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    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

    [The surgery of thyrotropin-secreting pituitary adenomas and the significance of thyroid stimulating hormone level in follow-up].
    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

    Endoscopic Endonasal Surgery for Remission of Cushing Disease Caused by Ectopic Intracavernous Macroadenoma: Case Report and Literature Review.
    World Neurosurg 2016 Dec 18. 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

    Incidence and prevalence of clinically relevant pituitary adenomas: retrospective cohort study in a Health Management Organization in Buenos Aires, Argentina.
    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

    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

    Cushing syndrome in a child due to pro-opiomelanocortin (POMC) secretion from a yolk sac tumor.
    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

    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

    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

    Pituitary tumors in MEN1: do not be misled by borderline elevated prolactin levels.
    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

    "Micromegaly": an update on the prevalence of acromegaly with apparently normal GH secretion in the modern era.
    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

    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:
    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

    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

    Suction Filter in Endoscopic Endonasal Surgery: A Technical Note.
    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

    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

    Pituitary magnetic resonance imaging in Cushing's disease.
    Endocrine 2016 Jul 19. 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

    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

    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

    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

    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

    Magnetic Resonance Imaging of Pituitary Tumors.
    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

    Endosphenoidal coil for intraoperative magnetic resonance imaging of the pituitary gland during transsphenoidal surgery.
    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

    Prolactinomas: evolution after menopause.
    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

    [Diagnosis and surgical management in patients with Cushing disease with negative magnetic resonance imaging].
    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

    Clinicopathological predictive factors in the early remission of corticotroph pituitary macroadenomas in a tertiary referral centre.
    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

    Multidisciplinary Approach for Acromegaly: A Single Tertiary Center's Experience.
    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

    The prevalence of structural pituitary abnormalities by MRI scanning in men presenting with isolated hypogonadotrophic hypogonadism.
    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

    The Clinical Utility of TIMP3 Expression in ACTH-Secreting Pituitary Tumor.
    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

    Utility of 11C-Methionine and 18F-FDG PET/CT in Patients With Functioning Pituitary Adenomas.
    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

    The USP8 mutational status may predict drug susceptibility in corticotroph adenomas of Cushing's disease.
    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

    Pure endoscopic transsphenoidal surgery for functional pituitary adenomas: outcomes with Cushing's disease.
    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

    Does DRD2 polymorphism influence the clinical characteristics of prolactinoma?
    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

    Current status and future directions of pharmacological therapy for acromegaly.
    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

    Therapeutic outcomes in patients undergoing surgery after diagnosis of Cushing's disease: A single-center study.
    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

    Headache and Depression in Patients with Hypothalamic-pituitary Disorders-etiology and Risk Factors.
    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

    Do We Need Hormonal Screening In Patients With Subcentimeter Pituitary Microadenomas?
    Bol Asoc Med P R 2015 Apr-Jun;107(2):89-91
    A 54-year-old woman came to our endocrinology clinics presenting with upper and lower extremity paresthesia, salt cravings, episodes of hypotension, fatigue and a long term history of depression. Physical exam was unremarkable. Cervical and brain MRI ordered by her neurologist three years ago revealed sella and pituitary normal in size, stable very small 3 mm pituitary incidentaloma and mild disc bulging. Read More

    [The importance of electrophysiological tests in early diagnosis of optic nerve dysfunction coexisting with pituitary adenomas--review and own experience].
    Klin Oczna 2015 ;117(1):50-5
    The paper discusses the role of electrophysiological testing (pattern electroretinogram, pattern visual evoked potentials, multifocal visual evoked potentials) in the early diagnosis of the optic nerve and retinal dysfunction secondary to pituitary tumors. Microadenomas and macroadenomas may cause dysfunction of retinal ganglio~ cells and their axons, even in the absence of changes in the routine ophthalmic examination, perimetry and optical coherent tomography of the optic disc. The early stage of optic nerve dysfunction may only be detected by pattern visual evoked potentials and/or multifocal visual evoked potentials. Read More

    Outcome of Transsphenoidal Surgery for Cushing Disease: A Single-Center Experience Over 32 Years.
    Neurosurgery 2016 Feb;78(2):216-23
    *Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan; ‡Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, Michigan; §Michigan Endocrine Consultants, Berkley, Michigan; ¶Department of Neurosurgery, University of San Diego Health System, San Diego, California; ‖Pediatric Neurosurgery Associates, Children's Healthcare of Atlanta, Atlanta, Georgia.
    Background: Transsphenoidal surgery is the standard approach for treating Cushing disease. Evidence is needed to document effectiveness.

    Objective: To analyze results of transsphenoidal surgery in 276 consecutive patients, including 19 children. Read More

    Longitudinal evaluation of the natural history of conservatively managed nonfunctioning pituitary adenomas.
    Clin Endocrinol (Oxf) 2015 Aug 20. Epub 2015 Aug 20.
    Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
    Context: The optimal management of nonfunctioning pituitary adenomas presenting without symptomatic mass effect remains uncertain. The objective of this study was to elucidate the natural history of nonfunctioning pituitary adenomas managed conservatively.

    Design: Volumetric evaluation of tumour growth in serial pituitary MRI scans by a single observer and retrospective review of changes in pituitary function. Read More

    [Pituitary tumors: 10 years of experience].
    Rev Fac Cien Med Univ Nac Cordoba 2015 ;72(1):32-8
    Introduction: Pituitary tumors comprise a quarter of the intracranial neoplasms and the adenomas represent the highest percentage of them. They are benign, but they can be invasive and they have an impact in morbidity and mortality.

    Objective: To analyze the clinical features of pituitary adenomas tumors, and create a computerized registry to improve strategies for diagnosis and monitoring of these patients. Read More

    Retrospective observational analysis of non-irradiated non-functioning pituitary adenomas.
    J Endocrinol Invest 2015 Nov 28;38(11):1191-7. Epub 2015 Jul 28.
    Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Ospedale S. Giovanni Battista-Molinette, Dogliotti 14, 10126, Turin, Italy.
    Purpose: The management of choice of non-functioning pituitary adenomas (NFPAs) remains debulking surgery when symptomatic. However, patient series systematically reporting the NFPAs outcome that were not treated either surgically, medically or with radiotherapy during long follow-up thereby giving an indication of their natural history are limited. Aim of the present study was to evaluate the natural course of presumed NFPAs, the outcome of confirmed NFPAs during a long follow-up period. Read More

    Clinical outcomes in patients with nonfunctioning pituitary adenomas managed conservatively.
    Clin Endocrinol (Oxf) 2015 Dec 12;83(6):861-5. Epub 2015 Aug 12.
    Imperial College Healthcare NHS Trust, London, UK.
    Context: The natural history and the optimum management of patients with nonfunctioning pituitary adenomas (NFPAs) are unclear.

    Objective: Our objective was to characterize the natural history of patients with NFPAs managed conservatively.

    Design And Patients: We conducted a retrospective analysis of patients presenting to a tertiary referral centre between 1986 and 2009. Read More

    J Endocrinol 2015 Aug 1;226(2):T141-60. Epub 2015 Jul 1.
    Department of EndocrinologyCarol Davila University of Medicine and Pharmacy, Bucharest, RomaniaCI Parhon National Institute of EndocrinologyBucharest, RomaniaDepartment of EndocrinologyOxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Old Road, Headington, Oxford OX3 7LE, UK
    Acromegaly (ACM) is a chronic, progressive disorder caused by the persistent hypersecretion of GH, in the vast majority of cases secreted by a pituitary adenoma. The consequent increase in IGF1 (a GH-induced liver protein) is responsible for most clinical features and for the systemic complications associated with increased mortality. The clinical diagnosis, based on symptoms related to GH excess or the presence of a pituitary mass, is often delayed many years because of the slow progression of the disease. Read More

    Long-Term Natural Course of Pituitary Tumors in Patients With MEN1: Results From the DutchMEN1 Study Group (DMSG).
    J Clin Endocrinol Metab 2015 Sep 30;100(9):3288-96. Epub 2015 Jun 30.
    Department of Endocrine Oncology (J.M.d.L., C.R.C.P., W.P.K., G.D.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrinology and Metabolism (O.M.D., A.M.P.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Department of Endocrinology (A.R.H.), Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands Department of Endocrinology (A.N.v.d.H.-S.), University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Internal Medicine, Section Endocrinology (M.L.D.), VU University Medical Center, 1007 MB Amsterdam, The Netherlands; Department of Endocrinology and Metabolism (P.H.B.), Academic Medical Center, 1100 DD Amsterdam Zuidoost, The Netherlands; Department of Internal Medicine, Division of Endocrinology (B.H.), Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands; and Department of Internal Medicine (W.W.d.H.), Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands.
    Context: Guidelines advise lifelong radiological followup for asymptomatic pituitary adenomas (PITs) because of the risk for growth and subsequent visual field defects. In the context of multiple endocrine neoplasia type 1 (MEN1) an even more comprehensive screening is advised because PITs are presumed to manifest more aggressive behavior. We studied the long-term course of MEN1-related PITs, which may be used as a model for sporadically occurring PITs. Read More

    Characteristic location and growth patterns of functioning pituitary adenomas: correlation with histological distribution of hormone-secreting cells in the pituitary gland.
    Clin Imaging 2015 Sep-Oct;39(5):770-4. Epub 2015 Jun 3.
    Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea, South Korea.
    Objective: To evaluate the correlation between the magnetic resonance imaging findings of functional pituitary adenomas and histological distribution of hormone-secreting cells in pituitary gland.

    Methods: Forty-nine patients with pathologically confirmed functional micro and macro pituitary adenomas were retrospectively reviewed for its location and growth direction.

    Results: Micro-prolactin, micro-adrenocorticotropic hormone (ACTH), and micro-growth hormone (GH) producing adenomas showed specific location (P-value <. Read More

    Impact of selective pituitary gland incision or resection on hormonal function after adenoma or cyst resection.
    Pituitary 2015 Dec;18(6):868-75
    Pacific Brain Tumor Center and Pituitary Disorders Program, John Wayne Cancer Institute, Saint John's Health Center, Santa Monica, CA, USA.
    Objective: With the resection of pituitary lesions, the anterior pituitary gland often obstructs transsphenoidal access to the lesion. In such cases, a gland incision and/or partial gland resection may be required to obtain adequate exposure. We investigate this technique and determine the associated risk of post-operative hypopituitarism. Read More

    Managing Prolactinomas during Pregnancy.
    Front Endocrinol (Lausanne) 2015 26;6:85. Epub 2015 May 26.
    Obesity, Endocrine, and Metabolism Center, King Fahad Medical City , Riyadh , Saudi Arabia.
    Prolactinomas are the most prevalent functional benign pituitary tumors due to a pituitary micro- or macroadenoma. The majority of patients presents with infertility and gonadal dysfunction. A dopamine agonist (DA) (bromocriptine or cabergoline) is the treatment of choice that can normalize prolactin levels, reduce tumor size, and restore ovulation and fertility. Read More

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