1,586 results match your criteria Pituitary Macroadenomas


Surgical Treatment of Cystic Pituitary Prolactin-Secreting Macroadenomas: A Single Center Study of 42 Patients.

Brain Sci 2022 May 27;12(6). Epub 2022 May 27.

Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.

This study evaluated the therapeutic effects of surgical treatment of cystic pituitary prolactin-secreting macroadenomas. The clinical data of 42 patients with cystic pituitary prolactin-secreting macroadenomas were retrospectively analyzed. Patients were divided into medication plus surgery and surgery alone groups based on the regularity of bromocriptine treatment before surgery. Read More

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Do We Need Gadolinium-Based Contrast Agents for Routine MRI Surveillance of Unoperated Pituitary Macroadenoma?

AJNR Am J Neuroradiol 2022 Jun 23. Epub 2022 Jun 23.

Division of Neuroradiology (P.J.M.), Department of Medical Imaging, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Background And Purpose: The use of gadolinium-based contrast agents contributes to the cost of MR imaging and prolongs image-acquisition time. There are also recent concerns regarding gadolinium deposition, particularly in patients who require frequent follow-up MRIs. The purpose of this study was to assess whether gadolinium-based contrast agents are needed during MR imaging follow-up for unoperated pituitary macroadenoma. Read More

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Surgical Experience of Transcranial Approaches to Large-to-Giant Pituitary Adenomas in Knosp Grade 4.

Front Endocrinol (Lausanne) 2022 12;13:857314. Epub 2022 May 12.

Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Pituitary adenomas in Knosp grade 4 are difficult to resect completely and are generally involved in poor prognosis, because of the close relationship between the tumor and internal carotid. In this study, the authors retrospectively reviewed the outcome of different transcranial approaches in the management of large-to-giant pituitary adenomas in Knosp grade 4. A total of 42 patients with large-to-giant pituitary adenomas in Knosp grade 4, who underwent craniotomy in the Pituitary Disease Subdivision, Department of Neurosurgery, Beijing Tiantan Hospital, between March 2012 and March 2015 were included in this study. Read More

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Resistant prolactinomas: a case series of 26 patients.

Endocrine 2022 May 23. Epub 2022 May 23.

Endocrine Institute, Rabin-Beilinson Medical Center, Petah-Tiqva, Israel.

Purpose: Prolactin (PRL)-secreting tumors are the most common functional pituitary adenomas. They usually respond to dopamine agonist (DA) treatment, with PRL normalization and adenoma shrinkage. Our aim was to characterize patients with prolactinoma resistant to DA treatment. Read More

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Changes in the peripapillary and subfoveal choroidal vascularity index after transsphenoidal surgery for pituitary macroadenoma.

Int Ophthalmol 2022 May 23. Epub 2022 May 23.

Department of Neurosurgery, Yeditepe University School of Medicine, Istanbul, Turkey.

Purpose: To investigate the changes in peripapillary and subfoveal choroidal vascular indexes (CVI) before and after pituitary macroadenoma surgery by using a binarization method.

Method: In this cross-sectional study, we examined 17 eyes in 9 patients with pituitary macroadenomas who had undergone transsphenoidal pituitary surgery due to chiasmal compression. We also compiled data from 17of in 17 healthy subjects. Read More

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The value of intraoperative MRI for resection of functional pituitary adenomas-a critical assessment of a consecutive single-center series of 114 cases.

Neurosurg Rev 2022 May 14. Epub 2022 May 14.

Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.

This series sought to evaluate the role of intraoperative MRI (iMRI) for resection of functional pituitary adenomas (FPAs). We retrospectively reviewed clinical data of 114 consecutive FPAs with excessive hormone secretion treated with transsphenoidal surgery and iMRI during 01/2010-12/2017. We focused on iMRI findings, extend of resection and postoperative hormonal remission. Read More

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Growth hormone (GH) deficiency and GH replacement therapy in patients previously treated for Cushing's disease.

Pituitary 2022 May 13. Epub 2022 May 13.

SEMPR (Endocrine Division), Department of Internal Medicine, Federal University of Parana, Agostinho Leão Junior 285, Curitiba, PR, 80030-110, Brazil.

Several complications associated with active Cushing's disease may persist even years after complete and successful therapeutic remission of hypercortisolism. Growth hormone deficiency (GHD) shares many clinical features seen in patients with Cushing's disease, and its presence after disease remission (GHD-CR) might negatively influence and potentially worsen the systemic complications caused by previous hypercortisolism. GHD-CR is more prevalent in women, and compared to other causes of GHD, patients are younger at the onset of the pituitary disease, at diagnosis of GHD-CR and at start of GH therapy; prevalence of pituitary macroadenomas and visual abnormalities are lower, while prevalence of diabetes, hypertension, low bone mass, fractures, and worst quality of life, are higher. Read More

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Evaluation of a perioperative steroid coverage after pituitary surgery.

Endocrinol Diabetes Nutr (Engl Ed) 2022 May 7;69(5):338-344. Epub 2022 May 7.

Servicio de Endocrinología y Nutrición, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain.

Introduction: Serum cortisol levels within the first days after pituitary surgery have been shown to be a predictor of post-surgical adrenal insufficiency. However, the indication of empirical glucocorticoids to avoid this complication remains controversial. The objective is to assess the role of cortisol in the early postoperative period as a predictor of long-term corticotropic function according to the pituitary perisurgical protocol with corticosteroid replacement followed in our center. Read More

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Pituitary adenoma in the elderly: surgical outcomes and treatment trends in the United States.

J Neurosurg 2022 Apr 29:1-12. Epub 2022 Apr 29.

Objective: Decision-making in how to manage pituitary adenomas (PAs) in the elderly (age ≥ 65 years) can be challenging given the benign nature of these tumors and concerns about surgical morbidity in these patients. In this study involving a large multicenter national registry, the authors examined treatment trends and surgical outcomes in elderly compared to nonelderly patients.

Methods: The National Cancer Data Base (NCDB) was queried for adults aged ≥ 18 years with PA diagnosed by MRI (in observed cases) or pathology (in surgical cases) from 2004 to 2016. Read More

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Deep Learning for Prediction of Progression and Recurrence in Nonfunctioning Pituitary Macroadenomas: Combination of Clinical and MRI Features.

Front Oncol 2022 20;12:813806. Epub 2022 Apr 20.

Department of Medical Imaging, Chi-Mei Medical Center, Tainan, Taiwan.

Objectives: A subset of non-functioning pituitary macroadenomas (NFMAs) may exhibit early progression/recurrence (P/R) after tumor resection. The purpose of this study was to apply deep learning (DL) algorithms for prediction of P/R in NFMAs.

Methods: From June 2009 to December 2019, 78 patients diagnosed with pathologically confirmed NFMAs, and who had undergone complete preoperative MRI and postoperative MRI follow-up for more than one year, were included. Read More

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Pituitary apoplexy: An emergent and potential life-threatening complication of pituitary adenomas.

Ulus Travma Acil Cerrahi Derg 2022 Apr;28(4):483-489

Department of Neurosurgery, Gaziantep University Faculty of Medicine, Gaziantep-Turkey.

Background: Pituitary apoplexy is an emergent and potential life-threatening complication of pituitary adenomas if not managed properly. The aim of our study is to present our series of pituitary adenomas and to focus on the clinical, radiological, and surgical characteristics of this rare complication.

Methods: In this study, a total of 143 patients with pituitary adenoma underwent surgical treatment between 2016 and 2018. Read More

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Pituitary Macroadenoma: Fooling the Ophthalmologist before Giving Him the Role of the Whistle-Blower.

Klin Monbl Augenheilkd 2022 Apr 26;239(4):468-475. Epub 2022 Apr 26.

Inflammatory and Retinal Eye Diseases, Centre for Ophthalmic Specialized Care, Lausanne, Switzerland.

Purpose: To describe cases diagnosed with pituitary macroadenoma during the follow-up of their primary ocular pathologies.

Methods: Charts of patients followed in the Centre for Ophthalmic Specialized Care for diverse pathologies and who had subsequently developed a pituitary macroadenoma were retrieved. The primary pathologies were noted. Read More

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Efficacy of lanreotide 120 mg primary therapy on tumour shrinkage and ophthalmologic symptoms in acromegaly after 1 month.

Clin Endocrinol (Oxf) 2022 Jul 5;97(1):52-63. Epub 2022 May 5.

Department of Endocrinology, Diabetology, and Metabolism, Lille University Hospital, Lille, France.

Introduction: Few studies have attempted to evaluate the early efficacy of first-generation somatostatin analogues in somatotroph macroadenomas.

Objective: To investigate the short-term efficacy of primary therapy with lanreotide 120 mg at 1 and 3 months on tumour shrinkage and ophthalmologic symptoms in newly diagnosed patients with acromegaly.

Design And Patients: This single-centre retrospective study included 21 patients with de novo acromegaly resulting from pituitary macroadenoma, with optic chiasm compression (Grade ≤ 2) and/or cavernous sinus invasion, treated with a monthly injection of lanreotide 120 mg. Read More

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Malignant Endo-suprasellar Glioma: A Case Report and a Brief Review of the Literature.

Int J Endocrinol Metab 2022 Jan 9;20(1):e121803. Epub 2022 Mar 9.

Department of Endocrinology No.1, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.

Introduction: Malignant sellar gliomas are very rare phenomena. To date, only few cases of sellar and suprasellar glioblastomas have been reported, most of which originate from the optic nerve or optic chiasm.

Case Presentation: We present a 34-year-old woman with malignant endo-suprasellar glioma, originating from the pituitary stalk, which was initially classified as a macroprolactinoma. Read More

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January 2022

Revisiting growth hormone nadir cut-offs for remission in patients with acromegaly.

Eur J Endocrinol 2022 Apr 25;186(6):657-665. Epub 2022 Apr 25.

Endocrinology, Institute of Endocrine Research, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.

Objective: Over the past decade, the growth hormone (GH) nadir cut-off during the oral glucose tolerance test for remission in patients with acromegaly was changed from 0.4 to 1.0 μg/L due to the limited use of ultrasensitive detection kits to measure GH levels. Read More

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Clinical Study and Systematic Review of Pituitary Microadenomas vs. Macroadenomas in Cushing's Disease: Does Size Matter?

J Clin Med 2022 Mar 11;11(6). Epub 2022 Mar 11.

Institute of Endocrinology, Rabin Medical Center Beilinson Hospital, Petach Tikva 4941492, Israel.

: Reports on clinical and biochemical differences between adrenocorticotropic hormone (ACTH)-secreting pituitary microadenomas and macroadenomas are limited and inconsistent. Compare clinical and biochemical characteristics of patients with corticotroph microadenomas and macroadenomas and assess predictive factors for biochemical response to dynamic testing for Cushing's disease (CD) in a clinical trial and a systematic review. A second aim was to evaluate differences between macroadenomas with and without cavernous and sphenoid sinus invasion. Read More

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Paediatric Pituitary Adenomas: Clinical Presentation, Biochemical Profile and Long-Term Prognosis.

Neurol India 2022 Jan-Feb;70(1):304-311

Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Context: Paediatric pituitary adenomas (PPAs) are uncommon, with evidence confined to small cohorts.

Aim: We aimed to elucidate the baseline profile and outcomes of PPAs in a large, contemporary, monocentric cohort.

Settings, Design: Pituitary clinic at PGIMER over 8 years (2010-2018). Read More

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Magnetic Resonance Elastography in Intracranial Neoplasms: A Scoping Review.

Top Magn Reson Imaging 2022 Feb;31(1):9-22

Department of Neurosurgery, Odense University Hospital, 5000 Odense, Denmark.

Background: Magnetic resonance elastography (MRE) allows noninvasive assessment of intracranial tumor mechanics and may thus be predictive of intraoperative conditions. Variations in the use of technical terms complicate reading of current literature, and there is need of a review using consolidated nomenclature.

Objectives: We present an overview of current literature on MRE relating to human intracranial neoplasms using standardized nomenclature suggested by the MRE guidelines committee. Read More

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February 2022

A Pilot Study of Fluorescence-Guided Resection of Pituitary Adenomas with Chlorin e6 Photosensitizer.

Bioengineering (Basel) 2022 Jan 28;9(2). Epub 2022 Jan 28.

Prokhorov General Physics Institute of the Russian Academy of Sciences, 119991 Moscow, Russia.

Fluorescence diagnostics is one of the promising methods for intraoperative detection of brain tumor boundaries and helps in maximizing the extent of resection. This paper presents the results of a pilot study on the first use of the chlorin e6 photosensitizer and a two-channel video system for fluorescence-guided resection of pituitary adenomas. The study's clinical part involved two patients diagnosed with hormonally inactive pituitary macroadenomas and one patient with a hormonally active one. Read More

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January 2022

Radiological evolution of autograft fat used for skull base reconstruction after transsphenoidal surgery for pituitary adenomas.

Pituitary 2022 Jun 22;25(3):468-473. Epub 2022 Feb 22.

Department of Neurosurgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Purpose: Cerebro-spinal fluid leak after transsphenoidal surgery for pituitary adenomas may be prevented by skull base reconstruction with fat autograft. However, graft changes may interfere with the interpretation of postoperative images. Our aim is to describe the radiological evolution of the fat autograft. Read More

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Determinants of immediate and long-term remission after initial transsphenoidal surgery for acromegaly and outcome patterns during follow-up: a longitudinal study on 659 patients.

J Neurosurg 2022 Jan 14:1-11. Epub 2022 Jan 14.

1Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing.

Objective: Treatment outcomes following initial transsphenoidal surgery (TSS) for acromegaly are erratic. Identifying outcome patterns can assist in informing patients about possible treatment outcomes and planning for individualized adjuvant treatments in advance. In this study, the authors aimed to investigate the immediate and long-term endocrine remission rates following initial TSS for acromegaly, identify clinical determinants of treatment outcomes, and explore outcome patterns during a long-term follow-up and the pattern-specific patient features. Read More

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January 2022

Detection of a pituitary macroadenoma with transcranial ultrasonography: Principles and potential clinical applications.

J Clin Ultrasound 2022 Mar 15;50(3):411-414. Epub 2022 Feb 15.

Radiology Department, Azienda Unità Sanitaria Locale Toscana Nord-Ovest, Pisa, Italy.

Transcranial color-coded duplex sonography (TCCS) allows to study intracranial vessels through the intact skull, but the visualization of normal and pathologic brain structures in adults is often suboptimal due to inadequate acoustic window. The full potential of TCCS for clinical practice remains unfulfilled. Here, we describe the ability of TCCS to detect a non-functioning pituitary macroadenoma in a 58-year-old man affected by headache. Read More

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A rare case of a giant prolactinoma with atypical histological features: 5 years of follow-up.

Hormones (Athens) 2022 Jun 10;21(2):323-327. Epub 2022 Feb 10.

Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, 'Aghia Sophia' Children's Hospital, Thivon & Levadeias Str., 11527, Athens, Greece.

Background: Giant prolactinomas are rare in childhood and adolescence and represent a challenge in diagnosis and management.

Case Presentation: A 15.7-year-old male adolescent presented with short stature and delayed puberty. Read More

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Functioning gonadotroph adenomas in premenopausal women: clinical and molecular characterization and review of the literature.

Pituitary 2022 Jun 9;25(3):454-467. Epub 2022 Feb 9.

Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 1# Shuai Fu Yuan, Dong Dan, Beijing, 100730, China.

Purpose: To summary the clinical features of premenopausal women with functioning gonadotroph adenomas (FGAs) and preliminarily explore their molecular characterization.

Methods: 12 premenopausal females with FGAs in our center were retrospectively analyzed. Previously reported cases were also summarized. Read More

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Diagnosis and Treatment of Acromegaly: An Update.

Mayo Clin Proc 2022 02;97(2):333-346

Neuroendocrine Unit and Neuroendocrine and Pituitary Tumor Clinical Center, Massachusetts General Hospital, Boston; Harvard Medical School, Boston, MA. Electronic address:

Acromegaly is typically caused by a growth hormone-secreting pituitary adenoma, driving excess secretion of insulin-like growth factor 1. Acromegaly may result in a variety of cardiovascular, respiratory, endocrine, metabolic, musculoskeletal, and neoplastic comorbidities. Early diagnosis and adequate treatment are essential to mitigate excess mortality associated with acromegaly. Read More

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February 2022

Outcomes and surgical nuances in management of giant pituitary adenomas: a review of 108 cases in the endoscopic era.

J Neurosurg 2022 Jan 21:1-12. Epub 2022 Jan 21.

1Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah.

Objective: Giant (maximum diameter ≥ 4 cm) pituitary macroadenomas are complex tumors that require resection for decompression of optic nerves, relief of mass effect, and symptom improvement. Given the lack of surgical accessibility, the lateral extent of the lesions, and the invasion of the cavernous sinus, management presents a significant challenge. Transsphenoidal, transcranial, and combined approaches have been viable options for resection. Read More

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January 2022

Non-Hodgkin Lymphoma Causing Hypopituitarism Can Imaging Help Diagnosis and Management?

Eur J Case Rep Intern Med 2021 23;8(12):002980. Epub 2021 Dec 23.

Department of Endocrinology & Diabetes, University Hospitals Coventry & Warwickshire NHS Trust, UK.

Non-Hodgkin lymphomas of the hypothalamus and pituitary are rare. They usually remain clinically silent until onset of compressive features affecting surrounding structures. When symptomatic, patients most commonly present with diabetes insipidus, headaches, ophthalmoplegia and/or bilateral hemianopia. Read More

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December 2021

Apparent Diffusion Coefficient Histogram Analysis for the Preoperative Evaluation of Ki-67 Expression in Pituitary Macroadenoma.

Clin Neuroradiol 2022 Mar 14;32(1):269-276. Epub 2022 Jan 14.

Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No. 82, 730030, Chengguan District, Lanzhou, China.

Purpose: To explore the value of an apparent diffusion coefficient (ADC) histogram in predicting the Ki-67 proliferation index in pituitary macroadenomas.

Material And Methods: This retrospective study analyzed the pathological and imaging data of 102 patients with pathologically confirmed pituitary macroadenoma. Immunohistochemistry staining was used to assess Ki-67 expression in tumor tissue samples, and a high Ki-67 labeling index was defined as 3%. Read More

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Pituitary Apoplexy in Geriatric Patients: A Report of Four Cases.

Cureus 2021 Dec 10;13(12):e20318. Epub 2021 Dec 10.

Department of Endocrinology, Diabetology, Nutrition, and Metabolic Diseases, Shaikh Khalifa Bin Zayed Al-Nahyan Hospital - Mohammed VI University of Health Sciences, Casablanca, MAR.

Pituitary apoplexy (PA) is a rare clinical syndrome related to abrupt hemorrhage and/or infarction of the pituitary gland, usually occurring in patients with preexisting pituitary disease. It is an endocrine emergency requiring rapid diagnosis and appropriate management. This is a literature review and a retrospective study reporting the observation of four patients that have suffered from pituitary macroadenomas. Read More

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December 2021

Long-term outcomes of patients with acromegaly: a report from the Swedish Pituitary Register.

Eur J Endocrinol 2022 Feb 1;186(3):329-339. Epub 2022 Feb 1.

Department of Medical Sciences, Endocrinology and Mineral Metabolism, Uppsala University, Uppsala, Sweden.

Objective: To describe the treatment and long-term outcomes of patients with acromegaly from all healthcare regions in Sweden.

Design And Methods: Analysis of prospectively reported data from the Swedish Pituitary Register of 698 patients (51% females) with acromegaly diagnosed from 1991 to 2011. The latest clinical follow-up date was December 2012, while mortality data were collected for 28. Read More

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February 2022