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    1272 results match your criteria Pituitary Macroadenomas

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    A review of Cushing's disease treatment by the Department of Neuroendocrinology of the Brazilian Society of Endocrinology and Metabolism.
    Arch Endocrinol Metab 2018 Feb;62(1):87-105
    Serviço de Endocrinologia, Hospital de Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
    The treatment objectives for a patient with Cushing's disease (CD) are remission of hypercortisolism, adequate management of co-morbidities, restoration of the hypothalamic-pituitary-adrenal axis, preservation of fertility and pituitary function, and improvement of visual defects in cases of macroadenomas with suprasellar extension. Transsphenoidal pituitary surgery is the main treatment option for the majority of cases, even in macroadenomas with low probability of remission. In cases of surgical failure, another subsequent pituitary surgery might be indicated in cases with persistent tumor imaging at post surgical magnetic resonance imaging (MRI) and/or pathology analysis of adrenocorticotropic hormone-positive (ACTH+) positive pituitary adenoma in the first procedure. Read More

    Investigating the application of diving endoscopic technique in determining the extent of pituitary adenoma resection via the trans-nasal-sphenoidal approach.
    Exp Ther Med 2018 Apr 2;15(4):3815-3819. Epub 2018 Mar 2.
    Department of Neurosurgery, Beijing Boai Hospital, China Rehabilitation Research Centre, Beijing 100068, P.R. China.
    The aim of the present study was to investigate the advantages and disadvantages of the diving endoscopic technique in pituitary adenoma surgery, and the application value in determining the extent of tumor resection. A total of 37 patients with pituitary adenoma initially underwent tumor resection under an endoscope-assisted microscope via standard trans-nasal-sphenoidal approach, and tumor cavity structure was observed by applying the diving endoscopic technique. Surgery was subsequently performed again under a microscope or endoscope. Read More

    Endonasal endoscopic surgery in pituitary adenomas: Surgical results in a series of 86 consecutive patients.
    Neurocirugia (Astur) 2018 Mar 23. Epub 2018 Mar 23.
    Servicio de Otorrinolaringología, Hospital General Universitario de Alicante, Alicante, España.
    Introduction: The endoscopic endonasal approach has become the gold standard for the surgical treatment of pituitary adenomas.

    Objectives: The aim of this study is to present the results obtained in our hospital in purely endoscopic surgery of pituitary adenomas.

    Methods: From February 2011 to August 2016, we conducted a prospective study on a series of 86 patients with pituitary adenoma, all of whom underwent surgery with a purely endoscopic endonasal approach. Read More

    Superiority of constructive interference in steady-state MRI sequencing over T1-weighted MRI sequencing for evaluating cavernous sinus invasion by pituitary macroadenomas.
    J Neurosurg 2018 Mar 23:1-8. Epub 2018 Mar 23.
    Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland Clinic.
    OBJECTIVE Preoperatively determining the extent of parasellar invasion of pituitary macroadenomas is useful for surgical planning and patient counseling. Here, the authors compared constructive interference in steady state (CISS), a T2-weighted gradient-echo MRI sequence, to volume-interpolated breath-hold examination (VIBE), a T1-weighted gradient-echo MRI sequence, for evaluation of cavernous sinus invasion (CSI) by pituitary macroadenomas. METHODS VIBE and CISS images of 98 patients with pituitary macroadenoma were retrospectively analyzed and graded using the modified Knosp classification. Read More

    Complete evaluation of pituitary tumours in a single tertiary care institution.
    Endocrine 2018 May 12;60(2):255-262. Epub 2018 Mar 12.
    Endocrinology and Metabolic Diseases Department, Internal Medicine III, Jena University Hospital, Jena, Germany.
    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. Read More

    Case report of a pituitary thyrotropin-secreting macroadenoma with Hashimoto thyroiditis and infertility.
    Medicine (Baltimore) 2018 Jan;97(1):e9546
    Department of Endocrinology and Metabolism.
    Rationale: Thyrotropin-secreting adenoma (TSHoma) is rare, diagnosis and treatment are often delayed if the condition coexists with Hashimoto thyroiditis. The enlarged pituitary adenoma may eventually induce panhypopituitarism, infertility, or the compression of optic nerves and optic chiasma.

    Patient Concerns: This patient was a 36-year-old man who had been referred to the pituitary disease multidisciplinary team (MDT) of the West China Hospital, due to infertility. Read More

    Extended endoscopic endonasal approach to the ventral skull base lesions.
    Clin Neurol Neurosurg 2018 Apr 21;167:129-140. Epub 2018 Feb 21.
    University of Health Sciences, Gulhane Education and Research Hospital, Department of Neurosurgery, Ankara, Turkey. Electronic address:
    Objective: With the use of multiple endoscopic endonasal surgical corridors, extended endoscopic endonasal approaches (EEEAs) are now being used to treat a wide range of ventral skull base lesions. Our aim was to present our experience with EEEAs to the ventral skull base lesions.

    Patients And Methods: The study group consisted of 106 patients (57 men and 49 women) who underwent surgery for skull base lesions using EEEAs from 2010 to 2017. Read More

    Cabergoline-Induced Pneumocephalus Following Treatment for Giant Invasive Macroprolactinoma Presenting With Spontaneous Cerebrospinal Fluid Rhinorrhea.
    Clin Med Insights Endocrinol Diabetes 2018 13;11:1179551418758640. Epub 2018 Feb 13.
    Obesity, Endocrine, and Metabolism Center, King Fahad Medical City, Riyadh, Saudi Arabia.
    Cerebrospinal fluid (CSF) rhinorrhea is rarely reported as the first presenting feature of giant invasive macroprolactinomas. Cerebrospinal fluid rhinorrhea is usually reported as a complication of trauma, neurosurgical, and skull-based procedures (such as pituitary surgery or radiations), and less frequently after medical treatment with dopamine agonists (DAs) for macroprolactinomas. This phenomenon results from fistula creation that communicates between the subarachnoid space and the nasal cavity. Read More

    Evaluation of Clinical and Magnetic Resonance Imaging Profile of Pituitary Macroadenoma: A Prospective Study.
    J Nat Sci Biol Med 2018 Jan-Jun;9(1):34-38
    Department of Radiodiagnosis, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
    Background: Pituitary macroadenoma is a common tumor of middle-aged people. Magnetic resonance imaging (MRI) is the investigation of choice for its evaluation. Various parameters regarding the extent, consistency, and contrast uptake can be studied and a noninvasive diagnosis is possible. Read More

    Perioperative lumbar drain utilization in transsphenoidal pituitary resection.
    Neurosciences (Riyadh) 2018 Jan;23(1):46-51
    Department of Neurosurgery, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia. E-mail:
    Objective: To evaluate lumbar drain (LD) efficacy in transnasal resection of pituitary macroadenomas in preventing postoperative cerebrospinal fluid (CSF) leak, technique safety, and effect on length of hospital stay.

    Methods: We conducted a retrospective data review of pituitary tumor patients in our institution who underwent surgery between December 2006 and January 2013. All patients were operated on for complete surgical resection of pituitary macroadenoma tumors. Read More

    CyberKnife robotic radiosurgery in the multimodal management of acromegaly patients with invasive macroadenoma: a single center's experience.
    J Neurooncol 2018 Feb 10. Epub 2018 Feb 10.
    Department of Neurological Surgery, Stanford Medical Center, Stanford University, Palo Alto, CA, USA.
    Surgery is the primary treatment for acromegaly. However, surgery may not be curative of some tumors, particularly invasive macroadenomas. Adjuvant radiation, specifically robotic stereotactic radiosurgery (rSRS), may improve the endocrine outcome. Read More

    Adrenal Axis Insufficiency After Endoscopic Transsphenoidal Resection of Pituitary Adenomas.
    World Neurosurg 2018 Apr 5;112:e869-e875. Epub 2018 Feb 5.
    Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California, USA.
    Introduction: Hormonal insufficiency of 1 or more pituitary axes can appear after pituitary surgery. Adrenal axis impairment after surgery can lead to serious consequences if not identified and treated.

    Objective: Assess early and late postoperative adrenal insufficiency (AI) and identify the risk factors predicting their occurrence after endoscopic transsphenoidal resection of pituitary adenomas. Read More

    Visual Outcome of an Endoscopic Endonasal Transsphenoidal Approach in Pituitary Macroadenomas: Quantitative Assessment with Diffusion Tensor Imaging Early and Long-Term Results.
    World Neurosurg 2018 Apr 22;112:e691-e701. Epub 2018 Feb 22.
    Department of Neurosurgery, Pituitary Research Centre, University of Kocaeli, İzmit, Kocaeli, Turkey.
    Background: Postoperative visual recovery in patients with pituitary adenoma can be influenced by the duration of symptoms, age, and tumor volume. Diffusion tensor imaging (DTI) allows visualization of white matter structure along with quantitative information. The aims of our study were to predict the visual recovery process in the early and long-term periods and to define the parameters affecting the recovery course. Read More

    Descent of the anterior communicating artery after removal of pituitary macroadenoma using transsphenoidal surgery.
    Surg Neurol Int 2017 27;8:306. Epub 2017 Dec 27.
    Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
    Background: After removal of pituitary macroadenoma, the anterior communicating artery (AComA) descends toward the original position. However, the process and contributing factors of this descent are not elucidated.

    Methods: This retrospective study included 102 patients who underwent transsphenoidal surgery (TSS) for macroadenomas with maximum diameters of >2 cm. Read More

    Somatotrophic Adenoma in Children Younger than 14 Years: Clinical Features and Treatment of 22 Cases at a Large Pituitary Center.
    World Neurosurg 2018 Apr 31;112:e561-e568. Epub 2018 Jan 31.
    Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Dongcheng District, Beijing, People's Republic of China; China Pituitary Disease Registry Center, Dongcheng District, Beijing, People's Republic of China; Chinese Pituitary Adenoma Cooperative Group, Dongcheng District, Beijing, People's Republic of China. Electronic address:
    Objective: To investigate the clinical features of somatotrophic adenoma in children younger than 14 years and to evaluate the short-term and long-term outcomes of transsphenoidal surgery.

    Methods: This single-center retrospective study included 22 patients with somatotrophic adenoma who were admitted to our institution between January 1997 and January 2017. The patients' demographics, hormone levels, imaging characteristics, surgical outcomes, and follow-up data were summarized. Read More

    MGMT assessment in pituitary adenomas: comparison of different immunohistochemistry fixation chemicals.
    Pituitary 2018 Jan 17. Epub 2018 Jan 17.
    Department of Neurosurgery, Medical University Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.
    Purpose: Despite the established role of O6-methyl-guanine-DNA methyltransferase (MGMT) as a marker for temozolomide response, consensus of the most reliable method to assess MGMT expression in pituitary adenomas is still missing. Currently, immunohistochemistry (IHC) assessment of formaldehyde fixed tissue samples is most widely used in a semiquantitative description. As formaldehyde fails to completely preserve nucleic acids, RCL2, an alcohol-based formaldehyde-free fixative, has been proposed as a more reliable alternative in terms of cell stability. Read More

    Diagnostic value of early postoperative MRI and diffusion-weighted imaging following trans-sphenoidal resection of non-functioning pituitary macroadenomas.
    Clin Radiol 2018 Jan 9. Epub 2018 Jan 9.
    Department of Radiodiagnosis, Faculty of Medicine, Zagazig University, Egypt.
    Aim: To establish the value of early contrast-enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) in differentiating residual pituitary adenoma from postoperative surgical changes.

    Materials And Methods: Thirty patients with non-functioning pituitary macroadenomas, who were undergoing trans-sphenoidal adenomectomy, were prospectively studied. Patients were imaged with both MRI and DWI in the early postoperative period, as well as 6-months post-surgery. Read More

    Cantú syndrome with coexisting familial pituitary adenoma.
    Endocrine 2018 Mar 11;59(3):677-684. Epub 2018 Jan 11.
    Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
    Context: Pseudoacromegaly describes conditions with an acromegaly related physical appearance without abnormalities in the growth hormone (GH) axis. Acromegaloid facies, together with hypertrichosis, are typical manifestations of Cantú syndrome.

    Case Description: We present a three-generation family with 5 affected members, with marked acromegaloid facies and prominent hypertrichosis, due to a novel missense variant in the ABCC9 gene. Read More

    Management of nonfunctioning pituitary adenomas (NFAs): observation.
    Pituitary 2018 Apr;21(2):162-167
    Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, 645 N. Michigan Avenue, Suite 530, Chicago, IL, 60611, USA.
    Clinically nonfunctioning pituitary adenomas (NFAs) range from those causing significant hypothalamic/pituitary dysfunction and visual field compromise due to their large size to those being completely asymptomatic. In the absence of hypersecretion, hypopituitarism or visual field defects, patients with NFAs may be followed by periodic surveillance using MRI to detect tumor enlargement. In some cases, endocrine tests are also needed during observation to discover new pituitary dysfunction. Read More

    Both invasiveness and proliferation criteria predict recurrence of non-functioning pituitary macroadenomas after surgery: a retrospective analysis of a monocentric cohort of 120 patients.
    Eur J Endocrinol 2018 Mar 19;178(3):237-246. Epub 2017 Dec 19.
    Department of Endocrinology, University Hospital Saint-LucBrussels, Belgium.
    Introduction: Additional robust criteria to predict early postoperative recurrence of non-functioning pituitary macroadenomas (NFMAs) are needed. Recently, a new classification of pituitary tumors has been proposed, which is based on both radiological and histological criteria and allows the grading into 5 groups of different potential aggressiveness. The aim of this study was to use this classification to further characterize predictive factors of recurrence in an independent series of NFMA. Read More

    The dangers of the "Head Down" position in patients with untreated pituitary macroadenomas: case series and review of literature.
    Pituitary 2017 Dec 13. Epub 2017 Dec 13.
    Department of Neurologic Surgery, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
    Purpose: Cavernous sinus syndrome is a rare phenomenon, characterized by simultaneous neuropathies of cranial nerves III-VI. Various pathological processes have been reported as precipitating etiologies, including infection, inflammation, vascular lesions, and neoplasms.

    Purpose: We report a unique case series of cavernous sinus syndrome attributable to prolonged Trendelenburg or prone positioning during non-cranial procedures and review the pertinent literature to enlighten on this rare but catastrophic phenomenon. Read More

    Assessment of the extent of pituitary macroadenomas resection in immediate postoperative MRI.
    Radiologia 2018 Jan - Feb;60(1):64-72. Epub 2017 Nov 26.
    Servicio de Radiología, Hospital Universitario de la Ribera, Alzira, Valencia, España.
    Objective: To evaluate if it is possible to determine the extent of pituitary macroadenomas resection in the immediate postoperative pituitary magnetic resonance imaging (MRI).

    Material And Methods: MRI of patient with pituitary macroadenomas from January 2010 until October 2014 were reviewed. Those patients who had diagnostic MRI, immediate post-surgical MRI and at least one MRI control were included. Read More

    Pediatric prolactinoma: initial presentation, treatment, and long-term prognosis.
    Eur J Pediatr 2018 Jan 22;177(1):125-132. Epub 2017 Nov 22.
    Department of Pediatrics and Pediatric Hematology/Oncology, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Rahel-Straus-Strasse 10, 26133, Oldenburg, Germany.
    Prolactinoma is a rare pituitary adenoma secreting prolactin. Studies on diagnostics, treatment, and prognosis in pediatric prolactinoma patients are rare. We analyzed clinical presentation, response to treatment, and prognosis of 27 pediatric prolactinoma patients (10 m/17 f. Read More

    Variability and Lack of Prognostic Value Associated With Atypical Pituitary Adenoma Diagnosis: A Systematic Review and Critical Assessment of the Diagnostic Criteria.
    Neurosurgery 2017 Nov 18. Epub 2017 Nov 18.
    Department of Neurosurgery, Keck School of Medicine of USC, Los Angeles, California.
    Background: Atypical pituitary adenomas (APAs) are a subset of pituitary adenomas (PAs) characterized by the 2004 World Health Organization (WHO) guidelines to have higher risk histopathological features than typical PAs. In July 2017, the WHO published an update to their classification of pituitary tumors and abandoned the APA terminology.

    Objective: To assess the prevalence and outcomes of patients diagnosed with APA through a literature review. Read More

    Early versus late Gamma Knife radiosurgery following transsphenoidal surgery for nonfunctioning pituitary macroadenomas: a multicenter matched-cohort study.
    J Neurosurg 2017 Oct 27:1-10. Epub 2017 Oct 27.
    Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia.
    OBJECTIVE Gamma Knife radiosurgery (GKRS) is frequently used to treat residual or recurrent nonfunctioning pituitary macroadenomas. There is no consensus as to whether GKRS should be used early after surgery or if radiosurgery should be withheld until there is evidence of imaging-defined progression of tumor. Given the high incidence of adenoma progression after subtotal resection over time, the present study intended to evaluate the effect of timing of radiosurgery on outcome. Read More

    mutations in Brazilian patients with sporadic pituitary adenomas: a single-center evaluation.
    Endocr Connect 2017 Nov 26;6(8):914-925. Epub 2017 Oct 26.
    Department of Internal Medicine and Endocrine UnitMedical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
    Aryl hydrocarbon receptor-interacting protein () gene mutations () are the most frequent germline mutations found in apparently sporadic pituitary adenomas (SPA). Our aim was to evaluate the frequency of among young Brazilian patients with SPA. We performed an observational cohort study between 2013 and 2016 in a single referral center. Read More

    The learning curve for endoscopic trans-sphenoidal resection of pituitary macroadenomas. A single institution experience, Leeds, UK.
    Acta Neurochir (Wien) 2018 Jan 23;160(1):39-47. Epub 2017 Oct 23.
    Department of Neurosurgery, Leeds General Infirmary, G Floor, Jubilee Building, Leeds, LS1 3EX, UK.
    Background: The object of this study was to assess whether increasing operative experience results in greater endoscopic trans-sphenoidal resection of pituitary macroadenomas and lower complications.

    Methods: A retrospective single institution cohort study was performed. Subjects underwent endoscopic trans-sphenoidal resection of pituitary macroadenoma between July 2009 and July 2016 by three neurosurgeons. Read More

    Dogs with macroadenomas have lower body temperature and heart rate than dogs with microadenomas.
    Vet J 2017 Sep 25;227:42-45. Epub 2017 Aug 25.
    The Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire AL9 7TA, United Kingdom and Cave Veterinary Specialists, George's Farm Nr Wellington, West Buckland, Wellington TA21 9LE, UK. Electronic address:
    Pituitary macroadenomas compress the hypothalamus, which partly regulates heart rate and body temperature. The aim of this study was to investigate whether heart rate and/or body temperature could aid in clinically differentiating dogs with macroadenomas from dogs with microadenomas (i.e. Read More

    Potential utility of FLAIR in MRI-negative Cushing's disease.
    J Neurosurg 2017 Oct 13:1-9. Epub 2017 Oct 13.
    Neurosurgery Unit for Pituitary and Inheritable Diseases, and.
    OBJECTIVE Accurate presurgical localization of microadenomas in Cushing's disease (CD) leads to improved remission rates and decreased adverse events. Volumetric gradient recalled echo (3D-GRE) MRI detects pituitary microadenomas in CD in up to 50%-80% cases as a focus of hypointensity due to delayed contrast wash-in. The authors have previously reported that postcontrast FLAIR imaging may be useful in detecting otherwise MRI-negative pituitary microadenomas as foci of hyperintensity. Read More

    Familial isolated pituitary adenomas (FIPA). Case report of four families and review of literature.
    Endokrynol Pol 2017 12;68(6):697-707. Epub 2017 Oct 12.
    Department of Endocrinology, Medical University of Lublin, Poland.
    Background The majority of pituitary adenomas are sporadic, but about 5% of them occur in a familial setting, predominantly in multiple endocrine neoplasia type 1 and Carney complex. Familial isolated pituitary adenomas (FIPA), unrelated to the syndromes mentioned above, were also described. The clinical course of FIPA differs significantly from sporadic cases, and is characterized by a larger tumor size, more aggressive course and younger patients' age at the moment of recognition. Read More

    Diagnosis and treatment of TSH-secreting adenomas: review of a longtime experience in a reference center.
    J Endocrinol Invest 2018 Apr 11;41(4):447-454. Epub 2017 Oct 11.
    Neuroendocrine Unit, Division of Endocrinology and Metabolism, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Botucatu, 806, Vila Clementino, São Paulo, CEP 04023-062, Brazil.
    Purpose: TSH-secreting pituitary adenomas are among the less prevalent pituitary tumors, corresponding to 0.9-1.5% of all pituitary adenomas in surgical series. Read More

    [Overgrowth in children and in adults: novel clinical view, novel genes, novel phenotypes].
    Cas Lek Cesk 2017 ;156(5):233-240
    Novel genetic findings allow to more reliably elucidate the aetiology and pathogenesis of overgrowth syndromes in children and in adults. The relatively prevalent overgrowth syndromes in foetuses and neonates include Beckwith-Wiedemann (BWS) and Sotos syndromes; in addition, several rare conditions may occur e.g. Read More

    Morbidity and mortality in patients with hyperprolactinaemia: the PROLEARS study.
    Endocr Connect 2017 Nov;6(8):580-588
    Division of Molecular and Clinical MedicineSchool of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.
    Purpose: High serum prolactin concentrations have been associated with adverse health outcomes in some but not all studies. This study aimed to examine the morbidity and all-cause mortality associated with hyperprolactinaemia.

    Methods: A population-based matched cohort study in Tayside (Scotland, UK) from 1988 to 2014 was performed. Read More

    Diagnosis and Outcomes of 341 Patients with Cushing's Disease Following Transsphenoid Surgery: A Single-Center Experience.
    World Neurosurg 2018 Jan 23;109:e75-e80. Epub 2017 Sep 23.
    Department of Neurosurgery, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China. Electronic address:
    Background: Transsphenoid surgery (TSS) is a standard treatment modality for Cushing's disease (CD). However, postoperative remission and recurrence rates vary among studies. Here we analyze the diagnosis and outcomes of 341 patients with a preoperative diagnosis of CD undergoing TSS in a single center over a 3-year period. Read More

    Microsurgical versus endoscopic transsphenoidal resection for acromegaly: a systematic review of outcomes and complications.
    Acta Neurochir (Wien) 2017 Nov 14;159(11):2193-2207. Epub 2017 Sep 14.
    Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA.
    Purpose: The aim of this systematic review is to evaluate the long-term endocrine outcomes and postoperative complications following endoscopic vs. microscopic transsphenoidal resection (TSR) for the treatment of acromegaly.

    Methods: A literature review was performed, and studies with at least five patients who underwent TSR for acromegaly, reporting biochemical remission criteria and long-term remission outcomes were included. Read More

    MGMT and MSH6 immunoexpression for functioning pituitary macroadenomas.
    Pituitary 2017 Dec;20(6):643-653
    Department of Neurosurgery, Medical University Vienna, Waehringer Guertel 18-20, 1097, Vienna, Austria.
    Purpose: Knowledge of biological behavior is crucial for clinical management of functioning pituitary macroadenomas. For recurrent cases unresponsive to standard treatment, temozolomide (TMZ) has been used as a therapeutic alternative. MGMT (O6-methyl-guanine-DNA methyltransferase) and MSH6 (mutS homolog 6) immunoexpression have been linked to the response to TMZ treatment and MGMT immunoexpression has been additionally linked to early recurrence of non-functioning pituitary adenomas. Read More

    Endoscopic Transsphenoidal Approach for Acromegaly with Remission Rates in 401 Patients: 2010 Consensus Criteria.
    World Neurosurg 2017 Dec 5;108:278-290. Epub 2017 Sep 5.
    Pituitary Research Centre, Kocaeli University, Kocaeli, Turkey; Neurosurgery Department, Kocaeli University, Kocaeli, Turkey.
    Background: Transsphenoidal surgery is the first-choice treatment for acromegaly. Postoperative remission is an important predictor of outcome. Various factors have been described as markers of remission: preoperative mean growth hormone (GH) and insulin-like growth factor-1 levels, cavernous sinus invasion, tumor size, extrapseudocapsular resection, and experience of the surgeon. Read More

    Prolonged preoperative treatment of acromegaly with Somatostatin analogs may improve surgical outcome in patients with invasive pituitary macroadenoma (Knosp grades 1-3): a retrospective cohort study conducted at a single center.
    BMC Endocr Disord 2017 Sep 6;17(1):55. Epub 2017 Sep 6.
    Key Laboratory of Endocrinology, Ministry of Health; Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China.
    Background: This study aimed to investigate preoperative somatostatin analogs (SSAs) treatment on the surgical outcome in patients with acromegaly.

    Methods: An analysis of 358 patients with acromegaly was conducted. The preoperative medical therapy group (81 patients) received SSA treatment for at least 3 months prior to surgery, while the primary surgery group (277 patients) underwent transsphenoidal surgery directly. Read More

    Reoperation for growth hormone-secreting pituitary adenomas: report on an endonasal endoscopic series with a systematic review and meta-analysis of the literature.
    J Neurosurg 2017 Sep 1:1-13. Epub 2017 Sep 1.
    Department of Neurosurgery, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York.
    OBJECTIVE Surgery is generally the first-line therapy for acromegaly. For patients with residual or recurrent tumors, several treatment options exist, including repeat surgery, medical therapy, and radiation. Reoperation for recurrent acromegaly has been associated with poor results, with hormonal control usually achieved in fewer than 50% of cases. Read More

    Surgical debulking of pituitary adenomas improves responsiveness to octreotide lar in the treatment of acromegaly.
    Pituitary 2017 Dec;20(6):668-675
    Division of MEND, University of Michigan, 24 Frank Lloyd Wright, G-1500, Ann Arbor, MI, 48106, USA.
    Background: Studies comparing primary medical treatment of acromegaly with surgery are often non-randomized, and not stratified by illness severity. We prospectively compared primary medical therapy with pituitary surgery in patients with acromegaly. All patients had macroadenomas, at least one random human growth hormone (GH) level ≥12. Read More

    Resection of pituitary macroadenomas via the pseudocapsule along the posterior tumor margin: a cohort study and technical note.
    J Neurosurg 2018 Feb 18;128(2):422-428. Epub 2017 Aug 18.
    Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia.
    OBJECTIVE Extracapsular resection of pituitary microadenomas improves remission rates, but the application of pseudocapsular techniques for macroadenomas has not been well described. In larger tumors, the extremely thin, compressed normal gland or its complete absence along the tumor's anterior surface limits the application of the traditional pseudocapsular technique that can be used for microadenomas. However, in the authors' experience, the interface between the pseudocapsule at the posterior margin of the adenoma and the compressed normal gland behind it is universally present, providing a surgical dissection plane. Read More

    Risk factors and the prognosis of sexual dysfunction in male patients with pituitary adenomas: a multivariate analysis.
    Asian J Androl 2018 Jan-Feb;20(1):43-49
    Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
    The impact of sexual dysfunction (SD) is distressing to many male patients with pituitary adenomas which affect both physical and psychological health. The research explored to identify risk factors affecting sexual function and the prognosis of male patients with pituitary adenomas. Two hundred and fifty-four male patients, who aged between 18 and 60 (mean ± s. Read More

    Long-term treatment outcomes of acromegaly patients presenting biochemically-uncontrolled at a tertiary pituitary center.
    BMC Endocr Disord 2017 Aug 4;17(1):49. Epub 2017 Aug 4.
    Pituitary Center, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA.
    Background: Acromegaly is a rare, slowly progressive disorder resulting from excessive growth hormone (GH) production by a pituitary somatotroph tumor. The objective of this study was to examine acromegaly treatment outcomes during long-term care at a specialized pituitary center in patients presenting with lack of biochemical control.

    Methods: Data came from an acromegaly registry at the Cedars-Sinai Medical Center Pituitary Center (center). Read More

    Prevalence, Clinical Features, and Natural History of Incidental Clinically Non-Functioning Pituitary Adenomas.
    Horm Metab Res 2017 Sep 31;49(9):654-659. Epub 2017 Jul 31.
    Department of Endocrinology, Hospital Universitario A Coruña, A Coruña, Spain.
    The objective of the study was to assess the prevalence and clinical features of incidentally discovered clinically non-functioning pituitary adenoma (CNFPA) and to analyze its natural history. A multicenter retrospective study in patients diagnosed with incidental CNFPA periodically followed-up in 3 specialized neuroendocrinology units from 1992 to 2015 was performed. Out of a total of 189 CNFPA patients, 57 cases (30. Read More

    Radiological Growth Patterns of Prolactinomas and Nonfunctioning Adenomas.
    Can J Neurol Sci 2017 Sep 3;44(5):508-513. Epub 2017 Jul 3.
    1Division of Endocrinology and Metabolism,Dalhousie University,Halifax,Nova Scotia,Canada.
    Objectives: To compare growth patterns of nonfunctioning and prolactin-producing pituitary macroadenomas, and to find whether their specific growth patterns are associated with clinically significant effects on vision.

    Materials And Methods: From our comprehensive provincial neuropituitary registry, we retrospectively identified 35 randomly selected patients each with nonfunctioning adenomas and prolactinomas >10 mm in any dimension. MRI scans were analyzed to determine the superior and inferior growth, volume, and maximum craniocaudal height of the adenomas. Read More

    Prolactinomas diagnosed in the postmenopausal period: Clinical phenotype and outcomes.
    Clin Endocrinol (Oxf) 2017 Nov 18;87(5):508-514. Epub 2017 Jul 18.
    Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
    Objective: Most prolactinomas in females are diagnosed during the reproductive age, and the majority are microadenomas. Prolactinomas detected in the postmenopausal period are less common with limited published data on their presentation and prognosis. Our objective was to assess the presenting clinical, biochemical and imaging findings, as well as the outcomes of women diagnosed with a prolactinoma in the postmenopausal period. Read More

    Cavernous Sinus Involvement by Pituitary Adenomas: Clinical Implications and Outcomes of Endoscopic Endonasal Resection.
    J Neurol Surg B Skull Base 2017 Jun 23;78(3):273-282. Epub 2017 Jan 23.
    Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, United States.
     Parasellar invasion of pituitary adenomas (PAs) into the cavernous sinus (CS) is common. The management of the CS component of PA remains controversial.  The objective of this study was to analyze CS involvement in PA treated with endoscopic endonasal approaches, including incidence, surgical risks, surgical strategies, long-term outcomes, and our treatment algorithm. Read More

    Long term follow-up of growth hormone-secreting pituitary adenomas submitted to endoscopic endonasal surgery.
    Arq Neuropsiquiatr 2017 May;75(5):301-306
    Faculdade de Ciências Médicas, Santa Casa de São Paulo, Departamento de Otorrinolaringologia São Paulo SP, Brasil.
    Objective: The aim of this study was to evaluate the results of the endoscopic transsphenoidal technique for growth hormone (GH)-secreting adenomas.

    Methods: A retrospective analysis based on medical records of 23 acromegalic patients submitted to endoscopic transsphenoidal surgery. Biochemical control was defined as basal GH < 1ng/ml, nadir GH < 0. Read More

    Acromegaly: surgical results in 548 patients.
    Pituitary 2017 Oct;20(5):522-528
    Neurosurgery Department, Puerta de Hierro Hospital, Madrid, Spain.
    Purpose: The goal of this study was to quantified the results of microsurgery, in all the patients with acromegaly treated by the same endocrinologist and the same surgeon between 1975 and 2015.

    Methods: A series of 548 patients with acromegaly were operated and followed-up from 6 months to 40 years. Patients were selected according to five criteria: (1) Operated by the same surgeon. Read More

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