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Pituitary tumour

Daniel S Olsson, Penelope Trimpou, Tobias Hallén, Ing-Liss Bryngelsson, Eva Andersson, Thomas Skoglund, Bengt-Åke Bengtsson, Gudmundur Johannsson, Anna G Nilsson
Hypopituitarism has been associated with an increased mortality, which may be due to untreated growth hormone (GH) deficiency but also to the various underlying disorders. We therefore analysed mortality in patients with only one underlying disorder, non-functioning pituitary adenoma (NFPA), with and without GH replacement therapy (GHRT). Patients with NFPA in the western region of Sweden, 1997-2011, were identified through the National Patient Registry and cross-referenced with several National Health Registries...
October 21, 2016: European Journal of Endocrinology
Kevin Phan, Joshua Xu, Rajesh Reddy, Piyush Kalakoti, Anil Nanda, Jacob Fairhall
BACKGROUND: The pituitary adenoma causing acromegaly is typically resected through a transsphenoidal approach and visualised with an operating microscope or endoscope. We undertook a systematic review and meta-analysis examining the clinical efficacy of endoscopic and microsurgical approaches. METHODS: Relevant studies using either endoscopic or microscopic transphenoid approaches for growth-hormone pituitary adenomas were identified up to Feb 2016. Data were extracted and analyzed according to predefined clinical endpoints...
October 15, 2016: World Neurosurgery
Christian Hagel, Rolf Buslei, Michael Buchfelder, Rudolf Fahlbusch, Markus Bergmann, Armin Giese, Jörg Flitsch, Dieter K Lüdecke, Markus Glatzel, Wolfgang Saeger
PURPOSE: To analyse the antigen expression profiles of 27 cases of pituicytoma, spindle cell oncocytoma, and granular cell tumour of the sellar region concerning a common pituicytic origin of neoplastic cells. METHODS: Material from 12 female and 15 male patients (13 granular cell tumours of the sellar region, 10 pituicytomas, four spindle cell oncocytomas) collected in the German Registry of Pituitary Tumours between 1993 and 2015 was re-evaluated according to the current WHO classification of tumours of the central nervous system and supplementary immunohistochemistry including S100-protein, CD56, CD68, thyroid transcription factor-1 (TTF-1), and Ki-67 was performed...
October 15, 2016: Pituitary
Giorgio Spatola, Laura Frosio, Marco Losa, Antonella Del Vecchio, Martina Piloni, Pietro Mortini
BACKGROUND: Gamma knife radiosurgery is an effective and safe treatment modality in the management of pituitary adenomas. Internal carotid occlusion is a rare but possible complication of Gamma Knife Radiosurgery for lesions within the cavernous sinus. AIM: To stress the importance of considering the Internal carotid artery as an organ at risk in cavernous sinus invading adenomas and reduce the dose delivered to this structure whenever possible. CASE DESCRIPTION: We report two cases of asymptomatic occlusion of the intracavernous segment of the internal carotid artery seven years after treatment in acromegalic patients...
November 2016: Reports of Practical Oncology and Radiotherapy
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
Kjell E Oberg, Steven Wj Lamberts
Acromegaly is a hormonal disorder that arises when the pituitary gland secretes excess growth hormone (GH), which in turn stimulates a concomitant increase in serum insulin-like growth factor 1 (IGF-1) levels. Gastroenteropancreatic neuroendocrine tumours (GEP-NET) constitute a heterogeneous group of tumours that can secrete serotonin and a variety of peptide hormones that may cause characteristic symptoms known as carcinoid syndrome, or other symptoms and hormonal hypersecretion syndromes depending on the tumour's site of origin...
October 3, 2016: Endocrine-related Cancer
Caroline Wilson, Hannah Brown, Ingunn Holen
Multiple factors influence the survival of disseminated breast tumour cells (DTCs) in bone. Whilst gene signature studies have identified genes that predict a propensity of tumours to metastasise to bone, the bone environment is key in determining the fate of these tumour cells. Breast cancer cells locate to specific niches within the bone that support their survival, regulated by host factors within the bone microenvironment including bone cells, cells of the bone micro vasculature, immune cells and the extracellular matrix...
September 29, 2016: Endocrine-related Cancer
M P Powell, G J Narimova, Z Ju Halimova
Transsphenoidal surgery (TSS) was introduced into the Republic of Uzbeksistan in 2005, and has been developed there since. The principal center for the management of all pituitary disease is in a single site for a nation of approxiamately 30 million population. Results in the surgery of Cushing's disease (CD) are a marker of surgical technical skill in TSS. All previously published series come from the developed world where sophisticated investigations and management are available. Many of these investigations are not available in Uzbekistan...
September 23, 2016: World Neurosurgery
Vincent Chen Ye, Ryojo Akagami
BACKGROUND: Our study evaluated the perioperative quality of life (QoL) in Cushing's disease (CD) patients, along with correlations between patient variables and cure rate. METHODS: The 36-item Short-Form Health Survey (SF)-36 questionnaire was used to assess perioperative QoL. Patients completed one survey preoperatively and two surveys postoperatively. Retrospective chart review was conducted to collect SF-36 data as well as examine variables including: age, hospital stay, size of tumour, pathological diagnosis, timing of cure, and complication rates...
September 20, 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Janez Ravnik, Tomaz Smigoc, Gorazd Bunc, Bostjan Lanisnik, Ursa Ksela, Maja Ravnik, Tomaz Velnar
Metastatic tumours to the pituitary gland are rare. The most frequent are metastases from breast and lung. We describe three patients with metastatic tumours: (I) a 54-year-old patient with metastatic renal clear-cell carcinoma and consequent disturbances in visual acuity, cranial nerve paresis and panhypopituitarism, (II) a 60-year-old patient with a diffuse large B-cell lymphoma with panhypopituitarism and diabetes insipidus and (III) a 57-year-old patient with metastasis of breast cancer and panhypopituitarism, visual impairment and cranial nerve paresis...
September 4, 2016: Neurologia i Neurochirurgia Polska
Elzbieta Skowronska-Jozwiak, Stanislaw Sporny, Joanna Szymanska-Duda, Dominika Baranowska, Andrzej Lewinski
Langerhans cell histiocytosis (LCH) in adults is a rare disorder of unknown etiology characterized by monoclonal proliferation of Langerhans cells. It belongs to dendritic cell disorders and occurs in 1-2 adults per million. The most common endocrine manifestation of classical LCH is associated with the posterior pituitary, with clinical symptoms of diabetes insipidus. Less than 80 reported cases of LCH involving the thyroid gland have been published so far. We present the case of a 39 years old woman with 10 years history of diabetes insipidus and secondary amenorrhoea, which appeared after second delivery...
July 12, 2016: Neuro Endocrinology Letters
Sharifah Faradila Wan Muhamad Hatta, M Farhan Hamdan, Siti Aishah Md Ali, Rohana Abdul Ghani
Idiopathic granulomatous hypophysitis (GH) is an uncommon inflammatory disease of the pituitary with impairment of pituitary gland function due to infiltration by lymphocytes, plasma cells and macrophages. We report the case of a 39-year-old woman who presented with worsening of headaches for 1 month and blurring of vision over 5 days. An MRI revealed a homogeneous supra-sellar mass evoking a pituitary tumour with bulky pituitary stalk extending into the left and right cavernous sinuses. Hormonal investigations showed anterior pituitary hormone deficiencies; meanwhile histopathological examination revealed an aspect of hypophysitis...
2016: BMJ Case Reports
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
Samuel J C Fishpool, Anthony Amato-Watkins, Caroline Hayhurst
The objective is to assess whether free middle turbinate (FMT) graft reconstruction, after endoscopic endonasal pituitary surgery, combines an acceptably low post-operative cerebrospinal fluid (CSF) leak rate with acceptable rhinological morbidity. This study identified 50 patients who underwent endoscopic endonasal pituitary surgery by the senior author in our teaching hospital between May 2011 and June 2012. FMT graft reconstruction was used in 32 cases. 18 patients were judged pre-operatively as not suitable for FMT reconstruction according to a novel skull base reconstructive algorithm...
September 1, 2016: European Archives of Oto-rhino-laryngology
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
Olympia Koulouri, Narayanan Kandasamy, Andrew C Hoole, Daniel Gillett, Sarah Heard, Andrew S Powlson, Dominic G O'Donovan, Anand K Annamalai, Helen L Simpson, Scott A Akker, Simon J B Aylwin, Antonia Brooke, Harit Buch, Miles J Levy, Niamh Martin, Damian Morris, Craig Parkinson, James R Tysome, Tom Santarius, Neil Donnelly, John Buscombe, Istvan Boros, Rob Smith, Franklin Aigbirhio, Nagui M Antoun, Neil G Burnet, Heok Cheow, Richard J Mannion, John D Pickard, Mark Gurnell
OBJECTIVE: To determine if functional imaging using (11)C-methionine positron emission tomography co-registered with 3D gradient echo MRI (Met-PET/MRI), can identify sites of residual active tumour in treated acromegaly, and discriminate these from post-treatment change, to allow further targeted treatment. DESIGN/METHODS: Twenty-six patients with persistent acromegaly after previous treatment, in whom MRI appearances were considered indeterminate, were referred to our centre for further evaluation over a 4...
November 2016: European Journal of Endocrinology
Kjersti Ringvoll Normann, Kristin Astrid Berland Øystese, Jens Petter Berg, Tove Lekva, Jon Berg-Johnsen, Jens Bollerslev, Nicoleta Cristina Olarescu
BACKGROUND: Real-time reverse transcription quantitative PCR (RT-qPCR) has become the method of choice for quantification of gene expression changes. The most important limitations of RT-qPCR are inappropriate data normalization and inconsistent data analyses. Pituitary adenomas are common tumours, and the appropriate interpretation of increasingly published data within this field is prevented by the lack of a proper selection and validation of stably expressed reference genes. AIM: To find and validate the optimal reference gene or gene combination for reliable RT-qPCR gene expression in both non-functioning (NFPA) and hormone secreting (GH and ACTH) pituitary adenomas...
December 5, 2016: Molecular and Cellular Endocrinology
Thinesh Kumran, Saffari Haspani, Jafri Malin Abdullah, Azmi Alias, Fan Rui Ven
BACKGROUND: To investigate factors influencing disconnection hyperprolactinemia, including tumour volume, degree of pituitary stalk displacement and extent of tumour growth based on a modified Wilson-Hardy classification in a non-functioning pituitary macroadenoma and to confirm reductions in serum prolactin levels after endoscopic transphenoidal surgery. METHODS: This prospective, descriptive study was conducted in the Department of Neurosurgery, General Hospital Kuala Lumpur from Jan 1, 2011 to Jan 1, 2013...
January 2016: Malaysian Journal of Medical Sciences: MJMS
Jitin Bajaj, Radhe Shyam Mittal, Achal Sharma
BACKGROUND: Pituitary masses are common lesions accounting for about 15-20% of all brain tumours. Oozing blood is an annoyance in microscopic sublabial trans-sphenoidal approach for these masses. There have been many ways of reducing the ooze, having their own pros and cons. OBJECTIVE: To find out the efficacy and safety of clonidine in reducing blood loss in pituitary adenoma surgery through a randomized masked trial. METHODS: It was a prospective randomized controlled trial done...
August 18, 2016: British Journal of Neurosurgery
N Phillips, P Nix
BACKGROUND: Endoscopic endonasal surgery to access the anterior skull base has evolved in many centres worldwide and provides a minimally invasive alternative, with better patient experience, to open techniques. METHOD: We present a basic approach to a midline lesion that is the fundamental starting point for wider access to the skull base. CONCLUSION: The nuances of this technique illustrated here have been developed in many centres to provide a safe procedure that has a low incidence of complications and excellent potential...
October 2016: Acta Neurochirurgica
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