Pituitary 2017 May 18. Epub 2017 May 18.

Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal.

Objective: Prolactinomas are the most common functional pituitary tumour. Dopamine agonists (DA) are its principal treatment. The criteria that should guide therapy withdrawal and the factors that influence disease remission or relapse are not yet fully established. Read More

Acta Otorhinolaryngol Ital 2017 Jun;37(3):237-241

Institute of Otorhinolaryngology, Catholic University School of Medicine, Rome, Italy.

During the last two decades endoscopic skull base surgery observed a continuous technical and technological development 3D endoscopy and ultra High Definition (HD) endoscopy have provided great advances in terms of visualisation and spatial resolution. Ultra-high definition (UHD) 4K systems, recently introduced in the clinical practice, will shape next steps forward especially in skull base surgery field. Patients were operated on through transnasal transsphenoidal endoscopic approaches performed using Olympus NBI 4K UHD endoscope with a 4 mm 0° Ultra Telescope, 300 W xenon lamp (CLV-S400) predisposed for narrow band imaging (NBI) technology connected through a camera head to a high-quality control unit (OTV-S400 - VISERA 4K UHD) (Olympus Corporation, Tokyo, Japan). Read More

Clin Neurol Neurosurg 2017 May 4;158:90-92. Epub 2017 May 4.

Department of Medical Chemistry, Medical University of Lublin, Chodźki 4, 20-093 Lublin, PL, Poland. Electronic address:

Objective: Gelatinases, Matrix MetalloProteinase(MMP)-2 and MMP-9, belong to zinc-dependent endopeptidases involved in several physiological and pathological processes including inflammation and tumor development. Because the information about the involvement of gelatinases in pituitary adenoma (PA) development are scant, our objective was the analysis of MMP-2 and MMP-9 activity in serum and tumor tissue of PA patients.

Patients And Methods: Twenty one patients with PA (macroadenoma n=18, microadenoma n=3), qualified to the endoscopic resection of tumors were enrolled. Read More

World Neurosurg 2017 Apr 29. Epub 2017 Apr 29.

Pituitary Center; Department of Neurosurgery, Seoul National University College of Medicine. Electronic address:

Objective: Endoscopic transsphenoidal surgery has recently been introduced in pituitary surgery. We investigated outcomes and complications of endoscopic surgery in two referral centers in Korea.

Methods: We enrolled 134 patients with acromegaly (microadenomas, n=15; macroadenomas, n=119) who underwent endoscopic transsphenoidal surgery at Seoul National University Hospital (n=74) and Samsung Medical center (n=60) between Jan 2009 and Mar 2016. Read More

World Neurosurg 2017 Apr 28. Epub 2017 Apr 28.

Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, 1 Gustave L. Levy Place, New York, NY, 10029, USA. Electronic address:

Introduction: Pituitary adenomas are the most common intrasellar mass. Functional pituitary adenomas (PAs) constitute the majority of pituitary tumors and can produce symptoms related to hormonal overproduction. Timely and accurate detection is therefore of vital importance to prevent potentially irreversible sequelae. Read More

J Neurosurg 2017 Apr 28:1-7. Epub 2017 Apr 28.

Department of Neurological Surgery and.

OBJECTIVE Many centers use conventional and dynamic contrast-enhanced MRI (DMRI) sequences in patients with Cushing's disease. The authors assessed the utility of the 3D volumetric interpolated breath-hold examination, a spoiled-gradient echo 3D T1 sequence (SGE) characterized by superior soft tissue contrast and improved resolution, compared with DMRI and conventional MRI (CMRI) for detecting microadenomas in patients with Cushing's disease. METHODS This study was a blinded assessment of pituitary MRI in patients with proven Cushing's disease. Read More

Front Endocrinol (Lausanne) 2017 22;8:55. Epub 2017 Mar 22.

Laboratory of Hormones and Molecular Genetics LIM-42, University of São Paulo Medical School, São Paulo, Brazil; Endocrinology Service, AC Cancer Center, São Paulo, Brazil.

ACTH-dependent hypercortisolism caused by a pituitary adenoma [Cushing's disease (CD)] is the most common cause of endogenous Cushing's syndrome. CD is often associated with several morbidities, including hypertension, diabetes, osteoporosis/bone fractures, secondary infections, and increased cardiovascular mortality. While the majority (≈80%) of the corticotrophinomas visible on pituitary magnetic resonance imaging are microadenomas (MICs, <10 mm of diameter), some tumors are macroadenomas (MACs, ≥10 mm) with increased growth potential and invasiveness, exceptionally exhibiting malignant demeanor. Read More

Neurosurgery 2017 Mar 29. Epub 2017 Mar 29.

Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California.

Background: Long-term remission rates from endoscopic transsphenoidal surgery for acromegaly and their relationship to prognostic indicators of disease aggressiveness are not well documented.

Objective: To investigate long-term remission rates in patients with acromegaly after endoscopic transsphenoidal surgery, and correlate this with molecular and radiographic markers of disease aggressiveness.

Methods: We identified all patients undergoing endoscopic transsphenoidal surgery for acromegaly from 2005 to 2013 at Cedars-Sinai Pituitary Center. Read More

Neurol Res 2017 May 16;39(5):387-398. Epub 2017 Mar 16.

a Department of Pharmaceutical Business and Administrative Sciences , MCPHS University , Boston , MA , USA.

Objectives: Growth hormone-secreting pituitary adenomas in adults can result in severe craniofacial disfigurement and potentially fatal medical complications. Surgical resection leading to remission of the disease is dependent on complete surgical resection of the tumor. Lesions that invade the cavernous sinus may not be safely accessible via an endonasal transsphenoidal surgery (TSS), and the rates of biochemical remission of patients with residual disease vary widely in the literature. Read More

Pituitary 2017 Mar 6. Epub 2017 Mar 6.

Department of Neurosurgery, the Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.

Context: Transsphenoidal surgery (TSS) to resect a pituitary adenoma is considered first-line treatment for patients with Cushing's disease (CD). Early, post-operative remission rates >80% are expected for patients with a microadenoma (≤ 10 mm) visible on magnetic resonance (MR) imaging.

Objective: To report surgical outcomes and predictors of remission in a specialist center for patients with CD. Read More

Arch Endocrinol Metab 2017 Feb 13. Epub 2017 Feb 13.

Department of Endocrinology and Metabolism, Diskapi Teaching and Research Hospital, Irfan Bastug Caddesi, Ankara, Turkey.

Ectopic adrenocorticotropic hormone (ACTH) syndrome is characterized by hypercortisolism due to the hypersecretion of a non-pituitary ACTH-secreting tumor leading to Cushing's syndrome. Only a few cases have been reported previously as causing ectopic ACTH related to paraganglioma. Herein, we present a case of Cushing's syndrome, in who was proved to be attributable to an ACTH-secreting renal malignant paraganglioma. Read More

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

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

Zhonghua Yi Xue Za Zhi 2016 Dec;96(47):3825-3828

Department of Neurosurgery, Peking Union Medical College (PUMC) Hospital, China Academy of Medical Sciences & PUMC, Beijing 100730, China.

Objective: To explore the clinical characteristics of thyrotropin-secreting pituitary adenomas and the effect of the transsphenoidal approach of procedure with/without drug treatment for thyrotropin-secreting pituitary adenomas, and to investigate the correlation between the prognosis of thyrotropin-secreting pituitary adenomas and the postoperative level of thyroid stimulating hormone (TSH). Methods: A total of 45 patients with thyrotropin-secreting pituitary adenoma who hospitalized in Peking Union Medical College Hospital from 2000 to 2015 were enrolled in the study.We collected the clinical features, hormone levels, imaging findings, treatment and follow-up data of these patients. Read More

World Neurosurg 2017 Feb 18;98:870.e5-870.e10. Epub 2016 Dec 18.

Department of Otolaryngology, University of Louisville, Louisville, Kentucky, USA.

Background: Complete surgical resection of an adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma is the gold standard of treatment of Cushing disease. Ectopic location of these adenomas is an extremely rare condition that may compromise the diagnosis and surgical success. We present the first case of an ectopic intracavernous ACTH-secreting macroadenoma totally resected with endoscopic endonasal surgery (EES). Read More

Arch Endocrinol Metab 2016 Nov-Dec;60(6):554-561. Epub 2016 Aug 25.

Research in Internal Medicine Unit, Department of Internal Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

Objectives: The main purpose of this study was to estimate the incidence rate and prevalence of clinically relevant pituitary adenomas (PAs) within the Hospital Italiano Medical Care Program (HIMCP), a well-defined population of 150,000 members living in the urban and suburban area of the city of Buenos Aires. We defined clinically relevant PAs as those associated with endocrine dysfunction and/or mass effect.

Subjects And Methods: A retrospective open cohort study was conducted, including all members of the HIMCP over 18 years old, with active memberships during the period of the study, from January 1st 2003, to January 1, 2014. Read More

Endocr Metab Immune Disord Drug Targets 2016 ;16(4):249-253

University of Luebeck, Department of Medicine I, Ratzeburger Allee 160, 23538 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

Eur J Endocrinol 2017 Feb 22;176(2):K1-K7. Epub 2016 Nov 22.

Department of EndocrinologyGreat Ormond Street Hospital for Children, London, UK

Context: Pituitary microadenomas and adrenal tumours are the most common causes for endogenous Cushing syndrome (CS) in children.

Case Description: We describe a two-year old girl with Cushing syndrome due to ectopic pro-opiomelanocortin (POMC) production from an abdominal yolk sac tumor. Cortisol concentrations were elevated but adrenocorticotropic hormone (ACTH) concentrations were equivocal. Read More

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

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

Pituitary 2016 Dec;19(6):601-604

Division of Endocrinology Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, 645 N. Michigan Avenue, Suite 530, Chicago, IL, 60611, USA.

Purpose: The objective of this case report is to demonstrate that the simple expedient of measuring periodic prolactin levels in patients with MEN1 who have modest hyperprolactinemia and normal pituitary MRI scans is insufficient to monitor for the development of pituitary adenomas.

Methods: Review of relevant literature and chart review.

Results: A 25 year old man with known MEN1 manifested by hyperparathyroidism and a gastrin-producing neuroendocrine tumor was found to have a prolactin [PRL] level of 20. Read More

Pituitary 2016 Dec;19(6):547-551

Division of Metabolism, Endocrinology, and Diabetes, Internal Medicine Department, University of Michigan, 24 Frank Lloyd Wright Drive, G-1500, P.O. Box 482, Ann Arbor, MI, 48106, USA.

Purpose: Approximately 25 % of cases of clinically active acromegaly cases treated in our academic center between 1996 and 2000, were diagnosed in patients who had elevated plasma IGF-1 levels, but apparently "normal" 24-h mean plasma GH levels. The current study served to update the data for patients with acromegaly referred to our facility, after increasing awareness of this "normal" GH subpopulation throughout the medical community.

Methods: A retrospective chart review was conducted on 157 patients with acromegaly who underwent resection of a confirmed somatotroph pituitary adenoma at the University of Michigan Health System between the dates of 1 Jan 2001 to 23 Sept 2015. Read More

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

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

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

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

Zhonghua Yi Xue Za Zhi 2016 Aug;96(31):2458-61

Peking Union Medical College Hospital, CAMS& PUMC, Beijing 100730, China.

Objective: To predict the therapeutic effect of Cushing's disease after transsphenoidal surgery by using morning serum cortisol level.

Methods: The clinical data of 275 cases that had transsphenoidal surgery in Peking Union Medical College Hospital from 2010 to 2014 were analyzed retrospectively.Early morning serum cortisol level less than 140 nmol/L 3 days postoperation was usedto predict endocrinological remission. Read More

World Neurosurg 2016 Nov 18;95:464-468. Epub 2016 Aug 18.

Center of Surgery for Pituitary Tumors and Endoscopic Skull Base Surgery, Department of Neurosurgery, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy.

Background: The collection of the greatest possible amount of pathologic tissue is of paramount importance in neurosurgery to achieve the most accurate histopathologic diagnosis, to perform all of the necessary biomolecular tests on the pathologic specimen, and to collect biological material for basic or translational science studies. This problem is particularly relevant in pituitary surgery because of the possible small size and soft consistency of tumors, which make them suitable for removal through suction, reducing the amount of available pathologic tissue. To solve this issue, we adopted a filter connected to the suction tube, which allows the surgeon to collect all of the tissue aspirated during surgery. Read More

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

Endocrine 2017 Mar 19;55(3):691-696. Epub 2016 Jul 19.

Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy.

Adrenocorticotropin-secreting pituitary tumor represents about 10 % of pituitary adenomas and at the time of diagnosis most of them are microadenomas. Transsphenoidal surgery is the first-line treatment of Cushing's disease and accurate localization of the tumor within the gland is essential for selectively removing the lesion and preserving normal pituitary function. Magnetic resonance imaging is the best imaging modality for the detection of pituitary tumors, but adrenocorticotropin-secreting pituitary microadenomas are not correctly identified in 30-50 % of cases, because of their size, location, and enhancing characteristics. Read More

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

Endocrine 2017 Mar 24;55(3):853-860. 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

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

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

Front Horm Res 2016 15;45:97-120. Epub 2016 Mar 15.

Service d'Endocrinologie, Centre Hospitalier Universitaire de Liège, Liège, Belgium.

Magnetic Resonance Imaging (MRI) is currently considered a major keystone of the diagnosis of diseases of the hypothalamic-hypophyseal region. However, the relatively small size of the pituitary gland, its location deep at the skull base and the numerous physiological variants present in this area impede the precise assessment of the anatomical structures and, particularly, of the pituitary gland itself. The diagnosis of the often tiny lesions of this region--such as pituitary microadenomas--is then difficult if the MRI technology is not optimized and if potential artifacts and traps are not recognized. Read More

J Neurosurg 2016 Dec 18;125(6):1451-1459. Epub 2016 Mar 18.

Radiology and Imaging Sciences, the National Institutes of Health, Bethesda, Maryland.

OBJECTIVE Pituitary MR imaging fails to detect over 50% of microadenomas in Cushing's disease and nearly 80% of cases of dural microinvasion. Surface coils can generate exceptionally high-resolution images of the immediately adjacent tissues. To improve imaging of the pituitary gland, a receive-only surface coil that can be placed within the sphenoid sinus (the endosphenoidal coil [ESC]) during transsphenoidal surgery (TSS) was developed and assessed. Read More

Arch Endocrinol Metab 2016 Feb;60(1):42-6

Departamento de Neuroendocrinología (Neuroendocrinology Department), Sociedad Argentina de Endocrinología y Metabolismo, Ciudad Autónoma de Buenos Aires, Argentina.

Objetive: The aim was to assess the evolution of tumor size and prolactin (PRL) levels in patients with micro and macroprolactinomas diagnosed and treated with dopamine agonists during fertile age, and the effects of suspension of drugs after menopause.

Subjects And Methods: Retrospective study, 29 patients with prolactinomas, 22 microadenomas and 7 macroadenomas, diagnosed during their fertile age were studied in their menopause; treatment was stopped in this period. Age at menopause was 49 ± 3. Read More

Zhonghua Yi Xue Za Zhi 2015 Oct;95(39):3213-6

Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; Email:

Objective: To analyze the outcome in patients who underwent transsphenoidal surgery (TSS) with Cushing's disease (CD) with no visible adenoma on magnetic resonance imaging (MRI).

Methods: Between 2012 and 2014, 118 patients with CD underwent TSS at PUMCH. We retrospectively analyzed data in 43 patients without visible adenomas on MRI and compared them with 75 patients with MRI-visible microadenomas. Read More

Eur J Endocrinol 2016 Apr 25;174(4):539-49. Epub 2016 Jan 25.

Departments of Endocrinology and Isotope TherapyNeurosurgeryMilitary Institute of Medicine, ul. Szaserów 128, 04-141 Warsaw, PolandDepartment of Epidemiology and BiostatisticsInstitute of Mother and Child, ul. Kasprzaka 17a, 01-211 Warsaw, PolandDepartment of PathologyM. Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, ul. Roentgena 5, 02-781 Warsaw, Poland.

Objective: Corticotroph macroadenomas are a rare cause of Cushing's disease (CD), but their properties are not well-recognised. The aim of this study was to evaluate the clinical and pathological aspects of corticotroph macroadenomas with particular emphasis on proliferation markers and their associations with the efficacy of surgical treatment.

Design: A prospective cohort study was conducted in a tertiary referral centre in Poland. Read More

World Neurosurg 2016 Apr 12;88:270-6. Epub 2016 Jan 12.

Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. Electronic address:

Background: Acromegaly is a multisystemic disease that requires a multidisciplinary approach. The aim of this study was to determine early and late remissions of patients who underwent surgery at our center and to evaluate relations between pathologic and radiologic properties of adenoma and medical and radiosurgical treatments with remissions.

Methods: The medical records of 103 patients with acromegaly who underwent endoscopic endonasal transsphenoidal surgery in Cerrahpasa Medical Faculty, Istanbul University, between 2007 and 2014 were reviewed. Read More

Endocr Pract 2016 04 20;22(4):466-75. Epub 2016 Jan 20.

Objective: We conducted a systematic review and meta-analysis to synthesize the evidence about predictors that may affect biochemical remission and recurrence after transsphenoidal surgery (TSS), radiosurgery (RS), and radiotherapy (RT) in Cushing disease.

Methods: We searched multiple databases through December 2014 including original controlled and uncontrolled studies that enrolled patients with Cushing disease who received TSS (first-line), RS, or RT. We extracted data independently, in duplicates. Read More

Clin Endocrinol (Oxf) 2016 Jun 12;84(6):858-61. Epub 2016 Feb 12.

Edinburgh Centre for Endocrinology and Diabetes, NHS Lothian and University of Edinburgh, Edinburgh, UK.

Objective: Hypogonadotrophic hypogonadism (HH) is commonly associated with ageing, obesity and type 2 diabetes. The indications for pituitary imaging are controversial, and current guidelines are based on small case series.

Design: Retrospective case series from a secondary/tertiary endocrinology referral centre. Read More

J Mol Neurosci 2016 Jan 16;58(1):137-44. Epub 2015 Dec 16.

Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China.

In recent years, the tissue inhibitor of metalloproteinase-3 (TIMP3) plays a pivotal role in tumorigenesis, while the role of TIMP3 in adrenocorticotrophic hormone (ACTH)-secreting pituitary adenomas remains unclear. In this study, 86 sporadic pituitary tumor specimens, including ACTH (40), GH (18), PRL-secreting (8), and non-functioining (20) and non-tumorous pituitary samples (n = 10) were available, and then, the mRNA and protein expression of TIMP3 was quantified by quantitative reverse transcriptase polymerase chain reaction (RT-PCR), western blotting, and immunohistochemistry, respectively. Our findings showed that TIMP3 expression was significantly correlated with Ki-67 expression and the invasiveness of pituitary adenomas. Read More

Clin Nucl Med 2016 Mar;41(3):e130-4

From the Departments of *Neurosurgery and Pituitary Tumor Center, and ‡Nuclear Medicine, The First Affiliated Hospital; and †Department of Histology and Embryology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.

Purpose: MRI is commonly used in the evaluation of pituitary adenomas (PAs). However, it has difficulty to locate the lesions sometimes, especially microadenomas and/or postoperative recurrent tumors. We aimed to evaluate the role of combined C-methionine (MET) and F-FDG PET/CT in patients with functioning PAs. Read More

Eur J Endocrinol 2016 Feb 17;174(2):213-26. Epub 2015 Nov 17.

Departments of Endocrinology and MetabolismPathologyToranomon Hospital, 2-2-2 Toranomon, Minato, Tokyo 105-8470, JapanDepartment of Biological SciencesTokyo Institute of Technology, 4259-B16 Nagatsuta, Midori, Yokohama 226-8501, JapanDepartment of Hypothalamic and Pituitary SurgeryToranomon Hospital, 2-2-2 Toranomon, Minato, Tokyo 105-8470, JapanOkinaka Memorial Institute for Medical Research2-2-2 Toranomon, Minato, Tokyo 105-8470, Japan Departments of Endocrinology and MetabolismPathologyToranomon Hospital, 2-2-2 Toranomon, Minato, Tokyo 105-8470, JapanDepartment of Biological SciencesTokyo Institute of Technology, 4259-B16 Nagatsuta, Midori, Yokohama 226-8501, JapanDepartment of Hypothalamic and Pituitary SurgeryToranomon Hospital, 2-2-2 Toranomon, Minato, Tokyo 105-8470, JapanOkinaka Memorial Institute for Medical Research2-2-2 Toranomon, Minato, Tokyo 105-8470, Japan

Context: Somatic mutations in the ubiquitin-specific peptidase USP8 gene were recently detected in one- to two-third(s) of corticotroph adenomas of Cushing's disease (CD). These mutations may lead to the deubiquitination of EGFR, thereby increasing EGFR signaling, which has been implicated in ACTH hypersecretion.

Objective: Our objective was to determine the impact of USP8 mutations on the clinicopathological features of CD. Read More

Acta Neurochir (Wien) 2016 Jan 17;158(1):77-86; discussion 86. Epub 2015 Nov 17.

Sections of Neurosurgery Department of Neurological Sciences, Christian Medical College, Vellore, India.

Background: This study was performed to examine patient outcomes following pure endoscopic transsphenoidal surgery (ETS) for Cushing's disease (CD).

Method: We studied 64 consecutive patients who underwent 69 endoscopic transsphenoidal procedures. Radiological evaluation comprised detailed examination of preoperative magnetic resonance images (MRI), including positron emission tomography (PET) for select cases. Read More

Ann Endocrinol (Paris) 2015 Oct 26;76(5):614-9. Epub 2015 Oct 26.

Bezmialem University, Department of Endocrinology and Metabolism, Vatan Caddesi, 34093 Istanbul, Turkey.

Objectives: Genetic alterations explaining the clinical variability of prolactinomas still could not be clarified and dopamine D2 receptor (DRD2) polymorphism is a putative candidate for the variable response to dopaminergic treatment. The present study was conducted to investigate the influence of DRD2 TaqI A polymorphism on initial and follow-up characteristics of prolactinoma.

Patients And Methods: Seventy-two patients with prolactinoma and 98 age and gender matched control subjects were recruited to the case-control study. Read More

Minerva Endocrinol 2016 Sep 20;41(3):351-65. Epub 2015 Oct 20.

Experimental Endocrinology Unit, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Mexico City, Mexico -

Acromegaly is a chronic systemic disorder caused in the vast majority of cases by a GH-secreting pituitary adenoma and resulting in significant morbidity and mortality if left untreated. The treatment of choice is the trans-sphenoidal resection of the adenoma, and although 80% of patients with microadenomas or confined macroadenomas achieve biochemical remission, the surgical success rate for patients harboring tumors with extrasellar extension is below 50%. Thus, a considerable proportion of patients will require some form of adjuvant treatment. Read More

Endocr J 2015 17;62(12):1115-25. Epub 2015 Oct 17.

Department of Hypothalamic & Pituitary Surgery, Toranomon Hospital, Tokyo 105-8470, Japan.

This study aimed to investigate early and late outcomes of patients who underwent neurosurgical procedures for the preoperative diagnosis of Cushing's disease (CD). Clinical, endocrine, imaging, and histologic data from 252 patients undergoing pituitary surgery at Toranomon Hospital through the end of 2012 were entered into a database and statistically analyzed. In 22 of these patients (8. Read More

Exp Clin Endocrinol Diabetes 2015 Oct 14;123(9):571-4. Epub 2015 Oct 14.

Department of Medicine I, Christian-Albrechts-University, Kiel, Germany.

Introduction: Headache and depression are common problems in patients with hypothalamic-pituitary disorders (HPD).

Aim: To determine the prevalence of headache and depression in patients with HPD and the specific characteristics in affected individuals in comparison to patients with cardiovascular problems (CD).

Methods: Patients with HPD and CD were asked to complete a questionnaire regarding headache and depression. Read More