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Endocrinol Diabetes Nutr (Engl Ed) 2022 May 7. Epub 2022 May 7.

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

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

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

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

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

EJNMMI Res 2022 May 7;12(1):26. Epub 2022 May 7.

Cambridge Endocrine Molecular Imaging Group, University of Cambridge, Addenbrooke's Hospital, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK.

Background: Pituitary adenomas (PA) affect ~ 1:1200 of the population and can cause a wide range of symptoms due to hormone over-secretion, loss of normal pituitary gland function and/or compression of visual pathways, resulting in significantly impaired quality of life. Surgery is potentially curative if the location of the adenoma can be determined. However, standard structural (anatomical) imaging, in the form of MRI, is unable to locate all tumors, especially microadenomas (< 1 cm diameter). Read More

Sci Rep 2022 Apr 20;12(1):6529. Epub 2022 Apr 20.

Department of Neurosurgery and Neurooncology, First Faculty of Medicine, Charles University and Military University Hospital, U Vojenske Nemocnice 1200, 169 02, Prague 6, Czech Republic.

Hormone-secreting adenomas are treated in many neurosurgical centers within Europe. The goal of the survey is to understand variance in practice management of pituitary tumors amongst neurosurgical centers. A list of departments performing pituitary surgery was created. Read More

J Neuroendocrinol 2022 Mar 15:e13123. Epub 2022 Mar 15.

Department of Endocrinology, Centre Hospitalier Universitaire de Liège, Université de Liège, Domaine Universitaire du Sart Tilman, Liège, Belgium.

Pituitary MRI is essential in the diagnosis of ACTH-dependent Cushing's syndrome, but its results are inconsistent. The demonstration of a sellar image compatible with the diagnosis of corticotropinoma varies from 40% to 90%, depending on the centre where the imaging is performed. In fact, the expertise of the neuroradiologist, use of a Tesla 3. Read More

Rev Endocr Metab Disord 2022 Mar 28. Epub 2022 Mar 28.

Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Differentiation of pituitary neuroendocrine tumor (PitNET) tissue from surrounding normal tissue during surgery is challenging. A number of fluorescent agents is available for visualization of tissue discrepancy, with the potential of improving total tumor resection. This review evaluates the availability, clinical and technical applicability of the various fluorescent agents within the field of pituitary surgery. Read More

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

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

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

Clin Endocrinol (Oxf) 2022 Mar 23. Epub 2022 Mar 23.

Department of Endocrine Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.

This review provides an overview of novel insights in the clinical management of patients with Multiple Endocrine Neoplasia Type 1, focusing on the last decade since the last update of the MEN1 guidelines. With regard to Diagnosis: Mutation-negative patients with 2/3 main manifestations have a different clinical course compared to mutation-positive patients. As for primary hyperparathyroidism: subtotal parathyroidectomy is the initial procedure of choice. Read More

Pituitary 2022 Feb 9. Epub 2022 Feb 9.

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

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

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

J Comput Assist Tomogr 2022 Jan-Feb 01;46(1):116-123

From the Department of Radiology, Liuzhou People Hospital, Liuzhou.

Objective: This study aimed to investigate the value of contrast-enhanced 3-dimensional (3D) T2-weighted (T2W) Volume Isotropic Turbo Spin Echo Acquisition (VISTA) sequence in prolactin-secreting pituitary adenoma diagnosis.

Methods: We enrolled 158 patients with hyperprolactinemia. Coronal dynamic contrast-enhanced (DCE) T1 spin echo and T2W VISTA sequences were performed. Read More

J Clin Neurosci 2022 Jan 10;95:134-141. Epub 2021 Dec 10.

UT Southwestern Medical School, Department of Neurological Surgery, Dallas, TX, USA. Electronic address:

Background: Non-functioning pituitary adenomas (NFPA) are often discovered incidentally. The natural history of NFPA is not well understood, obfuscating evidence-based management decisions. Meta-data of radiographically followed NFPA may help guide conservative versus operative treatment of these tumors. Read More

Front Endocrinol (Lausanne) 2021 30;12:769744. Epub 2021 Nov 30.

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

Objective: Control of prolactin excess is associated with the improvement in gluco-insulinemic and lipid profile. The current study aimed at investigating the effects of pituitary surgery and medical therapy with high dose cabergoline (≥2mg/week) on metabolic profile in patients with prolactinoma resistant to cabergoline conventional doses (<2mg/week).

Design: Thirty-four patients (22 men, 12 women, aged 33. Read More

Minerva Endocrinol (Torino) 2021 Dec 9. Epub 2021 Dec 9.

Neuroendocrine Unit, Division of Endocrinology and Metabolism, University of Sao Paulo Medical School, Sao Paulo, Brazil -

Background: The dopaminergic agonist cabergoline (CAB) has been used in the pharmacological treatment of Cushing's disease (CD). The effect is attributed to the frequent expression of the dopamine receptor subtype 2 in corticotroph tumors. However, in vivo studies have demonstrated the normalization of 24-h urinary cortisol (24-h UC) in approximately 30-40% of patients over the long term, mainly after surgical failure. Read More

Ann Endocrinol (Paris) 2022 Feb 3;83(1):1-8. Epub 2021 Dec 3.

Fédération d'endocrinologie, centre de référence maladies rares hypophysaires (HYPO), hospices civils de Lyon, groupement hospitalier Est, Bron, France; Université Lyon 1, Lyon, France; Inserm U1052, CNRS UMR5286, Cancer Research Center of Lyon, 69372 Lyon, France. Electronic address:

Background: Dopaminergic agonists (DA) are the first-line treatment in lactotroph pituitary tumor but treatment usually needs to be life-long. After surgical transsphenoid resection, remission rates range from 60 to 90%, with low morbidity.

Objective: The objective was to evaluate outcome of surgical treatment of selected non-invasive prolactinoma, and to identify factors associated with long-term remission. Read More

Front Endocrinol (Lausanne) 2021 18;12:743052. Epub 2021 Nov 18.

University of Southern California (USC) Pituitary Center, Department of Neurosurgery, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States.

Purpose: Determine predictive factors for long-term remission of acromegaly after transsphenoidal resection of growth hormone (GH)-secreting pituitary adenomas.

Methods: We identified 94 patients who had undergone transsphenoidal resection of GH-secreting pituitary adenomas for treatment of acromegaly at the USC Pituitary Center from 1999-2019 to determine the predictive value of postoperative endocrine lab values.

Results: Patients underwent direct endoscopic endonasal (60%), microscopic transsphenoidal (38%), and extended endoscopic approaches (2%). Read More

World Neurosurg 2021 Nov 25. Epub 2021 Nov 25.

Department of Neurosurgery, Emory University, Atlanta, Georgia, USA; Atlanta VA Health Care System, Decatur, Georgia, USA. Electronic address:

Objective: Increasing use of imaging is associated with increasing diagnoses of pituitary incidentalomas (PIs), which often do not require surgical or medical treatment. In this study, we evaluate U.S. Read More

Pan Afr Med J 2021 10;40:31. Epub 2021 Sep 10.

Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Introduction: acromegaly, an overproduction of growth hormone (GH), is associated with high rate of morbidity and mortality particularly in case of delayed in diagnosis and treatment. A wide variation of clinical presentations, treatment outcomes and morbidities have been reported.

Methods: a retrospective study was conducted to review clinical characteristics and treatment outcomes of patients with acromegaly treated in King Chulalongkorn Memorial Hospital, Bangkok, Thailand, between 2006 and 2018. Read More

Presse Med 2021 Dec 21;50(4):104081. Epub 2021 Oct 21.

Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10, Avenue Hippocrate, Brussels 1200, Belgium. Electronic address:

Pituitary incidentalomas (PI) are lesions of the pituitary region discovered fortuitously by imaging for reasons unrelated to pituitary disease. They range from small cysts to large invasive adenomas. All over the world, improvements in the quality and availability of radiological examinations are leading to an increase in the discovery of PI. Read More

J Clin Endocrinol Metab 2022 02;107(3):e1231-e1241

Pituitary Center, Oregon Health & Science University, Portland, OR, USA.

Context: Characterization of the clinical features and natural history of nonfunctioning pituitary microadenomas (NFPmAs) is limited by heterogeneous and small-scale studies.

Objective: To characterize the clinical presentation and natural history of NFPmAs and evaluate if imaging follow-up interval can be extended.

Methods: Retrospective single-center cohort study (years 2006-2021) of conservatively managed patients with NFPmAs. Read More

J Clin Med 2021 Oct 6;10(19). Epub 2021 Oct 6.

Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, 50-367 Wroclaw, Poland.

The aim of this study was to assess the diagnostic value of non-contrast pituitary MRI in children with growth or puberty disorders (GPDs) and to determine the criteria indicating the necessity to perform post-contrast examination. A retrospective study included re-analysis of 567 contrast-enhanced pituitary MRIs of children treated in a tertiary reference center. Two sets of sequences were created from each MRI examination: Set 1, including common sequences without contrast administration, and Set 2, which included common pre- and post-contrast sequences (conventional MRI examination). Read More

Radiographics 2021 Nov-Dec;41(7):2029-2046. Epub 2021 Oct 1.

From the Department of Radiology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814 (R.Y.S.); Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (J.W.S.); and Department of Radiology, Mayo Clinic, Rochester, Minn (K.K.K.).

Primary tumors of the pituitary gland are the second most common histologic category of primary central nervous system tumors across all age groups and are the most common in adolescents to young adults, despite originating from a diminutive endocrine gland that is often described as "about the size of a pea." The vast majority of these represent primary tumors of the adenohypophysis, specifically pituitary adenomas, which can be either functional or silent with regard to hormone hypersecretion. According to the fourth edition of the World Health Organization classification of endocrine tumors, published in 2017, cellular lineage and immunohistochemical stains for pituitary hormones and/or transcription factors help with making the correct pathologic diagnosis. Read More

Pituitary 2022 Feb 27;25(1):201-209. Epub 2021 Sep 27.

Harvard Medical School, Boston, MA, USA.

Purpose: To examine the contemporary epidemiology of adult pituitary tumors with a particular focus on uncommon tumor types, using the 2017 WHO Classification of pituitary tumors.

Methods: Adult patients presenting with a pituitary or sellar tumor between 2004 and 2017 were identified from the U.S. Read More

Endocrinol Diabetes Nutr (Engl Ed) 2021 Sep 2. Epub 2021 Sep 2.

Neuroendocrinology Unit, Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Instituto de Investigación Biomédica Ramón y Cajal, Madrid, Spain.

Purpose: Identify presurgical factors associated with surgical remission in Cushing's disease (CD).

Methods: All the patients with ACTH-dependent Cushing's Syndrome in follow-up at our centre between 2014-2021 (n=40) were identified. Those patients with CD diagnosis who underwent transsphenoidal surgery by the same neurosurgeon (n=32) were included. Read More

J Endocr Soc 2021 Oct 28;5(10):bvab074. Epub 2021 Apr 28.

Division of Endocrinology, Department of Medicine, Keck School of Medicine of USC, Los Angeles, California 90033, USA.

Context: Surgical management of prolactinomas is an important treatment for patients intolerant of dopamine agonist therapy. However, predictors of postoperative outcomes remain unclear.

Object: While transsphenoidal surgical resection (TSSR) is important second-line therapy in prolactinoma patients, predictors of surgical cure and biochemical remission following TSSR remain sparse. Read More

Maturitas 2021 Sep 3;151:36-40. Epub 2021 Jul 3.

Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy; Unesco Chair for Health Education and Sustainable Development, "Federico II" University, Naples, Italy. Electronic address:

Most prolactinomas are diagnosed in women of reproductive age and are generally microadenomas. Prolactinomas diagnosed in postmenopausal women are less common and are not usually associated with the typical syndrome induced by prolactin excess, including infertility and oligo-amenorrhea. This implies that the diagnosis of prolactinomas after menopause may be delayed and require greater clinical effort. Read More

Eur J Endocrinol 2021 Sep 1;185(4):587-595. Epub 2021 Sep 1.

Diabetes and Metabolism Research Unit, Vall d'Hebron University Hospital and Vall d'Hebron Research Institute (VHIR), Universidad Autónoma de Barcelona, Barcelona, Spain.

Objective: Transsphenoidal surgery (TSS) is mainly indicated in prolactinomas when dopamine agonist treatment fails. However, there is no established early predictor of cabergoline (CBG) response. The present study was aimed to identify predictors of CBG resistance in order to select patients who may benefit from early TSS. Read More

Clin Endocrinol (Oxf) 2022 04 4;96(4):578-588. Epub 2021 Aug 4.

Department of Radiology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.

Objective: Cushing disease is a potentially fatal endocrine disorder caused by adrenocorticotropin (ACTH)-secreting microadenomas in the pituitary gland. Accurate detection and localization of the adenomas is the key to clinical treatment. This study analysed the value of contrast-enhanced Sampling Perfection with Application-optimized Contrasts using different flip angle Evolutions (SPACE) sequence in magnetic resonance imaging (MRI) assessment of ACTH-secreting pituitary microadenomas. Read More

Pituitary 2021 Dec 21;24(6):878-886. Epub 2021 Jun 21.

Department of Nuclear Medicine, St. Claraspital, Basel, CH, Switzerland.

Purpose: 11-C-methionine (MET)-positron emission tomography (PET) as an adjunct to magnetic resonance imaging (MRI) has been proposed as a suitable molecular imaging modality for localizing pituitary adenomas in Cushing's disease. 18-F-Fluoroethyl-L-tyrosine (FET)-PET, which is more widely available has not yet been reported in this context.

Methods: Retrospective double-center cohort study on 15 patients who underwent transsphenoidal surgery for biochemically proven Cushing's disease between 2011 and 2019. Read More

Front Endocrinol (Lausanne) 2021 31;12:672178. Epub 2021 May 31.

Department of Neurosurgery, Military Institute of Medicine, Warsaw, Poland.

Purpose: Cushing's disease is the most common cause of endogenous hypercortisolemia due to a corticotroph pituitary tumor. Up-to-date there is no reliable biomarker of invasiveness among corticotroph tumors, while it is well established in the literature that sparsely granulated somatotroph tumors are characterized by poorer prognosis. The aim of the study was to correlate multiple data including clinical, biochemical, radiological, and pathological findings (including granulation pattern) as well as immediate post-operative remission status among patients operated on due to corticotroph tumors. Read More

Dtsch Arztebl Int 2021 Apr;118(14):237-243

Department of Internal Medicine/Endocrinology, DKD Helios Klinik Wiesbaden Medicover Oldenburg MVZ; Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of; Würzburg, Würzburg, Germany; Department of Neurosurgery, Johannes Wesling Klinikum Minden; Institute of Neuropathology, UKE Hamburg; Department of Neurosurgery, UKE Hamburg.

Background: The increasing use of cranial tomographic imaging has led to the more frequent discovery of pituitary tumors. In this review, we discuss the clinical symptoms that point toward a pituitary tumor, the required diagnostic studies, the potential need for follow-up studies, and the indications for neurosurgical treatment.

Methods: This review is based on pertinent publications from the years 2005-2020 that were retrieved by a selective search in PubMed, as well as on the current German S2k guideline, which was created with the present authors playing a coordinating role, and on further guidelines from abroad. Read More