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Neurosurg Focus 2020 Jun;48(6):E7

1Department of Neurosurgery, and.

Objective: The primary aim of this study was to investigate the value of multidisciplinary team (MDT) management in treating patients with Cushing's disease (CD). The secondary aim was to assess the concordance of bilateral inferior petrosal sinus sampling (BIPSS) lateralization with intraoperative observations.

Methods: The authors recruited 124 consecutive patients (128 procedures) who had undergone endoscopic endonasal resection of adrenocorticotropic hormone-secreting pituitary adenomas from May 2014 to April 2018 and assessed their clinical characteristics, surgical outcomes, and adjuvant therapies. Read More

Neurosurg Focus 2020 Jun;48(6):E10

1Department of Neurosurgery, USC Pituitary Center, Keck School of Medicine of University of Southern California, Los Angeles, California.

Objective: Acromegaly is a disease of acral enlargement and elevated serum levels of insulin-like growth factor-1 (IGF-1) and growth hormone (GH), usually caused by a pituitary adenoma. A lack of consensus on factors that reliably predict outcomes in acromegalic patients following endoscopic endonasal transsphenoidal surgery (EETS) warrants additional investigation.

Methods: The authors identified 52 patients with acromegaly who underwent an endoscopic endonasal approach (EEA) for resection of a GH-secreting pituitary adenoma. Read More

Front Endocrinol (Lausanne) 2020 5;11:256. Epub 2020 May 5.

Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Whether girls with central precocious puberty (CPP) should undergo routine brain magnetic resonance imaging (MRI) to identify potential intracranial pathologies is controversial. To evaluate the brain MRI results of girls with CPP and identify the clinical and endocrine predictors of brain abnormalities. This retrospective study obtained data from pediatric endocrine clinics at Chang Gung Children's Hospital. Read More

J Med Case Rep 2020 May 19;14(1):59. Epub 2020 May 19.

Department of Neurosurgery, Kocaeli University, Faculty of Medicine, Kocaeli, Turkey.

Background: The coexistence of two morphologically different tumors attached to each other creates a very rare type of tumor called a collision tumor. Collision tumors containing pituitary adenoma-sellar meningioma have only been described in four cases to date; we discuss a fifth case harboring a collision tumor comprising a pituitary corticotroph adenoma and a sellar meningioma in the same anatomic position.

Case Presentation: A 34-year-old Caucasian woman presented with menstrual irregularity, severe weakness of the proximal muscles, and 10-15 kg weight gain within a year. Read More

Zh Vopr Neirokhir Im N N Burdenko 2020 ;84(2):110-120

Burdenko Neurosurgical Center, Moscow, Russia.

According to previously accepted criteria, pituitary microadenoma is characterized by a diameter of less than 10 mm. Improvement and widespread use of MRI are accompanied by increased incidence of diagnosis of these neoplasms. Pituitary microadenomas is an extremely heterogeneous group of tumors with different biological behavior, endocrine secretion and clinical symptoms despite the common MR characteristics. Read More

Medicine (Baltimore) 2020 May;99(19):e19855

Neurosurgery Department.

The endoscopic endonasal transsphenoidal approach (EETA) is the primary treatment for growth hormone (GH) adenoma. This study aimed to investigate the outcomes of EETA in 33 patients with GH-secreting pituitary adenoma (PA).Thirty-three patients who underwent EETA in Eighth People's Hospital of Shenzhen between January 2013 and December 2017 were included in the comprehensive analysis. Read More

Pituitary 2020 May 6. Epub 2020 May 6.

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

Background: Suprasellar pituitary adenomas (SPAs) are a special type of pituitary adenoma. Although dozens of SPA cases have been reported, the exact definition and the characteristics of SPA have not been exhaustively discussed before.

Methods: In a retrospective electronic medical records review, 13 patients with SPA were identified in our hospital between January 2010 and December 2019. Read More

Diagnostics (Basel) 2020 Apr 16;10(4). Epub 2020 Apr 16.

Department of Endocrinology & Nutrition, Hospital General Universitario de Alicante, Miguel Hernández University, 03010 Alicante, Spain.

miR-17-5p and have been described as deregulated in cancer, but they have scarcely been studied in pituitary neuroendocrine tumours (PitNETs). This study evaluates the relationship of and miR-17-5p with the invasiveness and proliferation of PitNETs. In this cross-sectional descriptive study, we evaluated the expression of , , and miR-17-5p by quantitative real time PCR analysis in 60 PitNETs: 29 gonadotroph (GT), 15 functioning somatotroph (ST), and 16 corticotroph (CT) tumours, of which 8 were silent (sCT). Read More

J Endocr Soc 2020 Apr 18;4(4):bvaa021. Epub 2020 Feb 18.

Departments of Neurosurgery, Mount Sinai School of Medicine, New York, New York.

Context: Clinically nonfunctioning pituitary adenomas (CNFPAs) typically remain undetected until mass effect symptoms develop. However, currently, head imaging is performed commonly for many other indications, which may increase incidental discovery of CNFPAs. Since current presentation and outcome data are based on older, retrospective series, a prospective characterization of a contemporary CNFPA cohort was needed. Read More

Case Rep Endocrinol 2020 12;2020:2946868. Epub 2020 Mar 12.

Division of Endocrinology and Metabolism, Department of Medicine, and Hormonal and Metabolic Research Unit, Excellence Center in Diabetes, Hormone and Metabolism, Faculty of Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Patumwan, Bangkok 10330, Thailand.

The most common subtype of endogenous Cushing's syndrome (CS) is Cushing's disease (CD), with higher proportions of adrenal CS reported from Asia, compared to other continents. However, little was known about CS in this territory. This study was to investigate the distribution, clinical characteristics, and treatment outcomes of CS in a single tertiary hospital in Thailand. Read More

Thyroid 2020 May 4. Epub 2020 May 4.

Department of Endocrine & Metabolic Diseases, Shanghai Clinical Center for Endocrine & Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.

Diagnosis of thyrotropin (TSH)-secreting pituitary adenomas (TSHoma) before surgery remains a challenge, especially for microadenomas. We aimed to establish a short-term somatostatin analogue (SSA) test to differentiate TSHomas from other causes of syndromes of inappropriate secretion of TSH (IST), mainly resistance to thyroid hormone β (RTHβ). We first evaluated the sensitivity and specificity of SSA test in a training cohort (TSHoma,  = 32; RTHβ,  = 20). Read More

Eur Arch Otorhinolaryngol 2020 Apr 20;277(4):1079-1087. Epub 2020 Jan 20.

Department of Neurosurgery, University Hospital of Montpellier, Montpellier, France.

Purpose: To report the results of a series of patients undergoing the endoscopic subperichondrial transseptal (STRAS) approach for pituitary surgery and to evaluate the efficiency and the safety of this approach.

Methods: This is a single-centre retrospective study including all patients undergoing pituitary lesion resection through the STRAS approach from January 2002 to December 2017 by a multidisciplinary surgical team (ENT and neurosurgeon). Demographic data, tumour type, complication rate and pre- and post-operative visual, endocrine and tumour status were retrospectively analysed. Read More

Pituitary 2020 Apr;23(2):120-128

Division of Endocrinology and Metabolism, Hospital das Clinicas, Neuroendocrine Unit, University of Sao Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, no 155, 8° andar, bloco 3 (Endocrinologia), Sao Paulo, SP, 05403-000, Brazil.

Objective: To evaluate the maternal-fetal outcomes of CAB-induced pregnancies in patients with prolactinoma in a large cohort.

Methods: The prevalence of tumor growth, miscarriage, preterm, low birth weight, congenital malformations and impairment in neuropsychological development in children among women treated with CAB were assessed in a Brazilian multicentre retrospective observational study, RESULTS: We included 194 women with a mean age of 31 (17-45) years, 43.6% presenting microadenomas and 56. Read More

Pituitary 2020 Feb;23(1):58-64

Institute of Endocrinology, Metabolism, Diabetes and Hypertension, Tel Aviv-Sourasky Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel.

Purpose: Treatment goals in prolactinomas are to correct hypogonadism, restore fertility and control tumor mass in case of macroadenomas. According to current guidelines, medical treatment of asymptomatic postmenopausal women is not indicated. The purpose of this study was to review the current literature pertaining to biological behavior of prolactinomas during menopause, likelihood of successful dopamine agonist withdrawal during this period and possible prolactin-mediated increased morbidity that could modify current management. Read More

Kaohsiung J Med Sci 2020 Feb 23;36(2):81-88. Epub 2019 Oct 23.

Department of Neurology, Zibo Central Hospital, Zibo, Shandong Province, China.

The current study aimed to evaluate the expression and role of miR-212 in the progression of pituitary adenoma (PA), thereby providing a theoretical basis and potential therapy methods for PA patients. Our data showed that miR-212 levels were significantly reduced in PA tissues than normal pituitary tissues. However, no significant difference was identified in the serum of PA patients and healthy control. Read More

Pituitary 2020 Feb;23(1):3-8

Division of Neuropathology, Department of Pathology, University of Virginia School of Medicine, 1215 Lee Street, HEP-Room 3060, Charlottesville, VA, 22908-0214, USA.

Lactotroph adenomas, also called prolactinomas and prolactin-secreting adenomas, constitute nearly 80% of functioning pituitary tumors and about 30-50% of all adenomas in the clinical practice. Lactotroph adenomas occur in the general population at a prevalence of 45/100,000, are more common in women, but also involve men and children of both sexes. Most lactotroph adenomas are microadenomas occurring in reproductive-age women who present with oligo/amenorrhea, galactorrhea, and infertility. Read More

Clin Med Insights Reprod Health 2019 9;13:1179558119871921. Epub 2019 Sep 9.

INSERM U1172 Team 2, JPARC, Université de Lille, 59000 Lille, France.

Polycystic ovary syndrome (PCOS) and hyperprolactinemia (HPRL) are the two most common etiologies of anovulation in women. Since the 1950s, some authors think that there is a pathophysiological link between PCOS and HPRL. Since then, many authors have speculated about the link between these two endocrine entities, but no hypothesis proposed so far could ever be confirmed. Read More

J Intern Med 2019 11 4;286(5):526-541. Epub 2019 Oct 4.

Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.

Cushing's disease (CD) is caused by a pituitary tumour that secretes adrenocorticotropin (ACTH) autonomously, leading to excess cortisol secretion from the adrenal glands. The condition is associated with increased morbidity and mortality that can be mitigated by treatments that result in sustained endocrine remission. Transsphenoidal pituitary surgery (TSS) remains the mainstay of treatment for CD but requires considerable neurosurgical expertise and experience in order to optimize patient outcomes. Read More

World Neurosurg 2019 Dec 7;132:161-164. Epub 2019 Sep 7.

Puerto Rico Pathology Associates, San Juan, Puerto Rico.

Background: Double pituitary adenomas are a rare occurrence. Synchronous clinical manifestation is extremely rare.

Case Description: We report a case of a 51-year-old female with symptoms of both hypercortisolism and acromegaly during the past 2 years. Read More

J Clin Endocrinol Metab 2019 12;104(12):5906-5912

Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts.

Context: Pituitary lesions consistent with microadenomas are increasingly discovered by MRI. Sparse data are available on the long-term clinical and imaging course of such lesions in children.

Objective: The aim of this study was to define the clinical and imaging course of pituitary lesions representing or possibly representing nonfunctioning microadenomas in children to guide clinical management. Read More

Clin Neurol Neurosurg 2019 Sep 12;184:105423. Epub 2019 Jul 12.

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

To investigate the clinical characteristics of pituitary adenomas in patients under 14 years old. A total of 140 children and adolescents with pituitary adenomas were admitted to Peking Union Medical College Hospital (PUMCH) from December 1987 to December 2014, and their clinical manifestations, hormone secretions, images, pathological types, surgical complications and follow-up characteristics were analyzed. Fifty-eight (41. Read More

Radiologe 2019 Nov;59(11):982-991

Abteilung Neuroradiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.

Background: In this article, the most common pituitary gland tumors and the various differential diagnoses with focus on (neuro-)radiological diagnostic criteria are presented.

Materials And Methods: An intensive, selective search of the literature in PubMed was carried out.

Results: Pituitary adenomas account for approximately 10-15% of all intracranial brain tumors and are the most common tumors of the sellar region. Read More

World Neurosurg 2019 Oct 2;130:e634-e639. Epub 2019 Jul 2.

Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain. Electronic address:

Objective: Thyrotropin (TSH)-secreting pituitary tumors are rare and typically present with hyperthyroidism. Here we report the diagnosis, treatment, and surgical outcomes in a series of patients with TSH-secreting pituitary tumors in a tertiary referral center.

Methods: Descriptive retrospective study that included all patients with TSH-secreting pituitary tumors who underwent transsphenoidal surgery in the endocrinology and nutrition unit of the Virgen del Rocío University Hospital (Seville, Spain) between 2004 and 2016. Read More

Pituitary 2019 Oct;22(5):456-466

Department of Endocrinology, Hospital La Conception, Aix Marseille Univ, APHM, INSERM, MMG, 147 Boulevard Baille, 13005, Marseille, France.

Purpose: Carney complex (CNC) is a rare autosomal dominant syndrome, characterized by mucocutaneous pigmentation, cardiac, cutaneous myxomas and endocrine overactivity. It is generally caused by inactivating mutations in the PRKAR1A (protein kinase cAMP-dependent type I regulatory subunit alpha) gene. Acromegaly is an infrequent manifestation of CNC, reportedly diagnosed in 10% of patients. Read More

Cephalalgia 2019 Oct 29;39(12):1595-1600. Epub 2019 Jun 29.

Department of Neurology, Mayo Clinic, FL, USA.

Objective: To describe three new cases of the headache syndrome of long-lasting autonomic symptoms with hemicrania (LASH), and to establish a clinical phenotype utilizing all LASH cases noted in the medical literature.

Methods: A case series of patients was evaluated in an academic headache clinic over a two-year time period. LASH syndrome was defined by episodic headache attacks with associated cranial autonomic symptoms that start before headache onset, last the entire duration of the headache and continue on for a period of time after the headache ceases. Read More

Endocr Pathol 2019 Sep;30(3):180-188

Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.

Cushing's disease (CD) is most commonly caused by a microadenoma, which at surgical exploration may not provide adequate tissue for pathologic diagnosis using standard techniques. We wished to determine the accuracy of intraoperative pathologic examination and whether the addition of intraoperative cytology increased the diagnostic yield. We reviewed the pathology reports from 403 operations on 341 patients with CD microadenomas from a single institution. Read More

J Neurol Surg B Skull Base 2019 Jun 20;80(3):306-309. Epub 2018 Sep 20.

Department of Otorhinolaryngology, Central Hospital-Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo/SP, Brazil.

 Surgery has been the standard treatment for Cushing's disease. Currently, the endoscopic endonasal approach (EEA) is the most widely used technique. However, among some endocrinologists and neurosurgeons used to the microscope assisted technique, there are still questions about the effectiveness and safety of transitioning to the EEA. Read More

World Neurosurg 2019 02 25;122:e436-e442. Epub 2018 Oct 25.

Endocrinology and Clinical Nutrition Department, Virgen del Rocío University Hospital, Institute of Biomedicine of Seville (IBIS), Seville, Spain. Electronic address:

Objective: Cushing disease (CD) is a rare, poorly understood entity. Our aim was to add our clinical experience of >30 years in a multidisciplinary specialized unit to the global knowledge of CD.

Methods: This descriptive retrospective study included all patients admitted to the Endocrinology and Nutrition Department of the Virgen del Rocío University Hospital, Seville, Spain, from January 1980 to May 2016. Read More

Pituitary 2019 Aug;22(4):387-396

Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street No:53, Fatih, 34098, Istanbul, Turkey.

Purpose: To investigate the effects of preoperative somatostatin analogue (SSA) treatment on the annual cost of all acromegaly treatment modalities and on remission rates.

Methods: The medical records of 135 patients with acromegaly who were followed at endocrinology clinic of Cerrahpasa Medical Faculty for at least 2 years after surgery between 2009 and 2016 were reviewed.

Results: The mean follow-up time was 50. Read More

Rev Paul Pediatr 2019 19;37(3):386-391. Epub 2019 Jun 19.

Instituto Estadual de Diabetes e Endocrinologia Luis Capriglione, Rio de Janeiro, RJ, Brazil.

Objective: To present two clinical cases of pediatric Cushing disease caused by adrenocorticotropic hormone secreting pituitary adenomas, which were diagnosed by magnetic resonance imaging using 3 Tesla technology.

Case Description: Two cases of Cushing disease in 9-year-old children are reported. Both children presented pituitary adenomas that were smaller than 5 mm at their largest diameter, and which were not seen by standard 1. Read More

J Clin Endocrinol Metab 2019 May 14. Epub 2019 May 14.

Neurosurgery unit, CHU Grenoble-Alpes, Grenoble France.

Context: In patients with Cushing's disease (CD) and a typical image of adenoma at MRI, transsphenoidal surgery is consensual. However, when MRI is inconclusive or normal, some authors now advocate medical treatment instead. The implicit assumption is that modern MRI should miss only very small microadenomas, too difficult to visualize at surgery. Read More

J Am Coll Radiol 2019 May;16(5S):S161-S173

Specialty Chair, Emory University, Atlanta, Georgia.

Neuroendocrine dysfunction includes suspected hyper- and hypofunction of the pituitary gland. Causative lesions may include primary masses of the pituitary such as pituitary microadenomas and macroadenomas, as well as extrinsic masses, typically centered in the suprasellar cistern. Clinical syndromes related to hormonal dysfunction can be caused by excessive hormonal secretion or by inhibited secretion due to mass effect upon elements of the hypothalamic-pituitary axis. Read More

Best Pract Res Clin Endocrinol Metab 2019 04 16;33(2):101270. Epub 2019 Apr 16.

Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany. Electronic address:

Cushing's disease (CD) is the most common etiology of Cushing's syndrome (CD) due to corticotroph pituitary adenoma, which are in most cases small (80-90% microadenomas) and in about 40% cannot be visualized on imaging of the sella. First-line treatment for CD is transsphenoidal surgery (TSS) with the aim of complete adenoma removal and preservation of pituitary gland function. As complete adenoma resection is not always possible, surgical failure is a common problem. Read More

Oncol Lett 2019 May 28;17(5):4237-4244. Epub 2019 Feb 28.

GE Healthcare Life Sciences, Shanghai 200000, P.R. China.

The value of pharmacokinetic parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in distinguishing pituitary microadenoma subtypes was investigated in the present study. Pathology and follow-up outcomes were applied as the gold standard for differentiating between 76 patients with pituitary microadenomas (38 prolactin-producing tumors, 17 adrenocorticotropic hormone adenomas and 21 growth hormone-producing tumors) and 20 patients with normal pituitary glands. DCE-MRI was conducted to obtain the following quantitative permeability parameters: Volume transfer constant (K), rate constant (K) and extracellular extravascular volume fraction (V). Read More

Magn Reson Imaging 2019 07 27;60:38-43. Epub 2019 Mar 27.

Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Division of Diagnostic and Interventional Neuroradiology, Department of Radiology, University Hospital Basel, University of Basel, Basel, Switzerland.

Background and purpose To demonstrate the clinical feasibility of a novel MRI pulse sequence, Golden-angle radial sparse parallel MRI (GRASP) through comparison to the current imaging technique, dynamic T1- weighted contrast enhanced (DCE) imaging in terms of image quality and lesion depiction in the detection of microlesions (microadenomas and cysts) of the pituitary gland.

Materials And Methods: 16 patients (11 microadenomas, 5 cysts) underwent two MRI examinations (Siemens 1.5T and 3T) on separate dates, one using standard DCE (temporal resolution 30 s) and the other using GRASP (temporal resolution of 4. Read More

Endocr J 2019 Mar 14;66(3):259-264. Epub 2019 Feb 14.

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

Pituitary adenoma has been reported to be detectable in only 36-63% of Cushing's disease (CD) patients by magnetic resonance imaging (MRI). In this study, we investigate the outcomes and problems associated with tumor identification using 3-Tesla (3-T) MRI, which provides clearer images than ≤1.5-T MRI, in 115 patients who were initially diagnosed with CD. Read More

Endocr Connect 2018 Dec;7(12):1518-1527

Department of Neurosurgery, Fuzhou General Hospital, Fuzhou, China.

Tumor cells require large amounts of energy to sustain growth. Through the mediated transport of glucose transporters, the uptake and utilization of glucose by tumor cells are significantly enhanced in the hypoxic microenvironment. Pituitary adenomas are benign tumors with high-energy metabolisms. Read More

J Clin Endocrinol Metab 2019 04;104(4):1272-1282

Endocrinology Department, Hospital General Universitario de Alicante-ISABIAL, Miguel Hernández University, CIBERER, Alicante, Spain.

Context: Epigenetic alterations may play a role in the development and behavior of pituitary neuroendocrine tumors (PitNETs).

Objective: To evaluate the effect of methylation of tumor suppressor genes (TSGs) on their gene expression and on the behavior of PitNETs.

Material And Methods: We used methylation-specific multiplex ligation-dependent probe amplification and quantitative real-time PCR techniques to analyze the DNA-promoter hypermethylation and gene expression of 35 TSGs in 105 PitNETs. Read More

Medicine (Baltimore) 2018 Nov;97(45):e13198

Department of Neurosurgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi.

Background: Prolactinomas affect patients' quality of life and even endanger lives. The study aimed to investigate the effect of the endoscopic endonasal transsphenoidal approach (EETA) on 52 patients with prolactinomas.

Methods: A total of 52 patients with prolactinomas who had previously undergone EETA in the People's Hospital of Xinjiang Uygur Autonomous Region between January 2013 and December 2017 were retrospectively analyzed. Read More

J Clin Res Pediatr Endocrinol 2019 05 5;11(2):149-156. Epub 2018 Nov 5.

Uludağ University Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey

Objective: We aimed to report the characteristics at admission, diagnosis, treatment, and follow-up of cases of pediatric hyperprolactinemia in a large multicenter study.

Methods: We reviewed the records of 233 hyperprolactinemic patients, under 18 years of age, who were followed by different centers. The patients were divided as having microadenomas, macroadenomas, drug-induced hyperprolactinemia and idiopathic hyperprolactinemia. Read More

Pituitary 2019 Feb;22(1):79-88

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

Purpose: TSH-secreting pituitary adenomas are rare pituitary tumors. An efficient treatment is essential to limit the mortality and morbidity in untreated patients. The aim of this study is to summarize the evidence about the postoperative outcomes and management of this rare pathology. Read More

Doc Ophthalmol 2018 12 29;137(3):193-202. Epub 2018 Oct 29.

II Department of Ophthalmology, Pomeranian Medical University, Powstańców Wlkp. Street, 72, 70-111, Szczecin, Poland.

Background And Methods: Based on the available literature, it is suggested, in the clinical evaluation of the chiasmal tumors, that the following electrophysiological tests: visual evoked potentials to pattern-reversal stimulation, multifocal visual evoked potentials (mfVEPs), and pattern electroretinogram (PERG) play an important role in the diagnosis of the optic nerve and retinal dysfunction in the course of pituitary tumors.

Results: Macroadenomas and also microadenomas may cause dysfunction of retinal ganglion cells (RGCs) and their axons, even in the absence of changes in the routine ophthalmological examination, retinal sensitivity in standard automated perimetry, and retinal nerve fiber layer thickness in optical coherent tomography. The most frequently observed changes in electrophysiological tests were as follows: in PVEPs-the crossed/uncrossed asymmetry distribution, altered waveform, increase in P100-wave peak time, and/or reduction in amplitude; in mfVEPs-the peak time prolongation and/or amplitude reduction in C1-wave; in PERG-the reduction in N95-wave amplitude and decreased N95:P50 amplitude ratio. Read More

Neuroendocrinology 2019 22;109(1):28-33. Epub 2018 Oct 22.

School of Medicine, University of Belgrade, Belgrade, Serbia,

Hyperprolactinemia is not a common finding in postmenopausal women. Prolactinomas detected after menopause are usually macroadenomas. Due to atypical clinical features they may remain unrecognized for a long period of time. Read More

Horm Res Paediatr 2018 27;90(3):151-160. Epub 2018 Sep 27.

Division of Pediatric Endocrinology, Children's Hospital at Montefiore/Albert Einstein College of Medicine, Bronx, New York, USA.

Background/aims: Patients with short stature (SS)/growth hormone deficiency (GHD) and precocious puberty (PP) undergo brain MRI to evaluate for structural brain abnormalities or pituitary lesions, and pituitary microadenomas are a common finding. Theoretically, a mass effect from these lesions could cause GHD and growth hormone treatment could cause them to enlarge, but they should not cause PP, at least in females.

Methods: We investigated if pituitary microadenomas cause GHD by comparing their incidence in patients with SS/GHD to that in females with PP. Read More

F1000Res 2018 29;7. Epub 2018 Aug 29.

Max Planck Institute of Psychiatry, Clinical Neuroendocrinology Group, Munich, Germany.

Cushing's disease is the most frequent form of hypercortisolism and is caused by hypophyseal corticotroph adenomas secreting excessive amounts of adrenocorticotropic hormone. Most of the tumors develop sporadically and only a limited number of corticotroph adenomas have been found to be associated with different neuroendocrine syndromes or with familial isolated pituitary adenomas. The pathogenic mechanisms of corticotroph adenomas are largely unknown, but the discovered aberrant chaperoning activity of heat shock protein 90 on the one hand and the presence of ubiquitin-specific protease 8 mutations on the other hand partially explained the causes of their development. Read More

J Neurosurg 2018 09;131(2):500-506

1Department of Internal Medicine.

Objective: The natural history and proper algorithm for follow-up testing of nonfunctioning pituitary adenomas (PAs) are not well known, despite their relatively high prevalence. The aim of this study was to suggest the optimal follow-up algorithm for nonfunctioning PAs based on their natural history.

Methods: The authors followed up 197 patients with nonfunctioning PAs that had not been treated (including surgery and radiation therapy) at the time of detection, in a single center, between March 2000 and February 2017. Read More

J Res Med Sci 2018 26;23:61. Epub 2018 Jul 26.

Department of Internal Medicine, Duzce University Medicine Faculty, Duzce, Turkey.

Background: In this study, we aimed to retrospectively evaluate treatment outcomes and treatment methods in acromegaly patients.

Materials And Methods: The study included 65 acromegaly patients followed in Sakarya University Faculty of Medicine Department of Endocrinology in Turkey between 2004 and 2013. Clinical, biochemical, and radiological data were obtained retrospectively from the medical files of the patients. Read More

Endokrynol Pol 2018 3;69(5):530-535. Epub 2018 Aug 3.

Chair and Department of Endocrinology, Jagiellonian University Medical College, Kopernika 17, 31-501 Kraków, Poland.

Introduction: Cavernous sinus invasion by pituitary adenoma affects surgical procedure radicality and consequently the postoperative course and prognosis in pituitary adenoma treatment. The search for pituitary adenoma aggressive behaviour markers is still a matter of debate.

Material And Methods: This study evaluates the relation of pituitary adenoma invasiveness to the expression of topoisomerase IIα in 72 patients who underwent transsphenoidal pituitary surgery. Read More

J Clin Endocrinol Metab 2018 10;103(10):3919-3924

Endocrinology Service, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.

Context: The term micromegaly has been used to describe a subset of patients who have elevated IGF-1 levels but apparently normal basal GH (bGH) concentrations and often a glucose-suppressed GH of <1 ng/mL.

Objective: To evaluate the prevalence, clinical spectrum, and therapeutic outcome of acromegaly with normal bGH at diagnosis.

Design And Methods: Retrospective analysis of a cohort of patients with acromegaly diagnosed and treated at a tertiary care center. Read More