1,510 results match your criteria Pituitary Macroadenomas

The Interdisciplinary Management of Newly Diagnosed Pituitary Tumors.

Dtsch Arztebl Int 2021 Apr;118(14):237-243

Department of Internal Medicine/Endocrinology, DKD Helios Klinik Wiesbaden Medicover Oldenburg MVZ; Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of; Würzburg, Würzburg, Germany; Department of Neurosurgery, Johannes Wesling Klinikum Minden; Institute of Neuropathology, UKE Hamburg; Department of Neurosurgery, UKE Hamburg.

Background: The increasing use of cranial tomographic imaging has led to the more frequent discovery of pituitary tumors. In this review, we discuss the clinical symptoms that point toward a pituitary tumor, the required diagnostic studies, the potential need for follow-up studies, and the indications for neurosurgical treatment.

Methods: This review is based on pertinent publications from the years 2005-2020 that were retrieved by a selective search in PubMed, as well as on the current German S2k guideline, which was created with the present authors playing a coordinating role, and on further guidelines from abroad. Read More

View Article and Full-Text PDF

Post-operative volumes following endoscopic surgery for non-functioning pituitary macroadenomas are predictive of further intervention, but not endocrine outcomes.

BMC Endocr Disord 2021 Jun 10;21(1):116. Epub 2021 Jun 10.

Leeds Centre for Diabetes & Endocrinology, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Background: Transsphenoidal surgery (TSS) remains the treatment of choice for non-functioning pituitary macroadenomas (NFPMA). The value of measuring tumour volumes before and after surgery, and its influence on endocrine outcomes and further treatment of the residual or recurrent tumour are unknown.

Methods: Data from patients who underwent endoscopic TSS for a NFPMA (2009-2018) in a UK tertiary centre were analysed for pre- and post-operative endocrine and surgical outcomes. Read More

View Article and Full-Text PDF

CyberKnife for the management of Cushing's disease: our institutional experience and review of literature.

Br J Neurosurg 2021 May 6:1-6. Epub 2021 May 6.

Gandak Hospital, Birgunj, Nepal.

Introduction: Surgery is the primary treatment for Cushing's disease(CD). In cases with no biochemical remission after surgical resection or when recurrence occurs after a period of remission stereotactic radiosurgery (SRS) is used as alternative/adjuvant treatment. The aim of this study is to demonstrate the effectiveness of SRS and FSRS(Fractionated stereotactic radiosurgery) for the treatment of CD in a long term follow up. Read More

View Article and Full-Text PDF

Clinicopathological Features of Growth Hormone-producing Pituitary Adenomas and Correlation With Preoperative Laboratory Findings.

Anticancer Res 2021 May;41(5):2669-2680

"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

Background/aim: The histopathological variability of each type of pituitary adenoma (PA) that causes growth hormone (GH) excess influences the phenotype, radiological characteristics and therapy response of acromegaly patients. We correlated the immunohistochemical (IHC) features of GH-secreting PAs with their clinical, laboratory and imaging data.

Patients And Methods: We included 32 patients with documented acromegaly; tumour specimens were histologically and IHC examined: anterior pituitary hormones, pituitary-specific transcription factor-1 (PIT-1), Ki-67 labelling index were evaluated. Read More

View Article and Full-Text PDF

Magnetic resonance fingerprinting for preoperative differentiation between gonadotroph and non-gonadotroph pituitary macroadenomas.

Eur Radiol 2021 Apr 29. Epub 2021 Apr 29.

Department of Medical Imaging, Henan Provincial People's Hospital & the People's Hospital of Zhengzhou University, 7 Weiwu Road, Zhengzhou, 450003, Henan, China.

Objectives: To use magnetic resonance fingerprinting (MRF)-derived T1 and T2 values to differentiate gonadotroph from non-gonadotroph pituitary macroadenomas based on the 2017 World Health Organization classification of pituitary adenomas.

Methods: A total of 57 patients with suspected pituitary macroadenomas were enrolled for analyses in this study between May 2018 and January 2020. Conventional magnetic resonance imaging (MRI) and MRF were performed in all patients before surgery using a 3-T MRI scanner. Read More

View Article and Full-Text PDF

Long-term Outcome of Microscopic Transsphenoidal Surgery for Prolactinomas as an Alternative to Dopamine Agonists.

J Korean Med Sci 2021 Apr 19;36(15):e97. Epub 2021 Apr 19.

Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.

Background: Although long-term dopamine agonist (DA) therapy is recommended as a first-line treatment for prolactinoma, some patients may prefer surgical treatment because of the potential adverse effects of long-term medication, or the desire to become pregnant. This study aimed to determine whether surgical treatment of prolactinomas could be an alternative to DA therapy.

Methods: In this retrospective study, 96 consecutive patients (74 female, 22 male) underwent primary pituitary surgery without long-term DA treatment for prolactinomas at a single institution from 1990 to 2010. Read More

View Article and Full-Text PDF

A Nonfunctioning Pituitary Macroadenoma Presenting as Cyclical Vomiting and Severe Hyponatremia in a Young Female.

Case Rep Endocrinol 2021 31;2021:5570539. Epub 2021 Mar 31.

Sri Jayewardenepura General Hospital, Nugegoda, Colombo, Sri Lanka.

Introduction: Recurrent vomiting is a commonly overlooked debilitating symptom which causes significant impact on the quality of life. There are several causes for vomiting, ranging from commonly known causes to rare causes. Nonfunctioning pituitary macroadenomas generally present with visual disturbances, headache, and symptoms due to anterior pituitary hormone deficiencies. Read More

View Article and Full-Text PDF

Plurihormonal PIT-1-Positive Pituitary Adenomas: A Systematic Review and Single-Center Series.

World Neurosurg 2021 Apr 20. Epub 2021 Apr 20.

Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, California, USA. Electronic address:

Objective: The 2017 World Health Organization classification of pituitary adenomas identified the plurihormonal PIT-1-positive (PP1) adenoma as a distinct subtype. The reported data suggest that PP1 adenomas encompass the former class of silent subtype 3 (SS3) adenomas and might have an aggressive phenotype. In the present study, we summarized the current clinical data on PP1 and SS3 adenomas and compared the reported data with the data from a single institutional cohort. Read More

View Article and Full-Text PDF

Etiology-, Sex-, and Tumor Size-Based Differences in Adrenocorticotropin-Dependent Cushing Syndrome.

Endocr Pract 2021 May 15;27(5):471-477. Epub 2020 Dec 15.

Department of Histopathology, PGIMER, Chandigarh, India.

Objective: To examine demographic, clinical, and biochemical differences in patients with adrenocorticotropin (ACTH)-dependent Cushing syndrome (CS) based on etiology, sex, and tumor size.

Methods: This was a single-center study of 211 patients with ACTH-dependent CS followed for 35 years. Patients were stratified into 3 groups based on etiology: Cushing disease (CD)/transsphenoidal surgery, Cushing disease/total bilateral adrenalectomy (CD/TBA), and ectopic ACTH secretion (EAS). Read More

View Article and Full-Text PDF

Outcome of pituitary hormone deficits after surgical treatment of nonfunctioning pituitary macroadenomas.

Endocrine 2021 Apr 14. Epub 2021 Apr 14.

Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.

Objectives: Nonfunctionning pituitary macroadenomas (NFPMA) are benign tumors that cause symptoms of mass effects including hypopituitarism. Their primary treatment is transsphenoidal surgery. We aimed to determine the outcome of pituitary hormone deficits after surgical treatment of NFPMA and to identify factors predicting hormonal recovery. Read More

View Article and Full-Text PDF

Non-functioning pituitary macroadenomas: factors affecting postoperative recurrence, and pre- and post-surgical endocrine and visual function.

Endocrine 2021 Apr 6. Epub 2021 Apr 6.

Department of Endocrinology & Metabolism, Royal Preston Hospital, The Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK.

Background: Non-functioning pituitary macroadenomas (NFPAs) with visual field defects are ideally managed by transsphenoidal tumour resection to improve vision, and long-term postsurgical follow up is necessary to monitor for tumour recurrence. Regular updates from global data are necessary for developing optimal management strategies of these tumours.

Methods: Pre- and postoperative visual and endocrine profile, imaging characteristics and details of surgical interventions among patients with NFPAs managed between 2008 and 2019 in a UK regional centre were assessed. Read More

View Article and Full-Text PDF

A Novel Technique for Transpalatal Hypophysectomy.

J Neurol Surg B Skull Base 2021 Apr 18;82(2):216-232. Epub 2019 Sep 18.

Hospital Santa Casa de Campo Grande, Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil.

 A novel technique is described for transpalatal hypophysectomy as an option for sellar region surgery using a microscope and/or endoscope.  A straight submucosal tunnel (approximately 20 mm in diameter; 40-50 mm long-half the length required by conventional transsphenoidal hypophysectomy) is dissected in favorable alignment with the main tumor axis, providing a direct view that allows the surgeon to operate on large suprasellar tumors, even in cases of extra-axial expansion.  In a 25-year period, over 50 patients benefited from this surgery. Read More

View Article and Full-Text PDF

Long-Term Outcomes of Pituitary Gland Preservation in Pituitary Macroadenoma Apoplexy: Case Series and Review of the Literature.

J Neurol Surg B Skull Base 2021 Apr 11;82(2):182-188. Epub 2019 Nov 11.

Department of Neurological Surgery, Loyola University Stritch School of Medicine, Maywood, Illinois, United States.

 For patients presenting with neurological changes from pituitary tumor apoplexy, urgent surgical intervention is commonly performed for diagnosis, tumor resection, and optic apparatus decompression. Although identification and preservation of the pituitary gland during the time of surgery can be challenging, it may lead to improve endocrine outcomes.  A retrospective case series of all patients with macroadenomas presenting with apoplexy at Loyola University Medical Center from 2016 to 2018 was studied. Read More

View Article and Full-Text PDF

Pituitary Apoplexy Attributed to COVID-19 Infection in the Absence of an Underlying Macroadenoma or Other Identifiable Cause.

Cureus 2021 Feb 12;13(2):e13315. Epub 2021 Feb 12.

Neurosurgery, Cleveland Clinic Florida, Weston, USA.

The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), is responsible for an array of extrapulmonary manifestations, including direct and indirect neurological complications. Currently, all published cases noting pituitary apoplexy in patients with COVID-19 have discovered underlying pituitary macroadenomas. Herein, we describe the first documented case, to our knowledge, of pituitary apoplexy attributed solely to COVID-19 in the absence of other identifiable causes. Read More

View Article and Full-Text PDF
February 2021

Classic cardiovascular risk factors improve in very elderly hypopituitary patients treated on standard hormone replacement in long term follow- up.

Clin Diabetes Endocrinol 2021 Mar 17;7(1). Epub 2021 Mar 17.

Endocrinology Unit, Faculty of Medicine, University of Brasilia, Brasilia, Brazil.

Background: Hypopituitarism in the elderly population is an underdiagnosed condition and may increase comorbidities related to glucose metabolism, dyslipidemia, and cardiovascular risk factors. Optimization of hormone replacement that considers alterations in clearance rates of hormones, interaction with other medications, and evaluation of the risk-benefit ratio of treatment is a big challenge for clinical practice.

Objectives: This study aimed to evaluate classic cardiovascular risk factors in hypopituitary septuagenarians and octagenarians by diagnosis and after long-term hormone replacement. Read More

View Article and Full-Text PDF

Spontaneous Cerebrospinal Fluid Rhinorrhea from a Prolactin-Secreting Pituitary Macroadenoma.

Cureus 2021 Feb 3;13(2):e13111. Epub 2021 Feb 3.

Neurosurgery, University of Utah, Salt Lake City, USA.

Cerebrospinal fluid (CSF) rhinorrhea is a rare complication of macroprolactinomas that, in the vast majority of cases, is subsequent to either medical or surgical intervention. Here, we present the successful management of a rare case of spontaneous, noniatrogenic CSF rhinorrhea in a patient with an untreated macroprolactinoma. A 27-year-old man with no significant medical history presented with six months of persistent CSF rhinorrhea, which was confirmed by testing for beta-2-transferrin. Read More

View Article and Full-Text PDF
February 2021

Pituitary surgery in elderly patients: a safe and effective procedure.

Endocrine 2021 Jun 4;72(3):814-822. Epub 2021 Mar 4.

Endocrinology Department, University Hospital of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain.

Purpose: The incidence of pituitary adenoma (PA) increases with age. Transsphenoidal surgery (TSS) in elderly patients is often considered to have greater risk compared to the younger population. The aim of this study is to compare surgical results, evolution and postoperative complications between elderly and young patients undergoing TSS. Read More

View Article and Full-Text PDF

Outcomes of endoscopic transsphenoidal surgery for Cushing's disease.

BMC Endocr Disord 2021 Mar 3;21(1):36. Epub 2021 Mar 3.

Department of Neurosurgery, Beaumont Hospital, Dublin, Ireland.

Background: Transsphenoidal surgery (TSS) to resect an adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma is the first-line treatment for Cushing's disease (CD), with increasing usage of endoscopic transsphenoidal (ETSS) technique. The aim of this study was to assess remission rates and postoperative complications following ETSS for CD.

Methods: A retrospective analysis of a prospective single-surgeon database of consecutive patients with CD who underwent ETSS between January 2012-February 2020. Read More

View Article and Full-Text PDF

Endoscopic transsphenoidal surgery reduces the need for re-operation compared to the microscopic approach in pituitary macroadenomas.

Eur J Surg Oncol 2021 Jun 14;47(6):1352-1356. Epub 2021 Feb 14.

Department of Neurosurgery, Tel-Aviv Medical Center, Tel-Aviv, Israel, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address:

Introduction: Pituitary surgery has shifted in recent years from microscopic surgery(MS) to endoscopic endonasal surgery (EES). However, the comparative long-term outcome of these surgical approaches, including the need for subsequent re-operation has never been reported. We present our experience in a high-volume referral center experienced in both endoscopic and microscopic approaches to compare the need for re-operation after initial resection of non-functioning pituitary macroadenomas using these surgical approaches. Read More

View Article and Full-Text PDF

Robotic Radiosurgery for Persistent Postoperative Acromegaly in Patients with Cavernous Sinus-Invading Pituitary Adenomas-A Multicenter Experience.

Cancers (Basel) 2021 Jan 31;13(3). Epub 2021 Jan 31.

European Cyberknife Center, 81377 Munich, Germany.

Background: The rates of incomplete surgical resection for pituitary macroadenomas with cavernous sinus invasion are high. In growth hormone-producing adenomas, there is a considerable risk for persistent acromegaly. Thus, effective treatment options are needed to limit patient morbidity and mortality. Read More

View Article and Full-Text PDF
January 2021

Pituitary disease: An update.

Aust J Gen Pract 2021 Jan-Feb;50(1-2):30-35

MBBS, MD, FRACP, Senior Lecturer, Faculty of Medicine, The University of Queensland, Qld; Endocrinologist, Queensland Diabetes and Endocrine Centre, Mater Health, Qld.

Background: Pituitary lesions are present in >10% of the population. Approximately one in 1000 people has a symptomatic pituitary tumour, which may cause clinical problems from mass effect, hormonal hypersecretion and impairment of normal pituitary function.

Objective: The aim of this article is to outline the potential causes of a sellar and parasellar mass, with an emphasis on the presenting clinical features and screening investigations that are applicable to doctors working in the primary care setting. Read More

View Article and Full-Text PDF
February 2021


Endocr Pract 2021 Jan 18;27(1):8-14. Epub 2020 Nov 18.

Division of Endocrinology, Diabetes & Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. Electronic address:

Objective: To determine the utility of measuring free T index (FTI) in patients with low free T (FT) levels using immunoassay and normal thyroid-stimulating hormone for the evaluation of secondary hypothyroidism.

Methods: We performed a retrospective medical chart review of patients seen at a single institution as outpatients who had a simultaneously normal thyroid-stimulating hormone level, low FT level, and any FTI measured between June 2014 and October 2016. Demographic, laboratory, and imaging data were collected. Read More

View Article and Full-Text PDF
January 2021

Outcomes of pituitary apoplexy: a comparison of microadenomas and macroadenomas.

Pituitary 2021 Jan 19. Epub 2021 Jan 19.

Institute of Endocrinology, Diabetes and Metabolism, Rambam Health Care Campus, HaAliya HaShniya Street 8, 3109601, Haifa, Israel.

Purpose: We aimed to assess clinical characteristics of apoplexy of pituitary microadenomas compared to macroadenomas.

Methods: We retrieved clinical records of patients > 18 years old, hospitalized in Rambam hospital between January 2001 and October 2017, with pituitary apoplexy and follow-up of at least one year. We compared clinical course and outcomes of apoplexy between patients with microadenomas and macroadenomas, and between patients who received conservative or surgical treatment. Read More

View Article and Full-Text PDF
January 2021

Safety and Effectiveness of the Direct Endoscopic Endonasal Approach for Primary Sellar Pathology: A Contemporary Case Series of More Than 400 Patients.

World Neurosurg 2021 Apr 14;148:e536-e546. Epub 2021 Jan 14.

USC Pituitary Center, Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.

Background: The direct endoscopic endonasal approach (EEA) has become the primary technique used for resection of sellar pathology, meriting investigation into the risk factors for complications and predictors of postoperative outcomes after direct EEA.

Methods: We retrospectively analyzed the patient and tumor characteristics from 404 patients who had undergone direct EEA for sellar pathology at the USC Pituitary Center from September 2011 to December 2019.

Results: Of the 404 pathologic entities included, 349 (86%) were pituitary adenomas (PAs), 29 (7%) were Rathke cleft cysts, and 26 (6%) were other sellar lesions. Read More

View Article and Full-Text PDF

Good Visual Outcomes After Pituitary Tumor Surgery are Associated With Increased Visual Cortex Functional Connectivity.

J Neuroophthalmol 2020 Dec 30;Publish Ahead of Print. Epub 2020 Dec 30.

Division of Neurosurgery (STL, WHAR, YPS), Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Division of Ophthalmology (FEC), Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Canada; Division of Neurology (FEC), Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Department of Neurological Surgery (WHAR), Rush University, Chicago, IL; and Hotchkiss Brain Institute (STL, FEC), University of Calgary, Calgary, Canada.

Background: Patients presenting with visual impairment secondary to pituitary macroadenomas often experience variable recovery after surgery. Several factors may impact visual outcomes including the extent of neuroaxonal damage in the afferent visual pathway and cortical plasticity. Optical coherence tomography (OCT) measures of retinal structure and resting-state functional MRI (rsfMRI) can be used to evaluate the impact of neuroaxonal injury and cortical adaptive processes, respectively. Read More

View Article and Full-Text PDF
December 2020

Predictors of postoperative biochemical remission in acromegaly.

J Neurooncol 2021 Jan 4;151(2):313-324. Epub 2021 Jan 4.

Center for Pituitary Tumor Surgery, Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan 2nd Rd, Yuexiu District, Guangzhou, 510080, Guangdong, China.

Purpose: Acromegaly is a rare neuroendocrine condition that can lead to significant morbidity. Despite China's vast population size, studies on acromegaly remain sparse. This study aimed to investigate the clinical characteristics and predictors of biochemical remission after surgery for acromegaly using the China Acromegaly Patient Association (CAPA) database. Read More

View Article and Full-Text PDF
January 2021

Radiomics Approach for Prediction of Recurrence in Non-Functioning Pituitary Macroadenomas.

Front Oncol 2020 18;10:590083. Epub 2020 Dec 18.

Department of Radiological Sciences, University of California, Irvine, Irvine, CA, United States.

Objectives: A subset of non-functioning pituitary macroadenomas (NFPAs) may exhibit early progression/recurrence (P/R) after surgical resection. The purpose of this study was to apply radiomics in predicting P/R in NFPAs.

Methods: Only patients who had undergone preoperative MRI and postoperative MRI follow-ups for more than 1 year were included in this study. Read More

View Article and Full-Text PDF
December 2020

[Surgical treatment in acromegaly: experience in Córdoba].

Rev Fac Cien Med Univ Nac Cordoba 2020 12 9;77(4):301-306. Epub 2020 Dec 9.

Departamento Neuroendocrinología Sociedad de Endocrinología y Metabolismo Córdoba.

Introduction: Acromegaly prevalence is 35-70 / million. Transsphenoidal surgery is the first-line treatment, with a remission rate of 80% for microadenomas and 50% for macroadenomas. Our aim was to evaluate the surgical results in Córdoba and determine predictive remission factors due to the lack of records. Read More

View Article and Full-Text PDF
December 2020

Case Report: Suprasellar Pituitary Adenoma Presenting With Temporal Lobe Seizures.

Front Surg 2020 1;7:598138. Epub 2020 Dec 1.

Department of Neurosurgery, Yale School of Medicine, New Haven, CT, United States.

Seizures in patients with pituitary pathology are uncommon and typically secondary to electrolyte disturbances. Rarely, seizures have been described from mass effect related to large prolactinomas undergoing medical treatment. We describe a 54 year-old male who presented with a first-time generalized seizure, secondary to a pituitary macroadenoma compressing the left temporal lobe. Read More

View Article and Full-Text PDF
December 2020

[The value of conventional magnetic resonance imaging based radiomic model in predicting the texture of pituitary macroadenoma].

Zhonghua Yi Xue Za Zhi 2020 Dec;100(45):3626-3631

Medical Imaging Central, Yijishan Hospital of Wannan Medical College, Wuhu 241001, China.

To investigate the value of conventional magnetic resonance imaging (MRI) based radiomic model in predicting the texture of pituitary macroadenoma. The complete data of 101 patients with pituitary macroadenoma confirmed by surgery and pathology in Yijishan Hospital of Wannan Medical College from December 2014 to December 2019 were retrospectively analyzed. According to the texture of the intraoperative pituitary tumor, patients were divided into soft group (58) and hard group (43). Read More

View Article and Full-Text PDF
December 2020