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    Hypogonadotropic Hypogonadism in Non-Functioning Pituitary Adenomas: Impact of Intervention.
    Exp Clin Endocrinol Diabetes 2017 Feb 15. Epub 2017 Feb 15.
    Department of Endocrinology, Diabetes and Metabolism Centro Hospitalar S. João, Faculty of Medicine - Instituto de Investigação e Inovação em Saúde University of Porto,Portugal.
    To determine the prevalence of hypogonadotropic hypogonadism (HH) among patients with non-functioning pituitary adenomas (NFPA) and the post-surgery outcome on pituitary gonadotropins secretion (PGS); to determine the prevalence of erectile dysfunction (ED) on male patients with NFPA, to evaluate the impact of testosterone replacement therapy (TRT) in those with HH. Retrospective evaluation of gonadal function in 109 NFPA patients (45 males), with a mean age of 51.8 years, diagnosed on the last 10 years. Read More

    Diagnosis and Treatment of Pituitary Adenomas: A Review.
    JAMA 2017 Feb;317(5):516-524
    Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
    Importance: Pituitary adenomas may hypersecrete hormones or cause mass effects. Therefore, early diagnosis and treatment are important.

    Observations: Prevalence of pituitary adenomas ranges from 1 in 865 adults to 1 in 2688 adults. Read More

    Efficacy of Microsurgical Sublabial Approach (MSA) Versus Endoscopic Endonasal Approach (EEA) for the Treatment of Pituitary Adenomas Based on Radiological and Hormonal Outcome.
    Acta Neurochir Suppl 2017 ;124:101-106
    Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy.
    Background: The purpose of this study was to compare the surgical efficacy of the microsurgical sublabial approach (MSA) versus the endoscopic endonasal approach (EEA) for the treatment of pituitary adenomas, based on short-term (12 months) radiological and endocrinological follow-up.

    Methods: One hundred and fourteen patients affected by pituitary adenoma were enrolled at our Unit between January 2007 and February 2012; 72 were treated with MSA, and 42 with EEA. The preoperative parameters considered were: type of lesion (secreting or nonsecreting), lesion size, presence of intralesional hemorrhage, lesion perimeter (nodular vs. Read More

    Clinical Features, Management Considerations and Outcomes in a Case Series of Patients with Parasellar Intracranial Aneurysms Undergoing Anterior Skull Base Surgery.
    World Neurosurg 2016 Dec 9. Epub 2016 Dec 9.
    University of Virginia, Department of Neurosurgery, Charlottesville, VA 22908, United States.
    Background: The co-incidence of parasellar aneurysms (IA) and anterior skull base (ASB) lesions, while rare, presents a management challenge. IAs embedded within, or adjacent to, ASB lesions are at risk in the perioperative period, and may have unique presentations, natural histories, and outcomes. The objective of this study was to outline management options and nuances in patients with coexisting IAs and ASB lesions. Read More

    Prevalence and predictors of overweight and obesity in patients with pituitary dysfunctions.
    Endocr Metab Immune Disord Drug Targets 2016 Nov 30. Epub 2016 Nov 30.
    University of Luebeck - Department of Medicine I Luebeck, Germany.
    Background: Patients with hypothalamic-pituitary disorders (HPD) may be of increased risk to develop overweight and obesity, thereby fostering cardiovascular events. However, it remains unclear if patients with pituitary dysfunctions per se have an increased risk of becoming obese.

    Objective: The objective of this study was to evaluate prevalence and to identify possible predictors of overweight and obesity in patients with pituitary dysfunctions. Read More

    Vanishing Pituitary Macroadenoma: A Case Report.
    Cureus 2016 Oct 20;8(10):e838. Epub 2016 Oct 20.
    Department of Neurosurgery, Penn State Hershey Medical Center.
    Pituitary macroadenomas are the most common suprasellar lesions in adults and are typically managed surgically through transsphenoidal resection when symptomatic. Due to their close proximity to the optic chiasm, pituitary macroadenomas often present with signs of bitemporal hemianopsia. Alternatively, these tumors can cause mass effect, thus presenting with signs of elevated intracranial pressure or can present with signs and symptoms of endocrine dysfunction. Read More

    The identification of human pituitary adenoma-initiating cells.
    Acta Neuropathol Commun 2016 Nov 28;4(1):125. Epub 2016 Nov 28.
    McMaster Stem Cell and Cancer Research Institute, McMaster University, Hamilton, ON, L8S 4K1, Canada.
    Classified as benign central nervous system (CNS) tumors, pituitary adenomas account for 10% of diagnosed intracranial neoplasms. Although surgery is often curative, patients with invasive macroadenomas continue to experience significant morbidity and are prone to tumor recurrence. Given the identification of human brain tumor-initiating cells (TICs) that initiate and maintain tumor growth while promoting disease progression and relapse in multiple CNS tumors, we investigated whether TICs also drive the growth of human pituitary adenomas. Read More


    Characteristics and outcome of surgically treated pituitary tumours in South Africa: a single-centre experience.
    Clin Endocrinol (Oxf) 2016 Nov 12. Epub 2016 Nov 12.
    Department of Diabetes and Endocrinology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
    Aims: To describe the clinical, biochemical, radiological and histological features and to determine the outcome of all patients with pituitary tumours treated surgically at Inkosi Albert Luthuli Central Hospital (ILACH) in Durban over a 5-year period.

    Research Design: Retrospective chart review from 2008 to 2012. Clinical, biochemical and radiological data were collected before and 1 year after surgery. Read More

    Cabergoline and prolactinomas: lack of association between DRD2 polymorphisms and response to treatment.
    Pituitary 2016 Nov 15. Epub 2016 Nov 15.
    Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clínicas & Laboratory of Cellular and Molecular Endocrinology LIM-25, University of São Paulo Medical School, São Paulo, Brazil.
    Background: About 80% of prolactinomas respond to dopamine agonists (DA) with hormonal normalization and tumor shrinkage. Mechanisms of DA resistance include reduction of dopamine receptor subtype 2 (DRD2) expression, short and long isoform ratio and post-receptor mechanisms. It was suggested that polymorphisms in the gene encoding dopamine receptor subtype 2 gene (DRD2) could be associated with variable effectiveness of cabergoline (CAB). Read More

    Parasellar Extension Grades and Surgical Extent in Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Adenomas : A Single Surgeon's Consecutive Series with the Aspects of Reliability and Clinical Validity.
    J Korean Neurosurg Soc 2016 Nov 24;59(6):577-583. Epub 2016 Oct 24.
    Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
    Objective: The inter-rater reliability of the modified Knosp's classification was measured before the analysis. The clinical validity of the parasellar extension grading system was evaluated by investigating the extents of resection and complication rates among the grades in the endoscopic endonasal transsphenoidal surgery (EETS) for pituitary adenomas.

    Methods: From November 2008 to August 2015, of the 286 patients who underwent EETS by the senior author, 208 were pituitary adenoma cases (146 non-functioning pituitary adenomas, 10 adrenocorticotropic hormone-secreting adenomas, 31 growth hormone-secreting adenomas, 17 prolactin-secreting adenomas, and 4 thyroid-stimulating hormone-secreting adenomas; 23 microadenomas, 174 macroadenomas, and 11 giant adenomas). Read More

    A novel truncating AIP mutation, p.W279*, in a familial isolated pituitary adenoma (FIPA) kindred.
    Hormones (Athens) 2016 07;15(3):441-444
    Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, 20892, USA.
    Familial isolated pituitary adenomas (FIPA) constitute 2-3% of pituitary tumours. AIP is the most commonly mutated gene in FIPA. We herein report a novel germline mutation of the AIP gene in a family with FIPA. Read More

    Long-term complete remission of Crooke's corticotropinoma after temozolomide treatment.
    Endokrynol Pol 2016 ;67(5):526-533
    Department of Endocrinology, Medical University, Lublin, Poland.
    Introduction: Crooke's corticotropinomas are the unique cause of Cushing's disease. The majority of them are aggressive macroadenomas, refractory to conventional therapy, with a high recurrence rate. The aim of the study was the presentation, in relation to data from the literature, of a case of a patient with ACTH-dependent Cushing's syndrome caused by recurrent Crooke's cells corticotropinoma, who achieved 33-month complete remission after treatment with temozolomide (TMZ). Read More

    Paradoxical and atypical responses to pasireotide in aggressive ACTH-secreting pituitary tumors.
    Pituitary 2016 Dec;19(6):605-611
    Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann Street, 64239, Tel Aviv, Israel.
    Purpose: Pasireotide is the only pituitary targeted medication registered for the treatment of Cushing's disease. Drug efficacy data are largely based on a major prospective study in which the vast majority of patients had microadenomas. The purpose of this study was to summarize results of pasireotide treatment of ACTH secreting macroadenomas from our center. Read More

    Endoscopic Endonasal versus Microsurgical Transsphenoidal Approach for Growth Hormone-Secreting Pituitary Adenomas-Systematic Review and Meta-Analysis.
    World Neurosurg 2017 Jan 15;97:398-406. Epub 2016 Oct 15.
    Faculty of Medicine, University of New South Wales, Sydney, Australia; Department of Neurosurgery, Prince of Wales Hospital, Sydney, Australia.
    Background: The pituitary adenoma causing acromegaly is typically resected through a transsphenoidal approach and visualized 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 transsphenoidal approaches for growth hormone pituitary adenomas were identified until February 2016. Read More

    Epidemiology of acromegaly: review of population studies.
    Pituitary 2016 Oct 14. Epub 2016 Oct 14.
    Institute of Metabolism and Systems Research (IMSR), College of Medical and Dental Sciences, University of Birmingham, IBR Tower, Level 2, Birmingham, B15 2TT, UK.
    Acromegaly is a rare condition necessitating large population studies for the generation of reliable epidemiological data. In this review, we systematically analysed the epidemiological profile of this condition based on recently published population studies from various geographical areas. The total prevalence ranges between 2. Read More

    Quantitative analysis of anatomical relationship between cavernous segment internal carotid artery and pituitary macroadenoma.
    Medicine (Baltimore) 2016 Oct;95(41):e5027
    aDepartment of Neurological Surgery, Tri-Service General Hospital bDepartment of Surgery, Tri-Service General Hospital Songshan Branch cGraduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, R.O.C.
    Cavernous segment internal carotid artery (CSICA) injury during endoscopic transsphenoidal surgery for pituitary tumor is rare but fatal. The aim of this study is to investigate anatomical relationship between pituitary macroadenoma and corresponding CSICA using quantitative means with a sense to improve safety of surgery.In this retrospective study, a total of 98 patients with nonfunctioning pituitary macroadenomas undergoing endoscopic transsphenoidal surgeries were enrolled from 2005 to 2014. Read More

    Apparent diffusion coefficient and pituitary macroadenomas: pre-operative assessment of tumor atypia.
    Pituitary 2016 Oct 12. Epub 2016 Oct 12.
    Department of Radiology, University of California San Francisco, 505 Parnassus Avenue, M-391, San Francisco, CA, 94143-0628, USA.
    Rationale And Objectives: Pituitary macroadenomas are predominantly benign intracranial neoplasms that can be locally aggressive with invasion of adjacent structures. Biomarkers of aggressive behavior have been identified in the pathology literature, including the proliferative marker MIB-1. In the radiology literature, diffusion weighted imaging and low ADC values provide similar markers of aggressive behavior in brain tumors. Read More

    Predictive role of dynamic contrast enhanced T1-weighted MR sequences in pre-surgical evaluation of macroadenomas consistency.
    Pituitary 2016 Oct 11. Epub 2016 Oct 11.
    Department of Neuroradiology, S. Andrea Hospital, University Sapienza, Rome, Italy.
    Purpose: Our hypothesis was that pituitary macroadenomas show different areas of consistency detectable by enhanced magnetic resonance imaging (MRI) with Dynamic study during gadolinium administration.

    Materials And Methods: We analysed 21 patients with pituitary macroadenomas between June 2013 and June 2015. All patients underwent trans-sphenoidal surgery and neurosurgeon described macroadenomas consistency. Read More

    The epidemiology of pituitary adenomas in a community-based hospital: a retrospective single center study in Saudi Arabia.
    Ann Saudi Med 2016 Sep-Oct;36(5):341-345
    Khalid S. Aljabri, MD, FRCPC, Department of Endocrinology,, King Fahad Armed Forces Hospital,, PO Box 6572, Jeddah 24361,, Saudi Arabia, T: 966555544919, F: 966-22-576-0665, ORCID: http://orcid.org/000-0001-5831-5935.
    Background: Data on pituitary adenoma (PA) prevalence in Saudi Arabia are scarce.

    Objective: To estimate the epidemiology of PA in a well-defined population.

    Design: Retrospective analysis. Read More

    Landscape of Genomic Alterations in Pituitary Adenomas.
    Clin Cancer Res 2016 Oct 5. Epub 2016 Oct 5.
    Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
    Purpose: Pituitary adenomas are the second most common primary brain tumor, yet their genetic profiles are incompletely understood.

    Experimental Design: We performed whole-exome sequencing of 42 pituitary macroadenomas and matched normal DNA. These adenomas included hormonally active and inactive tumors, ones with typical or atypical histology, and ones that were primary or recurrent. Read More

    Progressive loss of vision caused by asymptomatic pituitary macroadenoma: role of OCT.
    Int Med Case Rep J 2016 16;9:291-293. Epub 2016 Sep 16.
    Ophthalmology Department, Clinical University Hospital of Valladolid, Valladolid, Spain.
    Introduction: Most pituitary adenomas are clinically inactive. In patients with long-standing compression of the optic chiasm, ganglion cells may undergo axonal degeneration. Spectral domain optical coherence tomography (SD-OCT) is able to identify retinal nerve fiber layer (RNFL) and ganglion cell loss in the retina. Read More

    Time Course of Resolution of Hyperprolactinemia After Transsphenoidal Surgery Among Patients Presenting with Pituitary Stalk Compression.
    World Neurosurg 2017 Jan 23;97:2-7. Epub 2016 Sep 23.
    Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
    Background: Primary lactotroph disinhibition, or stalk effect, occurs when mechanical compression of the pituitary stalk disrupts the tonic inhibition by dopamine released by the hypothalamus. The resolution of pituitary stalk effect-related hyperprolactinemia postoperatively has not been studied in a large cohort of patients. We performed a retrospective review to investigate the time course of recovery of lactotroph disinhibition after transsphenoidal surgery. Read More

    [Hyperprolactinemia: unusual association between peripheral hypothyroidism and microprolactinoma].
    Pan Afr Med J 2016 10;24:41. Epub 2016 May 10.
    Service d'Endocrinologie Diabétologie et Maladies Métaboliques, Hopital Arrazi, CHU Mohamed VI, Faculté de Médecine et de Pharmacie, Université Cadi Ayad, Marrakech, Maroc.
    We report a rare case of hyperprolactinemia revealing the association between peripheral hypothyroidism and prolactin pituitary macroadenomas. The patient was a 43-year old woman, presenting with spontaneous bilateral galactorrhea over a period of 1 year. Hyperprolactinemia was confirmed and etiologic investigation revealed peripheral hypothyroidism secondary to autoimmune thyroiditis. Read More

    Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on Primary Management of Patients With Nonfunctioning Pituitary Adenomas.
    Neurosurgery 2016 Oct;79(4):E533-5
    ‡Department of Neurological Surgery, University of Southern California, Los Angeles, California; §Guidelines Department, Congress of Neurological Surgeons, Schaumburg, Illinois; ¶Barrow Neurological Institute, Phoenix, Arizona; ∥Department of Neurosurgery, Emory University, Atlanta, Georgia; #Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California; **Department of Neurosurgery, George Washington University, Washington, DC; ‡‡Department of Neurosurgery, University of California, San Francisco, California.
    Background: Nonfunctioning pituitary adenomas (NFPAs) are among the most common pituitary lesions and may present clinically with vision loss and hypopituitarism.

    Objective: To characterize the existing literature as it pertains to the initial management of NFPAs.

    Methods: A systematic literature review was conducted to identify and screen articles assessing primary treatment options (surgical, medical, radiation based, or observation) for NFPAs. Read More

    PITUITARY APOPLEXY DUE TO DAIGNOSTIC TEST IN CUSHING'S DISEASE PATIENT.
    Turk Neurosurg 2016 Feb 5. Epub 2016 Feb 5.
    Bulent Ecevit University, Faculty of Medicine.
    Pituitary apoplexy is a medical condition that needs urgent diagnosis and treatment. It may occur spontaneously or may be precipitated by a variety of reasons including dynamic endocrine tests. Although pituitary apoplexy is usually seen in non-functional pituitary adenoma, it can also be seen in ACTH secreting macroadenomas. Read More

    Free middle turbinate mucosal graft reconstruction after primary endoscopic endonasal pituitary surgery.
    Eur Arch Otorhinolaryngol 2017 Feb 1;274(2):837-844. Epub 2016 Sep 1.
    Department of Neurosurgery, University Hospital of Wales, Cardiff, UK.
    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. Read More

    Surgical treatment of acromegaly according to the 2010 remission criteria: systematic review and meta-analysis.
    Acta Neurochir (Wien) 2016 Nov 2;158(11):2109-2121. Epub 2016 Sep 2.
    Service de Neurochirurgie, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (Unil), Rue du Bugnon 46, 1011, Lausanne, Switzerland.
    Background: In 2010, the Acromegaly Consensus Group revised the criteria for cure of acromegaly and thus rates of surgical remission need to be revised in light of these new thresholds. Two subgroups consisted of patients with discordant GH and IGF-1 levels and patients in remission according to the 2000 criteria, but not to the 2010 criteria, have been reported after adenomectomy and for these subgroups the precise incidence and management has not been established. The objective of the study was to update rates of surgical remission and complications and to evaluate the incidence, management, and long-term outcome of the two previously described subgroups of patients. Read More

    [Mini-orbitozygomatic craniotomy in surgery for supratentorial aneurysms and tumors of the anterior and middle cranial fossae].
    Zh Vopr Neirokhir Im N N Burdenko 2016;80(4):40-7
    Inozemtsev City Clinical Hospital, Moscow, Russia.
    Unlabelled: Progress in microneurosurgical techniques, neuroanesthesiology, and intraoperative imaging enables surgery using small incisions and craniotomy, in accordance with the keyhole surgery concept. Supraorbital craniotomy is the most widespread minimally invasive approach. There are a number of supraorbital craniotomy modifications, regarding different soft tissue incisions and the extent of craniotomy. Read More

    [Endoscopic treatment of 140 pituitary tumors, results and complications].
    Neurocirugia (Astur) 2016 Jul 29. Epub 2016 Jul 29.
    Servicio de Neurocirugía, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address:
    Objective: To present the clinical and radiographic outcomes of 140 patients with pituitary adenomas treated by an endoscopic endonasal approach (EEA) over a period of 4 years.

    Material And Methods: A retrospective analysis was performed between 2011 and 2014. Pre and post operative MRI, ophtalmological assessment, endocrinological laboratory evaluation and surgical morbidity and mortality were assessed. Read More

    The multimodal management of GH-secreting pituitary adenomas: predictive factors, strategies and outcomes.
    J Med Life 2016 Apr-Jun;9(2):187-92
    "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; "C.I. Parhon" National Institute of Endocrinology, Bucharest, Romania.
    Object. The aim of this study was to analyze a series of 28 patients with acromegaly who underwent a multimodal surgical, medical and radiosurgical therapy, with a special attention to the advantages, complications, and predictive factors of a successful outcome. Methods. Read More

    Sellar reconstruction without intrasellar packing after endoscopic surgery of pituitary macroadenomas is better than its reputation.
    Ger Med Sci 2016 23;14:Doc07. Epub 2016 Jun 23.
    Department of Otorhinolaryngology, University Hospital Brussels, Vrije Universiteit Brussels, Brussels, Belgium.
    Objectives: Sellar reconstruction with intrasellar packing following endoscopic resection of pituitary macroadenomas remains a subject of clinical and radiological discussion particularly, when an intraoperative cerebrospinal fluid (CSF) leakage is absent. This study was conducted to contribute our experience with sellar reconstruction after a standard endoscopic surgery of pituitary macroadenomas without intraoperative CSF leakage to the ongoing discussion between techniques with and without intrasellar packing.

    Methods: A consecutive series of 47 pituitary macroadenomas undergoing excision via a standard endoscopic endonasal transsphenoidal surgery (EETS) without evident intraoperative CSF leakage were retrospectively evaluated over a 10-months mean follow-up period. Read More

    Quantitative Analysis of the Displacement of the Anterior Visual Pathway by Pituitary Lesions and the Associated Visual Field Loss.
    Invest Ophthalmol Vis Sci 2016 Jul;57(8):3576-80
    Wilmer Eye Institute Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
    Purpose: To evaluate quantitatively the relationship between the displacement of anterior visual pathway structures by pituitary tumors and visual field damage with the goal of improving diagnosis and management.

    Methods: Subjects had pituitary macroadenomas and both magnetic resonance imaging (MRI) and static perimetry. Neuroradiologists measured the displacement of anterior visual pathway structures and right-left tumor asymmetry. Read More

    Negative correlation between tumour size and cortisol/ACTH ratios in patients with Cushing's disease harbouring microadenomas or macroadenomas.
    J Endocrinol Invest 2016 Dec 30;39(12):1401-1409. Epub 2016 Jun 30.
    Neuroendocrine Unit, Division of Endocrinology and Metabolism, University of Sao Paulo Medical School, São Paulo, SP, Brazil.
    Purpose: Pituitary macroadenomas (MACs) represent 10-30 % of Cushing's disease (CD) cases. The aim of this study was to report the clinical, laboratorial and imaging features and postsurgical outcomes of microadenoma (MIC) and MAC patients.

    Methods: Retrospective study with 317 CD patients (median 32 years old, range 9-71 years) admitted between 1990 and 2014, 74 (23. Read More

    Prevalence of clinically silent corticotroph macroadenomas.
    Clin Endocrinol (Oxf) 2016 Dec 27;85(6):874-880. Epub 2016 Jul 27.
    Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
    Objective: The prevalence of clinically silent corticotroph macroadenomas is unknown. Our aim was to determine the prevalence of clinically silent corticotroph macroadenomas among all pituitary macroadenomas.

    Design: Patients scheduled to have transsphenoidal surgery for any sellar mass were prospectively evaluated clinically and biochemically. Read More

    An evaluation of the effects of somatostatin analogue therapy in non-functioning pituitary adenomas in comparison to acromegaly.
    Endokrynol Pol 2016 27;67(3):292-8. Epub 2016 Jun 27.
    Department of Clinical Endocrinology, Chair of Endocrinology, Medical University of Lodz, Poland.
    Introduction: Non-functioning pituitary adenomas (NFPA) are often diagnosed late as invasive macroadenomas. The surgical resection is usually incomplete and about 50% of patients require additional surgery. Recent data suggest that somatostatin analogues (SSA), so important in the pharmacotherapy of acromegaly, can also be effective in the management of NFPA. Read More

    Advances in Gamma Knife radiosurgery for pituitary tumors.
    Curr Opin Endocrinol Diabetes Obes 2016 Aug;23(4):331-8
    Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA.
    Purpose Of Review: For the residual/recurrent pituitary adenomas, stereotactic radiosurgery (SRS) plays an important role in long-term tumor control and, for secretory adenomas, endocrine remission. The purpose of this review is to address the advances in SRS technique and detail the latest treatment strategies for various types of pituitary adenomas with a focus on recently published literature.

    Recent Findings: From recent publications, SRS may be considered as an upfront treatment in patients with an adenoma that resides largely in the cavernous sinus and for whom resection is unlikely to produce substantial reduction in the overall tumor volume. Read More

    Combined treatment with octreotide LAR and pegvisomant in patients with pituitary gigantism: clinical evaluation and genetic screening.
    Pituitary 2016 Oct;19(5):507-14
    Department of Endocrinology, Centre Hospitalier Universitaire de Liège, University of Liège, Domaine Universitaire du Sart-Tilman, 4000, Liège, Belgium.
    Introduction: Pituitary gigantism is a rare condition caused by growth hormone secreting hypersecretion, usually by a pituitary tumor. Acromegaly and gigantism cases that have a genetic cause are challenging to treat, due to large tumor size and poor responses to some medical therapies (e.g. Read More

    Analysis of the Medial Opticocarotid Recess in Patients with Pituitary Macroadenoma Using Three-Dimensional Images.
    World Neurosurg 2016 Sep 7;93:139-43. Epub 2016 Jun 7.
    Department of Neurosurgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
    Objective: The medial opticocarotid recess (MOCR), which contains the lateral tubercular recess (LTR), is an important landmark for the cavernous internal carotid artery (ICA) and for accessing the parasellar and suprasellar regions. These microanatomic landmarks for endoscopic endonasal surgery can be observed using surgical simulation with three-dimensional images. The aim of this study was to analyze the MOCR in patients with pituitary macroadenoma using three-dimensional images. Read More

    Three-dimensional reconstruction and morphological characterization of pituitary macroadenomas.
    Arch Med Sci 2016 Jun 18;12(3):576-86. Epub 2016 May 18.
    Department of Neurosurgery, Fuzhou General Hospital, Xiamen University Medical College, Fujian, China.
    Introduction: The aim was to investigate the relationship between the tumor (clinicopathologic and radiological) characteristics and the morphological parameters of pituitary macroadenoma or giant adenoma patients using a three-dimensional (3D) reconstructed model.

    Material And Methods: Magnetic resoanance imaging (MRI) was performed preoperatively; tumor grade was determined by the Knosp-Steiner classification and tumor morphology by the SIPAP classification. Pituitary adenomas and adjacent structures were reconstructed three-dimensionally by volume rendering. Read More

    The use of a three-dimensional endoscope for different skull base tumors: results of a preliminary extended endonasal surgical series.
    Acta Neurochir (Wien) 2016 Aug 8;158(8):1605-16. Epub 2016 Jun 8.
    Unit of Otorhinolaryngology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
    Background: The evolution of skull base surgery over the past decade has been influenced by advancement in visualization technology. Recently, as a result of such improvements, three-dimensional (3-D) scopes have been widely used during endoscopic endonasal approaches. In the present study, we describe the use of 3-D stereoscopic endoscope for the treatment of a variety of skull base lesions. Read More

    Recurrence of hyperprolactinemia following dopamine agonist withdrawal and possible predictive factors of recurrence in prolactinomas.
    J Endocrinol Invest 2016 Dec 31;39(12):1377-1382. Epub 2016 May 31.
    Unit of Endocrinology and Diabetology - Pad. Granelli, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Via F. Sforza, 35, 20122, Milan, Italy.
    Background: The optimal duration of cabergoline (CAB) treatment of prolactinomas that minimizes recurrences is not well established. 2011 Endocrine Society Guidelines suggested that withdrawal may be safely undertaken after 2 years in patients achieving normoprolactinemia and tumor reduction.

    Materials: We analyzed 74 patients (mean age = 46. Read More

    Proopiomelanocortin, glucocorticoid, and CRH receptor expression in human ACTH-secreting pituitary adenomas.
    Endocrine 2016 May 24. Epub 2016 May 24.
    Neuroendocrinology Research Laboratory, Istituto Auxologico Italiano IRCCS, Cusano Milanino, Milan, Italy.
    ACTH-secreting pituitary tumors are by definition partially autonomous, i.e., secrete ACTH independent of physiological control. Read More

    Atypical pituitary adenomas: clinical characteristics and role of ki-67 and p53 in prognostic and therapeutic evaluation. A series of 50 patients.
    Neurosurg Rev 2017 Jan 23;40(1):105-114. Epub 2016 May 23.
    Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, Italy.
    The aim of the study was to assess incidence rate, hormonal activity, and local invasiveness and evaluate outcomes of so-diagnosed atypical pituitary adenomas that underwent endoscopic endonasal surgery at the Division of Neurosurgery of Università degli Studi di Napoli Federico II. According to the 2004 WHO classification, atypical pituitary adenomas are defined by an invasive growth, Ki-67/MIB-1 proliferative index greater than 3 %, high p53 immunoreactivity, and increased mitotic activity. A retrospective analysis of a series of 434 pituitary adenomas that underwent endoscopic endonasal surgery at our department between March 2007 and February 2013 was performed. Read More

    Primary versus revision transsphenoidal resection for nonfunctioning pituitary macroadenomas: matched cohort study.
    J Neurosurg 2016 May 20:1-8. Epub 2016 May 20.
    Departments of 1 Neurosurgery and.
    OBJECTIVE The object of this study was to compare the outcomes of primary and revision transsphenoidal resection (TSR) of nonfunctioning pituitary macroadenomas (NFPMAs) using endoscopic methods. METHODS The authors retrospectively reviewed the records of 287 consecutive patients who had undergone endoscopic endonasal TSR for NFPMAs at their institution in the period from 2005 to 2011. Fifty patients who had undergone revision TSR were retrospectively matched for age, sex, and duration of follow-up to 46 patients who had undergone primary TSR. Read More

    Intraoperative Magnetic Resonance Imaging During Endoscopic Transsphenoidal Surgery of Growth Hormone-Secreting Pituitary Adenomas.
    World Neurosurg 2016 Jul 3;91:490-6. Epub 2016 May 3.
    Department of Neurosurgery, 1st Faculty of Medicine, Charles University, Central Military Hospital, Prague, Czech Republic.
    Background: The effect of intraoperative magnetic resonance imaging (iMRI) on the extent of sellar region tumors treated endonasally has been described in previous research. However, the effects of iMRI on endocrinologic outcome of growth hormone-secreting adenomas have been studied in only a few small cohort studies.

    Methods: Inclusion criteria were primary transsphenoidal surgery for growth hormone-secreting adenoma from January 2009 to December 2014, a minimum follow-up of 1 year, complete endocrinologic data, at least 1 iMRI, and at least 2 postoperative magnetic resonance images. Read More

    Giant prolactinomas larger than 60 mm in size: a cohort of massive and aggressive prolactin-secreting pituitary adenomas.
    Pituitary 2016 Aug;19(4):429-36
    Experimental Endocrinology Unit, Hospital de Especialidades, Centro Médico Nacional S.XXI, IMSS, Mexico City, Mexico.
    Objectives: Prolactin (PRL)-secreting macroadenomas usually measure between 10 and 40 mm. Giant (adenoma size ≥40 mm) PRL-tumors are not common, and larger prolactinomas (maximal diameter ≥60 mm) are rare, and their management outcomes have not been well characterized.

    Methods: We have identified 18 subjects (16 men, 2 females) with giant PRL-adenomas (size ≥60 mm; PRL > 1000 ng/ml) and summarized their characteristics and response to treatment. Read More

    Mononostril versus Binostril Endoscopic Transsphenoidal Approach for Pituitary Adenomas: A Systematic Review and Meta-Analysis.
    PLoS One 2016 28;11(4):e0153397. Epub 2016 Apr 28.
    Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China.
    Background: Over the past several decades, the endoscopic endonasal transsphenoidal approach (EETA) has gradually become a preferred option of pituitary adenomas surgery because of its minimal invasiveness and high efficiency. However, some EETA operations were performed through one nostril (mononostril), while other EETA operations were performed through both nostrils (binostril). Therefore, we conducted this study to compare the pros and cons of these two methods in an attempted to confirm which method is more effective. Read More

    A Benchmark for Preservation of Normal Pituitary Function After Endoscopic Transsphenoidal Surgery for Pituitary Macroadenomas.
    World Neurosurg 2016 Jul 23;91:371-5. Epub 2016 Apr 23.
    Division of Neuroradiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
    Introduction: We report a contemporary consecutive series of 80 patients operated on for benign pituitary macroadenomas, followed endocrinologically for at least 3 months postoperatively. These patients were systematically evaluated preoperatively by high-resolution magnetic resonance imaging designed to detect the position of normal gland relative to the lesion. The rate of preservation of normal pituitary was critically analyzed using this strategy combined with endoscopic transsphenoidal resection. Read More

    MANAGEMENT OF ENDOCRINE DISEASE: Pituitary 'incidentaloma': neuroradiological assessment and differential diagnosis.
    Eur J Endocrinol 2016 Oct 11;175(4):R171-84. Epub 2016 Apr 11.
    Department of EndocrinologyCentre Hospitalier Universitaire de Liège, University of Liège, Belgium
    Pituitary incidentalomas are a by-product of modern imaging technology. The term 'incidentaloma' is neither a distinct diagnosis nor a pathological entity. Rather, it is a collective designation for different entities that are discovered fortuitously, requiring a working diagnosis based on the input of the radiologist, endocrinologist and often a neurosurgeon. Read More

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