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    941 results match your criteria Pituitary Microadenomas

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    Investigating the application of diving endoscopic technique in determining the extent of pituitary adenoma resection via the trans-nasal-sphenoidal approach.
    Exp Ther Med 2018 Apr 2;15(4):3815-3819. Epub 2018 Mar 2.
    Department of Neurosurgery, Beijing Boai Hospital, China Rehabilitation Research Centre, Beijing 100068, P.R. China.
    The aim of the present study was to investigate the advantages and disadvantages of the diving endoscopic technique in pituitary adenoma surgery, and the application value in determining the extent of tumor resection. A total of 37 patients with pituitary adenoma initially underwent tumor resection under an endoscope-assisted microscope via standard trans-nasal-sphenoidal approach, and tumor cavity structure was observed by applying the diving endoscopic technique. Surgery was subsequently performed again under a microscope or endoscope. Read More

    Endonasal endoscopic surgery in pituitary adenomas: Surgical results in a series of 86 consecutive patients.
    Neurocirugia (Astur) 2018 Mar 23. Epub 2018 Mar 23.
    Servicio de Otorrinolaringología, Hospital General Universitario de Alicante, Alicante, España.
    Introduction: The endoscopic endonasal approach has become the gold standard for the surgical treatment of pituitary adenomas.

    Objectives: The aim of this study is to present the results obtained in our hospital in purely endoscopic surgery of pituitary adenomas.

    Methods: From February 2011 to August 2016, we conducted a prospective study on a series of 86 patients with pituitary adenoma, all of whom underwent surgery with a purely endoscopic endonasal approach. Read More

    Complete evaluation of pituitary tumours in a single tertiary care institution.
    Endocrine 2018 May 12;60(2):255-262. Epub 2018 Mar 12.
    Endocrinology and Metabolic Diseases Department, Internal Medicine III, Jena University Hospital, Jena, Germany.
    Introduction: We retrospectively evaluated all patients with pituitary tumours treated in our department from 1/1/1997 to 01/11/2014.

    Patients And Methods: Two hundred and fifteen patients (124 females, 91 males, mean age 50.9 years) were treated because of pituitary tumours. Read More

    Management of nonfunctioning pituitary adenomas (NFAs): observation.
    Pituitary 2018 Apr;21(2):162-167
    Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, 645 N. Michigan Avenue, Suite 530, Chicago, IL, 60611, USA.
    Clinically nonfunctioning pituitary adenomas (NFAs) range from those causing significant hypothalamic/pituitary dysfunction and visual field compromise due to their large size to those being completely asymptomatic. In the absence of hypersecretion, hypopituitarism or visual field defects, patients with NFAs may be followed by periodic surveillance using MRI to detect tumor enlargement. In some cases, endocrine tests are also needed during observation to discover new pituitary dysfunction. Read More

    Endoscopic therapy and curative effect in pituitary adenoma patients complicated by acromegalic cardiomyopathy.
    Neurosurg Rev 2017 Dec 13. Epub 2017 Dec 13.
    Department of Neurosurgery, The Huzhou Central Hospital, Huzhou, Zhejiang Province, People's Republic of China.
    The study aimed to retrospectively analyze the clinical characteristics of patients with pituitary adenomas complicated by acromegalic cardiomyopathy and to evaluate the effect of endoscopic surgery. Eighty-six pituitary adenoma patients complicated by acromegalic cardiomyopathy who were treated with endoscopic surgery in the First Affiliated Hospital of Soochow University from January 2010 to December 2016 were enrolled. We noted patient clinical characteristics and explored the relationships with surgical treatment. Read More

    Pediatric prolactinoma: initial presentation, treatment, and long-term prognosis.
    Eur J Pediatr 2018 Jan 22;177(1):125-132. Epub 2017 Nov 22.
    Department of Pediatrics and Pediatric Hematology/Oncology, Klinikum Oldenburg AöR, Medical Campus University Oldenburg, Rahel-Straus-Strasse 10, 26133, Oldenburg, Germany.
    Prolactinoma is a rare pituitary adenoma secreting prolactin. Studies on diagnostics, treatment, and prognosis in pediatric prolactinoma patients are rare. We analyzed clinical presentation, response to treatment, and prognosis of 27 pediatric prolactinoma patients (10 m/17 f. Read More

    Has acromegaly been diagnosed earlier?
    J Clin Neurosci 2018 Feb 4;48:138-142. Epub 2017 Nov 4.
    Department of Neurosurgery, Brain Research Institute, Niigata University, Japan.
    Purpose: We investigated whether acromegaly has been diagnosed earlier at the Niigata Medical and Dental University Hospital.

    Methods: Patients with acromegaly (n = 81) who underwent their first transsphenoidal surgery from 2006 to 2015 were reviewed. Two groups were compared: those who underwent surgery between 2006 and 2010 (n = 35) and those who underwent surgery between 2011 and 2015 (n = 46). Read More

    Dogs with macroadenomas have lower body temperature and heart rate than dogs with microadenomas.
    Vet J 2017 Sep 25;227:42-45. Epub 2017 Aug 25.
    The Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire AL9 7TA, United Kingdom and Cave Veterinary Specialists, George's Farm Nr Wellington, West Buckland, Wellington TA21 9LE, UK. Electronic address:
    Pituitary macroadenomas compress the hypothalamus, which partly regulates heart rate and body temperature. The aim of this study was to investigate whether heart rate and/or body temperature could aid in clinically differentiating dogs with macroadenomas from dogs with microadenomas (i.e. Read More

    Potential utility of FLAIR in MRI-negative Cushing's disease.
    J Neurosurg 2017 Oct 13:1-9. Epub 2017 Oct 13.
    Neurosurgery Unit for Pituitary and Inheritable Diseases, and.
    OBJECTIVE Accurate presurgical localization of microadenomas in Cushing's disease (CD) leads to improved remission rates and decreased adverse events. Volumetric gradient recalled echo (3D-GRE) MRI detects pituitary microadenomas in CD in up to 50%-80% cases as a focus of hypointensity due to delayed contrast wash-in. The authors have previously reported that postcontrast FLAIR imaging may be useful in detecting otherwise MRI-negative pituitary microadenomas as foci of hyperintensity. Read More

    Diagnosis and treatment of TSH-secreting adenomas: review of a longtime experience in a reference center.
    J Endocrinol Invest 2018 Apr 11;41(4):447-454. Epub 2017 Oct 11.
    Neuroendocrine Unit, Division of Endocrinology and Metabolism, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Botucatu, 806, Vila Clementino, São Paulo, CEP 04023-062, Brazil.
    Purpose: TSH-secreting pituitary adenomas are among the less prevalent pituitary tumors, corresponding to 0.9-1.5% of all pituitary adenomas in surgical series. Read More

    Corticotropin releasing hormone can selectively stimulate glucose uptake in corticotropinoma via glucose transporter 1.
    Mol Cell Endocrinol 2017 Oct 3. Epub 2017 Oct 3.
    Neurosurgery Unit for Pituitary and Inheritable Diseases, National Institute of Neurological Diseases and Stroke, Bethesda, MD, United States; Surgical Neurology Branch, National Institute of Neurological Diseases and Stroke, Bethesda, MD, United States. Electronic address:
    Background: Pre-operative detection of corticotropin (ACTH) secreting microadenomas causing Cushing's disease (CD) improves surgical outcomes. Current best magnetic resonance imaging fails to detect up to 40% of these microadenomas. F-fluorodeoxyglucose (F-FDG) positron emission tomography (PET) is specific, but not sensitive in detecting corticotropinomas. Read More

    Morbidity and mortality in patients with hyperprolactinaemia: the PROLEARS study.
    Endocr Connect 2017 Nov;6(8):580-588
    Division of Molecular and Clinical MedicineSchool of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.
    Purpose: High serum prolactin concentrations have been associated with adverse health outcomes in some but not all studies. This study aimed to examine the morbidity and all-cause mortality associated with hyperprolactinaemia.

    Methods: A population-based matched cohort study in Tayside (Scotland, UK) from 1988 to 2014 was performed. Read More

    Diagnosis and Outcomes of 341 Patients with Cushing's Disease Following Transsphenoid Surgery: A Single-Center Experience.
    World Neurosurg 2018 Jan 23;109:e75-e80. Epub 2017 Sep 23.
    Department of Neurosurgery, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China. Electronic address:
    Background: Transsphenoid surgery (TSS) is a standard treatment modality for Cushing's disease (CD). However, postoperative remission and recurrence rates vary among studies. Here we analyze the diagnosis and outcomes of 341 patients with a preoperative diagnosis of CD undergoing TSS in a single center over a 3-year period. Read More

    Decreased nitric oxide serum level after pituitary adenoma resection.
    J Neurosurg Sci 2017 Sep 22. Epub 2017 Sep 22.
    Department of Medical Chemistry, Medical University of Lublin, Lublin, Poland -
    Background: Nitric oxide (NO) is synthesized by the conversion of Arginine (Arg) into the NO and Citrulline (Cit). Although the NO is involved into the pathogenesis of several physiological and pathological processes, the role of NO in pituitary adenomas (PA) progres-sion is not determined. Our purpose was to evaluate the relationship between NO and PA as well as the effect of tumor resection on NO metabolites level in serum. Read More

    Microsurgical versus endoscopic transsphenoidal resection for acromegaly: a systematic review of outcomes and complications.
    Acta Neurochir (Wien) 2017 Nov 14;159(11):2193-2207. Epub 2017 Sep 14.
    Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA.
    Purpose: The aim of this systematic review is to evaluate the long-term endocrine outcomes and postoperative complications following endoscopic vs. microscopic transsphenoidal resection (TSR) for the treatment of acromegaly.

    Methods: A literature review was performed, and studies with at least five patients who underwent TSR for acromegaly, reporting biochemical remission criteria and long-term remission outcomes were included. Read More

    [Prolactin-secreting microadenoma in menopausal women].
    Pan Afr Med J 2017 5;27:177. Epub 2017 Jul 5.
    Service d'Endocrinologie, CHU Farhat Hached de Sousse, Tunisie.
    Prolactin-secreting adenoma is rare in elderly women. Patient's clinical picture may be confused with that of menopause, making diagnosis sometimes difficult. We report the case of a 57-year old woman with a 2-year history of secondary amenorrhea without hot flushes associated with galactorrhea in order to highlight the peculiarities of prolactin-secreting microadenomas. Read More

    Endoscopic Transsphenoidal Approach for Acromegaly with Remission Rates in 401 Patients: 2010 Consensus Criteria.
    World Neurosurg 2017 Dec 5;108:278-290. Epub 2017 Sep 5.
    Pituitary Research Centre, Kocaeli University, Kocaeli, Turkey; Neurosurgery Department, Kocaeli University, Kocaeli, Turkey.
    Background: Transsphenoidal surgery is the first-choice treatment for acromegaly. Postoperative remission is an important predictor of outcome. Various factors have been described as markers of remission: preoperative mean growth hormone (GH) and insulin-like growth factor-1 levels, cavernous sinus invasion, tumor size, extrapseudocapsular resection, and experience of the surgeon. Read More

    Lesson to be remembered from a skull base tumor.
    Neurochirurgie 2017 Sep 4;63(4):334-335. Epub 2017 Sep 4.
    Institut Mitovasc, unité CNRS 6214/Inserm1083, université d'Angers, 49100 Angers, France; Service d'endocrinologie diabétologie nutrition, centre de référence des maladies rares de la réceptivité hormonale, CHU d'Angers, Angers, France. Electronic address:
    The natural history of giant prolactinomas is not known. While it is commonly accepted that the enlargement of microadenoma is rare and more limited than macroadenoma, it is so far uncommon that macroadenoma progress to giant adenoma. Thus, spontaneous enlargement of adenomas is poorly documented. Read More

    Reoperation for growth hormone-secreting pituitary adenomas: report on an endonasal endoscopic series with a systematic review and meta-analysis of the literature.
    J Neurosurg 2017 Sep 1:1-13. Epub 2017 Sep 1.
    Department of Neurosurgery, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York.
    OBJECTIVE Surgery is generally the first-line therapy for acromegaly. For patients with residual or recurrent tumors, several treatment options exist, including repeat surgery, medical therapy, and radiation. Reoperation for recurrent acromegaly has been associated with poor results, with hormonal control usually achieved in fewer than 50% of cases. Read More

    Delayed Diagnosis of Cushing's Disease in a Pediatric Patient due to Apparent Remission from Spontaneous Apoplexy.
    J Clin Transl Endocrinol Case Rep 2016 Dec;2:30-34
    Clinical Center of the National Institutes of Health (NIH) 10 Center Dr, Bethesda, MD 20814.
    We report here a pediatric patient whose Cushing's Disease was diagnosed late because of her cyclical presentation, presumably due to subclinical pituitary apoplexy. Starting at age 8, she presented with observable signs of Cushing's but was not clinically assessed for Cushing's Syndrome until the age of 15. Initial tests at age 15 were consistent with Cushing's Disease, however, the patient presented with spontaneous remission of hypercortisolemia just a few short months later. Read More

    Resection of pituitary macroadenomas via the pseudocapsule along the posterior tumor margin: a cohort study and technical note.
    J Neurosurg 2018 Feb 18;128(2):422-428. Epub 2017 Aug 18.
    Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia.
    OBJECTIVE Extracapsular resection of pituitary microadenomas improves remission rates, but the application of pseudocapsular techniques for macroadenomas has not been well described. In larger tumors, the extremely thin, compressed normal gland or its complete absence along the tumor's anterior surface limits the application of the traditional pseudocapsular technique that can be used for microadenomas. However, in the authors' experience, the interface between the pseudocapsule at the posterior margin of the adenoma and the compressed normal gland behind it is universally present, providing a surgical dissection plane. Read More

    Risk factors and the prognosis of sexual dysfunction in male patients with pituitary adenomas: a multivariate analysis.
    Asian J Androl 2018 Jan-Feb;20(1):43-49
    Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
    The impact of sexual dysfunction (SD) is distressing to many male patients with pituitary adenomas which affect both physical and psychological health. The research explored to identify risk factors affecting sexual function and the prognosis of male patients with pituitary adenomas. Two hundred and fifty-four male patients, who aged between 18 and 60 (mean ± s. Read More

    Clinically non-functioning pituitary adenomas: Pathogenic, diagnostic and therapeutic aspects.
    Endocrinol Diabetes Nutr 2017 Aug - Sep;64(7):384-395. Epub 2017 Jul 4.
    Department of Medicine, American British Cowdray Medical Center, Mexico City, Mexico.
    Clinically non-functioning pituitary adenomas (NFPAs) are among the most common tumors in the sellar region. These lesions do not cause a hormonal hypersecretion syndrome, and are therefore found incidentally (particularly microadenomas) or diagnosed based on compressive symptoms such as headache and visual field defects, as well as clinical signs of pituitary hormone deficiencies. Immunohistochemically, more than 45% of these adenomas stain for gonadotropins or their subunits and are therefore called gonadotropinomas, while 30% of them show no immunostaining for any hormone and are known as null cell adenomas. Read More

    Prevalence, Clinical Features, and Natural History of Incidental Clinically Non-Functioning Pituitary Adenomas.
    Horm Metab Res 2017 Sep 31;49(9):654-659. Epub 2017 Jul 31.
    Department of Endocrinology, Hospital Universitario A Coruña, A Coruña, Spain.
    The objective of the study was to assess the prevalence and clinical features of incidentally discovered clinically non-functioning pituitary adenoma (CNFPA) and to analyze its natural history. A multicenter retrospective study in patients diagnosed with incidental CNFPA periodically followed-up in 3 specialized neuroendocrinology units from 1992 to 2015 was performed. Out of a total of 189 CNFPA patients, 57 cases (30. Read More

    Outcomes of Primary Transsphenoidal Surgery in Cushing Disease: Experience of a Tertiary Center.
    World Neurosurg 2017 Oct 13;106:374-381. Epub 2017 Jul 13.
    Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey; Pituitary Center, Istanbul University, Istanbul, Turkey. Electronic address:
    Background: To report the initial and long-term remission rates and related factors, secondary treatments, and outcomes of a series of patients with Cushing disease (CD).

    Methods: We included 147 consecutive adult patients with CD who underwent primary transsphenoidal surgery (TSS) between 1998 and 2014 in this study. Eighty-two were followed up in the Cerrahpasa Medical Faculty Endocrinology and Metabolism outpatient clinic. Read More

    [Tumors of the sellar region].
    Radiologe 2017 Sep;57(9):740-747
    Abteilung für Neuroradiologie, Kantonsspital Baden, Baden, Schweiz.
    Methodical Issue: The anatomy of the sellar region is complex and tumors of the sellar region are very variable because they arise from the many different tissue types in the sellar region, ranging from benign to life-threatening. Despite this variety, approximately 80% of sellar region tumors are due to the 5 most common lesions: adenomas, meningiomas, aneurysms, astrocytomas and craniopharyngiomas.

    Standard Radiological Methods: In addition to clinical and laboratory results, the magnetic resonance imaging (MRI) and computed tomography (CT) results including the exact anatomical position and the proliferation pattern of the lesion are decisive for the diagnosis. Read More

    Prolactinomas diagnosed in the postmenopausal period: Clinical phenotype and outcomes.
    Clin Endocrinol (Oxf) 2017 Nov 18;87(5):508-514. Epub 2017 Jul 18.
    Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
    Objective: Most prolactinomas in females are diagnosed during the reproductive age, and the majority are microadenomas. Prolactinomas detected in the postmenopausal period are less common with limited published data on their presentation and prognosis. Our objective was to assess the presenting clinical, biochemical and imaging findings, as well as the outcomes of women diagnosed with a prolactinoma in the postmenopausal period. Read More

    Optimized multi-stable stochastic resonance for the enhancement of pituitary micoadenoma in MRI.
    IEEE J Biomed Health Inform 2017 Jun 13. Epub 2017 Jun 13.
    Magnetic resonance imaging (MRI) is the modality of choice as far as imaging diagnosis of pathologies in the pituitary gland is concerned. Further, the advent of dynamic contrast enhanced (DCE) has enhanced the capability of this modality in detecting minute benign but endocrinologically significant tumors called microadenoma. These lesions are visible with difficulty and a low confidence level in routine MRI sequences, even after administration of intravenous gadolinium. Read More

    Acromegaly: surgical results in 548 patients.
    Pituitary 2017 Oct;20(5):522-528
    Neurosurgery Department, Puerta de Hierro Hospital, Madrid, Spain.
    Purpose: The goal of this study was to quantified the results of microsurgery, in all the patients with acromegaly treated by the same endocrinologist and the same surgeon between 1975 and 2015.

    Methods: A series of 548 patients with acromegaly were operated and followed-up from 6 months to 40 years. Patients were selected according to five criteria: (1) Operated by the same surgeon. Read More

    Prolactinoma management: predictors of remission and recurrence after dopamine agonists withdrawal.
    Pituitary 2017 Aug;20(4):464-470
    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

    Preliminary experience with 4K ultra-high definition endoscope: analysis of pros and cons in skull base surgery.
    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

    Different patterns of gelatinolytic activity in pituitary macro- and microadenomas.
    Clin Neurol Neurosurg 2017 Jul 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

    Outcome of Endoscopic Transsphenoidal Surgery for Acromegaly.
    World Neurosurg 2017 Aug 29;104:272-278. Epub 2017 Apr 29.
    Pituitary Center, Seoul National University College of Medicine, Seoul, Korea; Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea. Electronic address:
    Objective: Endoscopic transsphenoidal surgery has recently been introduced in pituitary surgery. We investigated outcomes and complications of endoscopic surgery in 2 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 January 2009 and March 2016. Read More

    Metabolic In Vivo Visualization of Pituitary Adenomas: a Systematic Review of Imaging Modalities.
    World Neurosurg 2017 Aug 28;104:489-498. Epub 2017 Apr 28.
    Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York, USA. Electronic address:
    Objective: Pituitary adenomas (PAs) are the most common intrasellar mass. Functional PAs constitute most 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

    Comparison of MRI techniques for detecting microadenomas in Cushing's disease.
    J Neurosurg 2018 Apr 28;128(4):1051-1057. 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

    Transcriptome Analysis Showed a Differential Signature between Invasive and Non-invasive Corticotrophinomas.
    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

    Long-Term Endocrine Outcomes Following Endoscopic Endonasal Transsphenoidal Surgery for Acromegaly and Associated Prognostic Factors.
    Neurosurgery 2017 Aug;81(2):357-366
    Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, Cali-fornia.
    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

    Efficacy of transsphenoidal surgery in achieving biochemical cure of growth hormone-secreting pituitary adenomas among patients with cavernous sinus invasion: a systematic review and meta-analysis.
    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

    Surgical outcomes in patients with Cushing's disease: the Cleveland clinic experience.
    Pituitary 2017 Aug;20(4):430-440
    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

    A rare case of ectopic ACTH syndrome originating from malignant renal paraganglioma.
    Arch Endocrinol Metab 2017 May-Jun;61(3):291-295. 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

    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.
    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). 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 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

    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 ;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

    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

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