
A 53-year-old man presented with smooth-domed, variegated cysts (polycystic disease) of all 4 eyelids, worse on the left side. Some of the cysts were clear, while others were creamy-white colored. In addition, multiple, very fine vesicopapules were noted along the eyelid margins. Histopathologic examination revealed a trichilemmal cyst, several pure apocrine hidrocystomas displaying multiple chambers, a hybrid cyst, and many small eccrine cysts of the deep dermis. The apocrine lesions, including the small ones at the eyelid margins, predominated...
January 18, 2018: Ophthalmic Plastic and Reconstructive Surgery
Depicha Jindatip, Ken Fujiwara, Tewarit Sarachana, Apiwat Mutirangura, Takashi Yashiro
Prolactinomas are the most common tumor of the human pituitary. They result in excessive prolactin secretion and important changes in the vasculature. Pericytes are perivascular cells associated with capillaries and have crucial roles in physiological and pathological neovascularization. We previously reported that pericytes produce type I and III collagens in the anterior pituitary of adult rats. In addition, pituitary pericytes contained well-developed cell organelles and actively synthesized collagens during early postnatal development...
January 17, 2018: Medical Molecular Morphology
Xing Su, Zhi Qiang Wu, Xiao Jiang Yang, An Ping Wang, Kun Zhao, Tao Guang Wu, Yi Sun, Jie Sun, Zheng Yao Chang, Xiao Yong Guo, Qing Hua Guo, Yi Ming Mu
Prolactinoma is an estrogen-related tumor and leukemia-related protein 16 (LRP16) is correlated with the progression of estrogen-related tumors, but the regulatory mechanism between LRP16 and prolactinoma remain unclear. This study demonstrates a variation in LRP16 with estrogen receptor α (ERα) in prolactinoma models and the up and downregulation effects of LRP16 on prolactin secretion of pituitary adenomas cells (GH3 cells). In our study, 50 male SD rats (30-day-old) were randomly divided into five groups of 10 rats each...
December 2017: Biomedical and Environmental Sciences: BES
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