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https://www.readbyqxmd.com/read/28913674/prognostic-significance-of-corticotroph-staining-in-radiosurgery-for-non-functioning-pituitary-adenomas-a-multicenter-study
#1
Or Cohen-Inbar, Zhiyuan Xu, Cheng-Chia Lee, Chin-Chun Wu, Tomáš Chytka, Danilo Silva, Mayur Sharma, Hesham Radwan, Inga S Grills, Brandon Nguyen, Zaid Siddiqui, David Mathieu, Christian Iorio-Morin, Amparo Wolf, Christopher P Cifarelli, Daniel T Cifarelli, L Dade Lunsford, Douglas Kondziolka, Jason P Sheehan
Silent corticotroph staining pituitary adenoma (SCA) represents an uncommon subset of Non-Functioning adenomas (NFAs), hypothesized to be more locally aggressive. In this retrospective multicenter study, we investigate the safety and effectiveness of Stereotactic Radiosurgery (SRS) in patients with SCA compared with other non-SCA NFA's. Eight centers participating in the International Gamma-Knife Research Foundation (IGKRF) contributed to this study. Outcomes of 50 patients with confirmed SCAs and 307 patients with confirmed non-SCA NFA's treated with SRS were evaluated...
September 14, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28912338/duration-of-post-operative-hypocortisolism-predicts-sustained-remission-after-pituitary-surgery-for-cushing-s-disease
#2
Prachi Ashok Kumar Bansal, Anurag Ranjan Lila, Manjunath Goroshi, Swati Jadhav, Nilesh Keshavrao Lomte, Kunal Thakkar, Atul Goel, Abhidha Shah, Shilpa S Sankhe, Naina Goel, Neelam Jaguste, Tushar Ramkrishna Bandgar, Nalini Shah
PURPOSE: Transsphenoidal surgery(TSS) is the primary treatment modality for Cushing's disease(CD). However, the predictors of post-operative remission and recurrence remain debatable. Thus, we studied the post-operative remission and long term recurrence rates, as well as their respective predictive factors. METHODS: Retrospective analysis of case records of 230 CDpatients who underwent primary microscopic TSS at our tertiary care referral center between 1987-2015was undertaken...
September 14, 2017: Endocrine Connections
https://www.readbyqxmd.com/read/28910955/-the-localization-diagnosis-of-patients-with-adrenocorticotropic-hormone-dependent-cushing-s-syndrome-in-adolescence
#3
S Chen, Z X Pan, L Lu, A L Tong, H Pan, H J Zhu, Y Yao, M Feng, R Z Wang, Z L Lu
Objective: To elucidate the clinical characteristics and localization diagnosis of patients with adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome (CS) in adolescence. Methods: The clinical data, laboratory examination and localization diagnosis from 35 patients aged less than 18 years old with adolescent CS who were treated at Peking Union Medical College Hospital between January 1990 and March 2012 were analyzed. Results: There were 29 cases of Cushing's disease (CD) and 6 cases of ectopic ACTH syndrome (EAS)...
September 12, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28887280/transsphenoidal-surgery-for-mixed-pituitary-gangliocytoma-adenomas
#4
Matthew J Shepard, Mohamed A Elzoghby, Daffer Ghanim, M Beatriz S Lopes, John A Jane
OBJECTIVE: Most sellar gangliocytomas are discovered with a concurrent pituitary adenoma, also known as a mixed gangliocytoma-adenoma (MGA). MGAs are rare with less than 100 cases reported in the literature and only one previously documented surgical series. As MGAs are radiologically indistinguishable from pituitary adenomas, their diagnosis is often made following surgery. This, combined with the paucity of clinical outcome data for these tumors, makes their diagnosis and management challenging...
September 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28816283/-surgery-treatment-of-ectopic-adrenocorticotrophic-hormone-syndrome
#5
H Fan, H Z Li, W F Xu, Z G Ji, Y S Zhang
OBJECTIVE: To investigation the diagnosis and treatment of ectopic adrenocorticotrophic hormone (ACTH) syndrome. METHODS: The clinical characters of 57 cases of ecotopic ACTH syndrome from Jan. 1996 to Dec. 2016 were collected and analyzed. The 57 cases included 32 males and 25 females. The age ranged from 11 to 68 years (average 32 years). ACTH levels significantly increased from 16.5 to 365.6 pmol/L, with average 77.6 pmol/L (normal range <10.1 pmol/L). The pituitary MRI did not found lesions...
August 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28814582/adrenal-myelolipoma-s-as-presenting-manifestation-of-subclinical-cushing-s-disease-eutopic-acth-dependent-cushing-s-syndrome
#6
Partha Pratim Chakraborty, Shinjan Patra, Sugata Narayan Biswas, Rana Bhattacharjee
Primary adrenal myelolipomas, relatively rare benign tumours of the adrenal cortex are typically unilateral, hormonally inactive and asymptomatic, hence often diagnosed as 'adrenal incidentaloma'. Bilateral adrenal myelolipomas, in particular, may be associated with underlying endocrinopathies associated with elevated circulating adrenocorticotropic hormone (ACTH) concentration. Subclinical cortisol hypersecretion, irrespective of its ACTH dependency, does not manifest typical clinical phenotype of hypercortisolemia, and thus termed subclinical Cushing's syndrome...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28730425/at-101-acts-as-anti-proliferative-and-hormone-suppressive-agent-in-mouse-pituitary-corticotroph-tumor-cells
#7
B S Yurekli, B Karaca, A Kisim, E Bozkurt, H Atmaca, S Cetinkalp, G Ozgen, C Yilmaz, S Uzunoglu, R Uslu, F Saygili
PURPOSE: Gossypol, a naturally occurring compound in cottonseeds, has anticancer effects against several tumor cell lines. It has been extensively studied in clinical trials and is well tolerated with a favorable safety profile. AT-101, a derivative of R (-)-gossypol, binds to Bcl-2 family proteins and induces apoptosis in vitro. Although transsphenoidal surgical excision of the pituitary corticotroph adenoma is the gold standard of care, it is not successful all the time. Medical therapy for Cushing's disease still remains a challenge for the clinicians...
July 20, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28689311/frequency-of-familial-pituitary-adenoma-syndromes-among-patients-with-functioning-pituitary-adenomas-in-a-reference-outpatient-clinic
#8
N V Marques, L Kasuki, M C Coelho, C H A Lima, L E Wildemberg, M R Gadelha
INTRODUCTION: Pituitary adenomas (PA) occur mainly as sporadic disease, but familial syndromes are found in approximately 5% of cases. Identification of these syndromes is important in order to diagnose individuals at risk at an earlier stage. AIMS: To evaluate the frequency of familial PA in a reference outpatient clinic devoted to PA treatment and to identify family members suspected to have pituitary disease. METHODS: Patients with PA were interviewed with respect to the presence of family members with diagnosis of PA or with signs or symptoms suggestive of them...
July 8, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28642375/acquired-resistance-to-corticotropin-therapy-in-nephrotic-syndrome-role-of-de-novo-neutralizing-antibody
#9
Pei Wang, Yan Zhang, Yu Wang, Andrew S Brem, Zhangsuo Liu, Rujun Gong
There is increasing evidence supporting the use of corticotropin as an alternative treatment of refractory proteinuric glomerulopathies. The efficacy of short-acting corticotropin, however, remains unknown and was tested here in an adolescent with steroid-dependent nephrotic syndrome caused by minimal change disease. After developing Cushing syndrome and recently being afflicted with severe cellulitis, the patient was weaned off all immunosuppressants, including corticosteroids. This resulted in a relapse of generalized anasarca, associated with massive proteinuria and hypoalbuminemia...
July 2017: Pediatrics
https://www.readbyqxmd.com/read/28614036/an-individualized-approach-to-the-evaluation-of-cushing-syndrome
#10
REVIEW
Susmeeta T Sharma
Cushing syndrome (CS) is caused by chronic exposure to excess glucocorticoids. Early recognition and treatment of hypercortisolemia can lead to decreased morbidity and mortality. The diagnosis of CS and thereafter, establishing the cause can often be difficult, especially in patients with mild and cyclic hypercortisolism. Surgical excision of the cause of excess glucocorticoids is the optimal treatment for CS. Medical therapy (steroidogenesis inhibitors, medications that decrease adrenocorticotropic hormone [ACTH] levels or glucocorticoid antagonists) and pituitary radiotherapy may be needed as adjunctive treatment modalities in patients with residual, recurrent or metastatic disease, in preparation for surgery, or when surgery is contraindicated...
June 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28614003/biochemical-control-during-long-term-follow-up-of-230-adult-patients-with-cushing-disease-a-multicenter-retrospective-study
#11
Eliza B Geer, Ismat Shafiq, Murray B Gordon, Vivien Bonert, Alejandro Ayala, Ronald S Swerdloff, Laurence Katznelson, Yelena Lalazar, Ekaterina Manuylova, Karen J Pulaski-Liebert, John D Carmichael, Zeina Hannoush, Vijaya Surampudi, Michael S Broder, Dasha Cherepanov, Marianne Eagan, Jackie Lee, Qayyim Said, Maureen P Neary, Beverly M K Biller
OBJECTIVE: Cushing disease (CD) results from excessive exposure to glucocorticoids caused by an adrenocorticotropic hormone-secreting pituitary tumor. Inadequately treated CD is associated with significant morbidity and elevated mortality. Multicenter data on CD patients treated in routine clinical practice are needed to assess treatment outcomes in this rare disorder. The study purpose was to describe the burden of illness and treatment outcomes for CD patients. METHODS: Eight pituitary centers in four U...
August 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28597198/long-term-treatment-of-cushing-s-disease-with-pasireotide-5-year-results-from-an-open-label-extension-study-of-a-phase-iii-trial
#12
S Petersenn, L R Salgado, J Schopohl, L Portocarrero-Ortiz, G Arnaldi, A Lacroix, C Scaroni, S Ravichandran, A Kandra, B M K Biller
BACKGROUND: Treating hypercortisolism in patients with Cushing's disease after failed surgery often requires chronic medication, underlining the need for therapies with favourable long-term efficacy and safety profiles. METHODS: In a randomised, double-blind study, 162 adult patients with persistent/recurrent or de novo Cushing's disease received pasireotide. Patients with mean urinary free cortisol at/below the upper limit of normal or clinical benefit at month 12 could continue receiving pasireotide during an open-ended, open-label phase, the outcomes of which are described herein...
July 2017: Endocrine
https://www.readbyqxmd.com/read/28532906/first-report-of-coexistence-of-two-ectopic-pituitary-tumors-rathke-cleft-cyst-and-silent-adrenocorticotropic-hormone-adenoma
#13
Mirza Pojskić, Blazej Zbytek, Neal S Beckford, Frederick A Boop, Kenan I Arnautović
BACKGROUND: Rathke cleft cysts (RCCs) and pituitary adenomas (PAs) are thought to have a common embryonic ancestry; however, PAs with a concomitant RCC inside the sella turcica are rarely observed. Ectopic pituitary tumors are also rare. CASE DESCRIPTION: We present the case of a 65-year-old woman with an ectopic RCC in the sphenoid sinus and outside the sella turcica concomitant with an adrenocorticotropic hormone (ACTH)-staining, clinically silent PA. The patient had headache but no endocrine or visual disturbances...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28487882/identification-of-a-novel-rasd1-somatic-mutation-in-a-usp8-mutated-corticotroph-adenoma
#14
Andrew V Uzilov, Khadeen C Cheesman, Marc Y Fink, Leah C Newman, Chetanya Pandya, Yelena Lalazar, Marco Hefti, Mary Fowkes, Gintaras Deikus, Chun Yee Lau, Aye S Moe, Yayoi Kinoshita, Yumi Kasai, Micol Zweig, Arpeta Gupta, Daniela Starcevic, Milind Mahajan, Eric E Schadt, Kalmon D Post, Michael J Donovan, Robert Sebra, Rong Chen, Eliza B Geer
Cushing's disease (CD) is caused by pituitary corticotroph adenomas that secrete excess adrenocorticotropic hormone (ACTH). In these tumors, somatic mutations in the gene USP8 have been identified as recurrent and pathogenic and are the sole known molecular driver for CD. Although other somatic mutations were reported in these studies, their contribution to the pathogenesis of CD remains unexplored. No molecular drivers have been established for a large proportion of CD cases and tumor heterogeneity has not yet been investigated using genomics methods...
May 2017: Cold Spring Harbor Molecular Case Studies
https://www.readbyqxmd.com/read/28450229/endoscopic-endonasal-surgery-for-tumors-of-the-cavernous-sinus-a-series-of-234-patients
#15
Maria Koutourousiou, Francisco Vaz Guimaraes Filho, Juan C Fernandez-Miranda, Eric W Wang, Susan Tonya Stefko, Carl H Snyderman, Paul A Gardner
BACKGROUND: Cavernous sinus (CS) tumors often are considered inoperable. We present our experience with endoscopic endonasal surgery (EES) and compare the outcomes for different tumor. METHODS: EES (medial or lateral approach) was used in 234 patients with CS tumors. The cohort included 175 (75%) pituitary adenomas and 59 (25%) nonadenomatous lesions. RESULTS: Presenting symptoms were significantly different between the 2 groups, with cranial neuropathies occurring mainly in nonadenomas (P < 0...
July 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28422946/pediatric-cushing-disease-disparities-in-disease-severity-and-outcomes-in-the-hispanic-and-african-american-populations
#16
Alexandra Gkourogianni, Ninet Sinaii, Sharon H Jackson, Alexander S Karageorgiadis, Charalampos Lyssikatos, Elena Belyavskaya, Margaret F Keil, Mihail Zilbermint, Prashant Chittiboina, Constantine A Stratakis, Maya B Lodish
BackgroundLittle is known about the contribution of racial and socioeconomic disparities to severity and outcomes in children with Cushing disease (CD).MethodsA total of 129 children with CD, 45 Hispanic/Latino or African-American (HI/AA) and 84 non-Hispanic White (non-HW), were included in this study. A 10-point index for rating severity (CD severity) incorporated the degree of hypercortisolemia, glucose tolerance, hypertension, anthropomorphic measurements, disease duration, and tumor characteristics. Race, ethnicity, age, gender, local obesity prevalence, estimated median income, and access to care were assessed in regression analyses of CD severity...
August 2017: Pediatric Research
https://www.readbyqxmd.com/read/28420444/case-report-acth-secreting-pituitary-carcinoma-metastatic-to-the-liver-in-a-patient-with-a-history-of-atypical-pituitary-adenoma-and-cushing-s-disease
#17
Amy S Joehlin-Price, Douglas A Hardesty, Christina A Arnold, Lawrence S Kirschner, Daniel M Prevedello, Norman L Lehman
BACKGROUND: Pituitary carcinoma is a rare entity requiring the presence of metastasis to confirm its malignant potential. We report a case of pituitary carcinoma and discuss the diagnosis and management of this lesion in relation to the existing literature. CASE PRESENTATION: The patient is a 51-year-old woman with Cushing's disease and intact adrenal glands who was diagnosed with metastatic pituitary carcinoma to the liver, 29 months after initial resection of an ACTH-secreting primary atypical pituitary adenoma (APA)...
April 18, 2017: Diagnostic Pathology
https://www.readbyqxmd.com/read/28380523/genomewide-association-study-reveals-a-risk-locus-for-equine-metabolic-syndrome-in-the-arabian-horse
#18
S L Lewis, H M Holl, C Streeter, C Posbergh, B J Schanbacher, N J Place, M F Mallicote, M T Long, S A Brooks
Equine obesity can cause life-threatening secondary chronic conditions, similar to those in humans and other animal species. Equine metabolic syndrome (EMS), primarily characterized by hyperinsulinemia, is often present in obese horses and ponies. Due to clinical similarities to conditions such as pituitary pars intermedia dysfunction (formerly equine Cushing's disease), conclusive diagnosis of EMS often proves challenging. Aside from changes in diet and exercise, few targeted treatments are available for EMS, emphasizing the need for early identification of at-risk individuals to enable implementation of preventative measures...
March 2017: Journal of Animal Science
https://www.readbyqxmd.com/read/28364356/diabetes-in-cushing-disease
#19
REVIEW
G Mazziotti, A M Formenti, S Frara, F Maffezzoni, M Doga, A Giustina
PURPOSE OF REVIEW: This review focuses on the pathophysiological and clinical aspects of diabetes mellitus occurring in patients with Cushing disease (CD). RECENT FINDINGS: Insulin resistance and impairment in insulin secretion are both involved in the pathogenesis of glucocorticoid-induced diabetes. Correction of glucocorticoid excess does not always resolve abnormalities of glucose homeostasis, and correction of hyperglycaemia is specifically required. In fact, insulin resistance may persist even after correction of glucocorticoid excess and diabetes needs to be treated for long term...
May 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28355719/-a-clinical-analysis-of-123-cases-of-primary-empty-sella
#20
J Li, H W Jia, C L Wang, R Zhang, M Y Qu, W Li, M H Yuan, J Cui, Q He, H Y Wei, T H Zhu, Z S Ma, W Liu, Z L Dong, Z G Gao
Objective: This study was conducted to analyze the clinical characteristics and pituitary function of patients with primary empty sella (PES). Methods: The clinical data from 123 hospitalized adult patients with PES from January 2010 to May 2016 were retrospectively studied. Results: (1) The average age of the 123 (male 43, female 80) PES patients was (59.2±13.6) years (ranging 24-92 years), among whom 61% patients were in the age group between 50-69 years. (2) The symptoms of the patients included fatigue (56...
April 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
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