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1. Ali O, Banerjee S, Kelly DF, Lee PD: Management of type 2 diabetes mellitus associated with pituitary gigantism. Pituitary; 2007;10(4):359-64
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  • [Title] Management of type 2 diabetes mellitus associated with pituitary gigantism.
  • Pituitary gigantism, a condition of endogenous growth hormone (GH) hypersecretion prior to epiphyseal closure, is a rare condition.
  • In the adult condition of GH excess, acromegaly, the occurrence of type 2 diabetes mellitus (T2DM) and diabetic ketoacidosis (DKA) have been reported, with resolution following normalization of GH levels.
  • We report the case of a 16-year-old male with pituitary gigantism due to a large invasive suprasellar adenoma who presented with T2DM and DKA.
  • Despite surgical de-bulking, radiotherapy and medical treatment with cabergoline and pegvisomant, GH and insulin-like growth factor-I (IGF-I) levels remained elevated.
  • We review the pathophysiology of T2DM and DKA in growth hormone excess and available treatment options.
  • [MeSH-minor] Adenoma / complications. Adenoma / surgery. Adenoma / therapy. Adolescent. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Ergolines / therapeutic use. Human Growth Hormone / analogs & derivatives. Human Growth Hormone / therapeutic use. Humans. Hypoglycemic Agents / therapeutic use. Insulin / analogs & derivatives. Insulin / therapeutic use. Insulin Glargine. Insulin, Long-Acting. Male. Metformin / therapeutic use. Pituitary Neoplasms / complications. Pituitary Neoplasms / surgery. Pituitary Neoplasms / therapy. Radiotherapy

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  • (PMID = 17629784.001).
  • [ISSN] 1386-341X
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Ergolines; 0 / Hypoglycemic Agents; 0 / Insulin; 0 / Insulin, Long-Acting; 12629-01-5 / Human Growth Hormone; 2ZM8CX04RZ / Insulin Glargine; 9100L32L2N / Metformin; LL60K9J05T / cabergoline; N824AOU5XV / pegvisomant
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2. Minniti G, Jaffrain-Rea ML, Osti M, Esposito V, Santoro A, Solda F, Gargiulo P, Tamburrano G, Enrici RM: The long-term efficacy of conventional radiotherapy in patients with GH-secreting pituitary adenomas. Clin Endocrinol (Oxf); 2005 Feb;62(2):210-6
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  • [Title] The long-term efficacy of conventional radiotherapy in patients with GH-secreting pituitary adenomas.
  • OBJECTIVE: To assess the long-term efficacy and safety of conventional radiotherapy (RT) in the control of acromegaly according to recent stringent criteria of cure.
  • PATIENTS AND METHODS: Forty-seven patients with active acromegaly were treated with conventional RT between 1982 and 1994.
  • All patients were first operated on and successively irradiated at a dose of 45-50 Gy in 25-28 fractions for persistent (n = 40) or recurrent (n = 7) disease.
  • MEASUREMENTS: Long-term GH/IGF-I secretion and local tumour control were evaluated regularly, and possible side-effects were searched for systematically, especially in terms of secondary endocrine dysfunction.
  • Biochemical cure of acromegaly was defined by glucose-suppressed plasma GH levels below 1 microg/l during an oral glucose tolerance test (OGTT) and normal age-corrected IGF-I values.
  • Suppression of GH during OGTT was seen in 9% of patients at 2 years, 29% at 5 years, 52% at 10 years, and 77% at 15 years.
  • Normalization of GH/IGF-I mainly depended on pre-RT levels.
  • CONCLUSION: Conventional RT is effective in the long-term control of GH-secreting pituitary adenomas, although with a high prevalence of progressive hypopituitarism.
  • [MeSH-major] Acromegaly / radiotherapy. Adenoma / radiotherapy. Adenoma / secretion. Growth Hormone / secretion. Pituitary Neoplasms / radiotherapy. Pituitary Neoplasms / secretion
  • [MeSH-minor] Adult. Female. Follow-Up Studies. Glucose Tolerance Test. Humans. Insulin-Like Growth Factor I / analysis. Male. Middle Aged. Retrospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 15670198.001).
  • [ISSN] 0300-0664
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 67763-96-6 / Insulin-Like Growth Factor I; 9002-72-6 / Growth Hormone
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3. Ferone D, de Herder WW, Pivonello R, Kros JM, van Koetsveld PM, de Jong T, Minuto F, Colao A, Lamberts SW, Hofland LJ: Correlation of in vitro and in vivo somatotropic adenoma responsiveness to somatostatin analogs and dopamine agonists with immunohistochemical evaluation of somatostatin and dopamine receptors and electron microscopy. J Clin Endocrinol Metab; 2008 Apr;93(4):1412-7
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  • [Title] Correlation of in vitro and in vivo somatotropic adenoma responsiveness to somatostatin analogs and dopamine agonists with immunohistochemical evaluation of somatostatin and dopamine receptors and electron microscopy.
  • OBJECTIVE AND PATIENTS: Twenty-four pituitary adenomas from acromegalic patients (13 females, 11 males; age range 19-65 yr) were characterized for somatostatin receptor subtype 2A (sst(2A)), dopamine D(2) receptor (D(2)R), GH, and prolactin (PRL) expression by immunohistochemistry, and results correlated with the in vitro and in vivo hormone responses to octreotide and quinagolide.
  • In nine cases, GH and PRL content was further studied by immunoelectron microscopy.
  • Sst(2A) was scored as 2 in 13 cases, 1 in 10, and 0 in one; D(2)R was scored as 2 in 13 cases, 1 in nine, and 0 in 2; GH was 2 in 15 cases and 1 in nine; PRL was 2 in six cases, 1 in 13, and 0 in 5.
  • Sst(2A) was positively correlated with in vitro (P = 0.003) and in vivo (P = 0.006) percent GH suppression by octreotide and with the chronic suppression of IGF-I by somatostatin analogs (P =0.008).
  • D(2)R was positively correlated with in vitro percent GH (P =0.000) and PRL (P =0.005) suppression by quinagolide.
  • Electron microscopy revealed two pure somatotroph adenomas, five somatomammotrophs with a variable coexpression of GH and PRL in the same cells, and two tumors consisting of mixed cell types, which were less sensitive to quinagolide and octreotide.
  • CONCLUSION: Sst(2A) and D(2)R are frequently coexpressed in adenomas from acromegalic patients, and immunohistochemistry may be helpful in characterizing receptor expression in pituitary adenomas to select patients responsive to different treatments.
  • [MeSH-major] Adenoma / drug therapy. Aminoquinolines / therapeutic use. Dopamine Agonists / therapeutic use. Growth Hormone-Secreting Pituitary Adenoma / drug therapy. Octreotide / therapeutic use. Receptors, Dopamine D2 / analysis. Receptors, Somatostatin / analysis
  • [MeSH-minor] Adult. Female. Human Growth Hormone / blood. Humans. Immunohistochemistry. Male. Microscopy, Electron. Middle Aged. Prolactin / blood

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  • (PMID = 18211974.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Dopamine Agonists; 0 / Receptors, Dopamine D2; 0 / Receptors, Somatostatin; 0 / somatostatin receptor sst2A; 12629-01-5 / Human Growth Hormone; 80Q9QWN15M / quinagolide; 9002-62-4 / Prolactin; RWM8CCW8GP / Octreotide
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4. Schindler K, Christ ER, Mindermann T, Wieser HG: Transient MR changes and symptomatic epilepsy following gamma knife treatment of a residual GH-secreting pituitary adenoma in the cavernous sinus. Acta Neurochir (Wien); 2006 Aug;148(8):903-8; discussion 908
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  • [Title] Transient MR changes and symptomatic epilepsy following gamma knife treatment of a residual GH-secreting pituitary adenoma in the cavernous sinus.
  • OBJECTIVE: To report a rare side effect of gamma knife treatment of pituitary macroadenoma.
  • CASE REPORT: In a forty-one-year old female patient acromegaly was diagnosed due to a growth hormone secreting pituitary macroadenoma.
  • Following transsphenoidal surgery the patient underwent gamma knife treatment for persistent uncontrolled acromegaly activity of residual tumor, infiltrating the left cavernous sinus.
  • CONCLUSION: Gamma knife surgery of a pituitary adenoma may cause radiation induced MR changes of the mesial temporal lobe mimicking glioma or radionecrosis and cause symptomatic epileptic seizures.
  • [MeSH-major] Adenoma / surgery. Brain Injuries / etiology. Epilepsy / etiology. Growth Hormone-Secreting Pituitary Adenoma / surgery. Radiation Injuries / etiology. Radiosurgery / adverse effects
  • [MeSH-minor] Acromegaly / etiology. Acromegaly / surgery. Adult. Cavernous Sinus / pathology. Cavernous Sinus / physiopathology. Cavernous Sinus / surgery. Female. Humans. Magnetic Resonance Imaging. Necrosis / diagnosis. Necrosis / etiology. Necrosis / physiopathology. Neoplasm Recurrence, Local / surgery. Pituitary Gland / pathology. Pituitary Gland / physiopathology. Pituitary Gland / surgery. Positron-Emission Tomography. Postoperative Complications / diagnosis. Postoperative Complications / etiology. Postoperative Complications / physiopathology. Temporal Lobe / pathology. Temporal Lobe / radiation effects. Temporal Lobe / radionuclide imaging

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  • (PMID = 16761113.001).
  • [ISSN] 0001-6268
  • [Journal-full-title] Acta neurochirurgica
  • [ISO-abbreviation] Acta Neurochir (Wien)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Austria
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5. Ben Salem Hachmi L, Kammoun I, Bouzid C, Smida H, Nagi S, Turki Z, Ben Slama C: [Management of acromegaly in pregnant woman]. Ann Endocrinol (Paris); 2010 Feb;71(1):60-3
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  • [Title] [Management of acromegaly in pregnant woman].
  • [Transliterated title] Prise en charge de l'acromégalie évolutive au cours de la grossesse.
  • On the other hand, pregnancy may cause an enlargement of the adenoma or an increase of growth hormone (GH) secretion.
  • We report the case of a 26-year-old woman with a GH-secreting pituitary macroadenoma who was operated by transphenoidal approach.
  • After surgery, she had a persistent acromegaly due to an intrasellar tumour.
  • Lanreotide was stopped when the diagnosis of pregnancy was established.
  • The pituitary adenoma was not significantly enlarged during pregnancy.
  • Therefore, pregnancy doesn't influence acromegaly in young women well controlled by medical treatment.
  • [MeSH-major] Acromegaly / surgery. Adenoma / surgery. Growth Hormone-Secreting Pituitary Adenoma / surgery. Pregnancy Complications / surgery
  • [MeSH-minor] Adult. Anti-Inflammatory Agents / therapeutic use. Female. Human Growth Hormone / blood. Humans. Insulin-Like Growth Factor I / metabolism. Magnetic Resonance Imaging. Peptides, Cyclic / therapeutic use. Pregnancy. Pregnancy Outcome. Somatostatin / analogs & derivatives. Somatostatin / therapeutic use

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  • [Copyright] Copyright (c) 2009 Elsevier Masson SAS. All rights reserved.
  • (PMID = 19926070.001).
  • [ISSN] 0003-4266
  • [Journal-full-title] Annales d'endocrinologie
  • [ISO-abbreviation] Ann. Endocrinol. (Paris)
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Anti-Inflammatory Agents; 0 / Peptides, Cyclic; 118992-92-0 / lanreotide; 12629-01-5 / Human Growth Hormone; 51110-01-1 / Somatostatin; 67763-96-6 / Insulin-Like Growth Factor I
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6. Abbassioun K, Amirjamshidi M, Mehrazin A, Khalatbary I, Keynama M, Bokai H, Abdollahi M: A prospective analysis of 151 cases of patients with acromegaly operated by one neurosurgeon: a follow-up of more than 23 years. Surg Neurol; 2006 Jul;66(1):26-31; discussion 31
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  • [Title] A prospective analysis of 151 cases of patients with acromegaly operated by one neurosurgeon: a follow-up of more than 23 years.
  • BACKGROUND: Transsphenoidal adenomectomy has been the accepted surgical management for treatment of growth hormone (GH)-secreting pituitary adenomas.
  • Although the goal of treatment might be to keep the GH level in the reference range, the actual definition of success in control of acromegaly is not yet clear.
  • The preoperative hormonal studies documenting the high GH and/or insulin-like growth factor were available in all the cases.
  • RESULTS: There were 90 patients with pure GH-secreting adenoma (59.6%) with the highest GH level of 235 mU/L.
  • A second group of 12 patients had normal GH level but elevated serum level of insulin-like growth factor 1 (8%).
  • The group with mixed secretion of GH and prolactin included 49 cases (32.4%).
  • Normal postoperative serum GH level could be achieved in 98 patients (94.2%) of 104 cases with full follow-up.
  • CONCLUSION: In the developing countries, early diagnosis and proper surgical extirpation of the GH-secreting adenoma by an experienced and dedicated pituitary surgeon is mandatory to reduce the mortality and increase the chance of cure of this rather mortal endocrionopathy.
  • [MeSH-major] Acromegaly / surgery. Adenoma / surgery. Growth Hormone-Secreting Pituitary Adenoma / surgery. Hypophysectomy / methods
  • [MeSH-minor] Adolescent. Adult. Aged. Cerebrospinal Fluid Rhinorrhea / etiology. Cerebrospinal Fluid Rhinorrhea / physiopathology. Diabetes Insipidus / etiology. Diabetes Insipidus / physiopathology. Early Diagnosis. Female. Follow-Up Studies. Growth Hormone / blood. Growth Hormone / secretion. Humans. Hypopituitarism / etiology. Hypopituitarism / physiopathology. Insulin-Like Growth Factor I / metabolism. Insulin-Like Growth Factor I / secretion. Male. Middle Aged. Pituitary Gland / physiopathology. Pituitary Gland / secretion. Pituitary Gland / surgery. Postoperative Complications / etiology. Postoperative Complications / physiopathology. Prolactin / blood. Prolactin / secretion. Prospective Studies. Sella Turcica / anatomy & histology. Sella Turcica / pathology. Sella Turcica / surgery. Sphenoid Bone / anatomy & histology. Sphenoid Bone / pathology. Sphenoid Bone / surgery. Treatment Outcome

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  • (PMID = 16793431.001).
  • [ISSN] 0090-3019
  • [Journal-full-title] Surgical neurology
  • [ISO-abbreviation] Surg Neurol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 67763-96-6 / Insulin-Like Growth Factor I; 9002-62-4 / Prolactin; 9002-72-6 / Growth Hormone
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7. Wang HF, Huang CC, Chen YF, Ho DM, Lin HD: Pituitary apoplexy after thyrotropin-releasing hormone stimulation test in a patient with pituitary macroadenoma. J Chin Med Assoc; 2007 Sep;70(9):392-5
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  • [Title] Pituitary apoplexy after thyrotropin-releasing hormone stimulation test in a patient with pituitary macroadenoma.
  • Pituitary apoplexy is a rare complication of pituitary tumors.
  • We report a case of a 41-year-old female with acromegaly due to a pituitary macroadenoma, who developed pituitary apoplexy after a thyrotropin-releasing hormone (TRH) 200 microgram intravenous injection stimulation test.
  • Two days later, the pituitary mass, removed by transsphenoidal approach, showed ischemic necrosis and acute hemorrhage.
  • The TRH test is generally safe for evaluating pituitary function, but pituitary apoplexy may occur after the procedure.
  • CT and MRI may miss the diagnosis of pituitary apoplexy, especially if performed immediately after the acute episode.
  • [MeSH-major] Adenoma / complications. Pituitary Apoplexy / etiology. Pituitary Function Tests / adverse effects. Pituitary Neoplasms / complications. Thyrotropin-Releasing Hormone
  • [MeSH-minor] Adult. Female. Human Growth Hormone / blood. Humans

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  • (PMID = 17908654.001).
  • [ISSN] 1726-4901
  • [Journal-full-title] Journal of the Chinese Medical Association : JCMA
  • [ISO-abbreviation] J Chin Med Assoc
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] China (Republic : 1949- )
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 5Y5F15120W / Thyrotropin-Releasing Hormone
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8. Flitsch J, Lüdecke DK, Saeger W, Veit JA, Metternich FU: [Acromegaly-associated lesions of the nasal mucosa. Case report]. HNO; 2009 Aug;57(8):845-50
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  • [Title] [Acromegaly-associated lesions of the nasal mucosa. Case report].
  • Acromegaly is a rare disease caused by a growth-hormone-secreting pituitary adenoma.
  • Besides these "cosmetic" symptoms, the disease is associated with hypertension and diabetes mellitus, as well as with an increased risk for adenomas and carcinomas of the colon.
  • The average time span from first symptom to diagnosis is well over 6 years; a single determination of insulin-like growth factor 1 in serum can confirm the disease.
  • The treatment of choice remains surgical resection of the adenoma in suitable patients, whereas in extensive disease with invasion of surrounding tissue, drug therapy and/or radiotherapy may be necessary.
  • [MeSH-major] Acromegaly / complications. Acromegaly / surgery. Adenoma / etiology. Adenoma / surgery. Nasal Mucosa / surgery. Nose Neoplasms / etiology. Nose Neoplasms / surgery

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  • (PMID = 19557321.001).
  • [ISSN] 1433-0458
  • [Journal-full-title] HNO
  • [ISO-abbreviation] HNO
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Germany
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9. Wasko R, Jaskuła M, Plewa R, Komarowska H, Poreba E, Goździcka-Józefiak A, Liebert W, Bednarek J, Sowiński J: The evaluation of ghrelin mRNA expression in human somatotroph adenomas. Neuro Endocrinol Lett; 2006 Feb-Apr;27(1-2):169-73
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  • [Title] The evaluation of ghrelin mRNA expression in human somatotroph adenomas.
  • Ghrelin is one of the peptides involved into GH-release, binding to specific GHS receptors on hypothalamus and pituitary.
  • The ghrelin peptide and ghrelin mRNA have been detected in several regions of hypothalamus, in normal pituitary, as well as in various types of pituitary adenoma, with different levels of expression in different tumour types.
  • We decided to determine the expression of ghrelin in somatotroph adenomas.
  • Human pituitary somatotroph adenoma tissues were obtained at the time of transsphenoidal surgery from 3 acromegalic patients and studied for ghrelin mRNA expression.
  • We wished to determine the number of copies of ghrelin gene within the single cell.
  • [MeSH-major] Adenoma / metabolism. Human Growth Hormone / metabolism. Peptide Hormones / biosynthesis. Pituitary Neoplasms / metabolism

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  • (PMID = 16648773.001).
  • [ISSN] 0172-780X
  • [Journal-full-title] Neuro endocrinology letters
  • [ISO-abbreviation] Neuro Endocrinol. Lett.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Sweden
  • [Chemical-registry-number] 0 / Actins; 0 / DNA, Complementary; 0 / Ghrelin; 0 / Peptide Hormones; 0 / RNA, Messenger; 12629-01-5 / Human Growth Hormone; EC 1.2.1.- / Glyceraldehyde-3-Phosphate Dehydrogenases
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10. Cordero RA, Barkan AL: Current diagnosis of acromegaly. Rev Endocr Metab Disord; 2008 Mar;9(1):13-9
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  • [Title] Current diagnosis of acromegaly.
  • Acromegaly is a rare and chronic condition that is characterized by sustained unregulated hypersecretion of growth hormone (GH).
  • More than 99% of the cases of acromegaly are due to a pathologic proliferation of pituitary somatotrophs presenting in the form of a pituitary adenoma.
  • The excessive amounts of GH and its target hormone, insulin like growth factor-1 (IGF-1) cause metabolic changes and tissue enlargement that, collectively, lead to significant morbidity and a two to threefold increase in mortality.
  • Thus, early diagnosis has proved to be crucial to improve survival and quality of life in this condition.
  • The development of radioimmunoassay (RIA) in the 1960s provided clinicians with a biochemical tool to diagnose acromegaly.
  • Many limitations were inherent to this methodology which necessitated the development of more sensitive tools, such as immunoradiometric (IRMA) or immunoluminometric (ILMA) assays for GH and IGF-1 measurements.
  • The reference ranges to describe normalcy of the somatotropic axis and the biochemical criteria of "cure" of acromegaly are areas of great debate.
  • Nevertheless, the current international consensus agrees that the diagnosis of acromegaly should be based on both clinical presentation and biochemical data.
  • [MeSH-major] Acromegaly / diagnosis. Growth Hormone / blood. Insulin-Like Growth Factor I / metabolism
  • [MeSH-minor] Adenoma / blood. Adenoma / complications. Adenoma / pathology. Humans. Pituitary Gland / metabolism. Pituitary Gland / pathology. Pituitary Neoplasms / blood. Pituitary Neoplasms / complications. Pituitary Neoplasms / pathology

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  • (PMID = 18236162.001).
  • [ISSN] 1389-9155
  • [Journal-full-title] Reviews in endocrine & metabolic disorders
  • [ISO-abbreviation] Rev Endocr Metab Disord
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 67763-96-6 / Insulin-Like Growth Factor I; 9002-72-6 / Growth Hormone
  • [Number-of-references] 72
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11. Bhayana S, Booth GL, Asa SL, Kovacs K, Ezzat S: The implication of somatotroph adenoma phenotype to somatostatin analog responsiveness in acromegaly. J Clin Endocrinol Metab; 2005 Nov;90(11):6290-5
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  • [Title] The implication of somatotroph adenoma phenotype to somatostatin analog responsiveness in acromegaly.
  • CONTEXT: Persistently elevated GH and IGF-I levels are associated with increased mortality.
  • OBJECTIVE: The objective of this study was to examine the significance of somatotroph adenoma type on response to SSA.
  • PATIENTS: Forty patients with acromegaly were studied.
  • MAIN OUTCOME MEASURES: Normalization of IGF-I levels and GH responses were the main outcome measures.
  • RESULTS: Univariate analysis revealed that responders were more likely to have densely granulated somatotroph adenomas (80% vs. 43.8%; P = 0.024), to be older (51.3 vs. 38.2 yr; P < 0.003), to have smaller tumors (stage < or =3; 78.6% vs. 35.7%; P = 0.022), to have lower baseline IGF-I (453 vs. 716 microg/liter; P < 0.001) and GH levels (2.7 vs. 7.8 microg/liter; P < 0.05), and to require a lower maximum dose of SSA (24 vs. 31 mg every 4 wk; P = 0.013).
  • Multivariate analysis confirmed that a densely granulated adenoma was the strongest predictor of complete response [adjusted odds ratio (OR), 58.41; 95% confidence interval (CI), 1.24-1000.00; P = 0.04] compared with other covariates, including older age at time of diagnosis (OR, 1.15/yr; 95% CI, 1.01-1.31; P = 0.03), and tumor stage of 3 or less (OR, 29.77; 95% CI, 1.01-885.45; P < 0.05).
  • CONCLUSIONS: Somatotroph tumor type represents a strong clinical predictor of response to SSA treatment and will help to identify patients who warrant more vigilant management of their disease.
  • [MeSH-major] Acromegaly / drug therapy. Adenoma / drug therapy. Octreotide / therapeutic use. Pituitary Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Female. Human Growth Hormone / blood. Humans. Insulin-Like Growth Factor I / analysis. Male. Middle Aged. Multivariate Analysis. Phenotype. Retrospective Studies

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  • (PMID = 16118335.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I; RWM8CCW8GP / Octreotide
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12. Noh SJ, Ahn JY, Lee KS, Kim SH: Pituitary adenoma and concomitant Rathke's cleft cyst. Acta Neurochir (Wien); 2007 Dec;149(12):1223-8
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  • [Title] Pituitary adenoma and concomitant Rathke's cleft cyst.
  • Although pituitary adenomas and Rathke's cleft cysts have a shared ancestry, they rarely occur simultaneously.
  • Only 32 reports involving a pituitary adenoma and a concomitant Rathke's cleft cyst were identified upon review of the literature.
  • Next to growth hormone, Prolactin was the most commonly hypersecreted pituitary hormone.
  • Here, we report a patient with a growth hormone- secreting pituitary adenoma associated with a Rathke's cleft cyst.
  • When a non-enhancing cyst-like structure is demonstrated on imaging in a patient with a pituitary adenoma, the possibility of a coexisting Rathke's cleft cyst should be considered.
  • [MeSH-major] Adenoma / surgery. Central Nervous System Cysts / surgery. Growth Hormone-Secreting Pituitary Adenoma / surgery. Neoplasms, Multiple Primary / surgery. Pituitary Neoplasms / surgery
  • [MeSH-minor] Diagnosis, Differential. Female. Humans. Image Processing, Computer-Assisted. Magnetic Resonance Imaging. Middle Aged. Neuronavigation. Pituitary Gland / pathology

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  • (PMID = 17914599.001).
  • [ISSN] 0942-0940
  • [Journal-full-title] Acta neurochirurgica
  • [ISO-abbreviation] Acta Neurochir (Wien)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Austria
  • [Number-of-references] 28
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13. Pegvisomant: new preparation. A last resort in acromegaly. Prescrire Int; 2005 Feb;14(75):10-3
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  • [Title] Pegvisomant: new preparation. A last resort in acromegaly.
  • (1) The first-line treatment for acromegaly is transsphenoidal surgery.
  • As an adjunct to surgery, and for patients with inoperable tumours, the first-line drug therapy is a somatostatin analogue (octreotide or lanreotide). (2) Pegvisomant, a growth hormone (GH) receptor antagonist, is licensed for patients who have a poor response to surgery and/or radiation therapy and in whom somatostatin analogue therapy has failed. (3) There are no published comparative trials evaluating pegvisomant as alternative for patients who have already tried a somatostatin analogue.
  • It showed that pegvisomant, at a dose of 10 mg to 20 mg/day subcutaneously, normalised the level of insulin-like growth factor type 1 (IGF-1) and improved some symptoms.
  • This trial does not provide enough evidence to support the approved indication. (4) Pegvisomant lowers the IGF-1 level but also increases the GH level.
  • An increase in the size of the pituitary adenoma, due to the resulting hyperfunctioning, was observed in four of the 160 patients treated in clinical trials. (5) Evaluation data on pegvisomant does not resolve the question of possible hepatic toxicity. (6) In practice, pegvisomant therapy is justified for patients with serious complications of acromegaly and who have no other treatment options.
  • [MeSH-major] Acromegaly / drug therapy. Human Growth Hormone / therapeutic use
  • [MeSH-minor] Adenoma / surgery. Drug Approval. Europe. Humans. Octreotide / administration & dosage. Octreotide / adverse effects. Octreotide / therapeutic use. Randomized Controlled Trials as Topic. Somatostatin / administration & dosage. Somatostatin / adverse effects. Somatostatin / analogs & derivatives. Somatostatin / therapeutic use

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  • (PMID = 15751152.001).
  • [ISSN] 1167-7422
  • [Journal-full-title] Prescrire international
  • [ISO-abbreviation] Prescrire Int
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 51110-01-1 / Somatostatin; RWM8CCW8GP / Octreotide
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14. Andrioli M, Pecori Giraldi F, Losa M, Terreni M, Invitti C, Cavagnini F: Cushing's disease due to double pituitary ACTH-secreting adenomas: the first case report. Endocr J; 2010;57(9):833-7
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  • [Title] Cushing's disease due to double pituitary ACTH-secreting adenomas: the first case report.
  • Double pituitary adenomas are rare occurrences in autoptical, surgical and neuroradiological series and are mostly due to non-functioning pituitary adenomas, GH-secreting and prolactin-secreting adenomas.
  • ACTH secreting tumours are more rare and, to our knowledge, two distinct ACTH-producing adenomas within the same pituitary have never been reported.
  • We herewith describe a 56 year old woman with Cushing' s disease due to two clearly distinct ACTH-secreting pituitary adenomas.
  • She presented with signs and symptoms of hypercortisolism and hormonal testing was indicative for pituitary-dependent Cushing' s syndrome.
  • Sellar MRI visualized an asymmetric pituitary gland with suspect lesions in both the right and the left pituitary lobes.
  • Pathology confirmed the existence of two distinct adenomas located in different sites in the gland.
  • Our case indicates that double ACTH-secreting pituitary adenomas may occur in patients with Cushing' s disease.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / pathology. Adenoma / pathology. Neoplasms, Multiple Primary / pathology. Pituitary ACTH Hypersecretion / etiology
  • [MeSH-minor] Cushing Syndrome / etiology. Female. Humans. Middle Aged. Pituitary Neoplasms / pathology

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  • (PMID = 20595779.001).
  • [ISSN] 1348-4540
  • [Journal-full-title] Endocrine journal
  • [ISO-abbreviation] Endocr. J.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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15. Isikay I, Berker M, Balci S, Cila A: Somatotroph adenoma cells may populate paranasal sinus mucosa. Acta Neurochir (Wien); 2010 Sep;152(9):1629-30; discussion 1630
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  • [Title] Somatotroph adenoma cells may populate paranasal sinus mucosa.
  • [MeSH-major] Growth Hormone-Secreting Pituitary Adenoma / secondary. Nasal Mucosa / pathology. Neoplasm Invasiveness / pathology. Paranasal Sinus Neoplasms / secondary. Pituitary Neoplasms / pathology. Sphenoid Sinus / pathology

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  • (PMID = 20446098.001).
  • [ISSN] 0942-0940
  • [Journal-full-title] Acta neurochirurgica
  • [ISO-abbreviation] Acta Neurochir (Wien)
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] Austria
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16. Mercado M, Galeana M: [Pharmacological treatment of acromegaly]. Gac Med Mex; 2006 Jul-Aug;142(4):327-31
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  • [Title] [Pharmacological treatment of acromegaly].
  • [Transliterated title] Tratamiento farmacológico de la acromegalia.
  • Acromegaly is an endocrine disorder usually due to a growth hormone (GH)-secreting pituitary adenoma.
  • This deforming disease is associated with several metabolic abnormalities and results in an elevated cardiovascular mortality.
  • Pituitary transsesphenoidal surgery has been considered the treatment of choice, however, even in the most experienced hands this procedure succeeds in curing only 50 to 60% of the patients.
  • Therefore, close to 50% of patients require an adjunctive form of treatment such as radiation therapy or the use of diverse medications that modulate GH secretion (somatostatin analogues) or action (GH receptor antagonists).
  • [MeSH-major] Acromegaly / drug therapy
  • [MeSH-minor] Humans. Receptors, Somatotropin / antagonists & inhibitors. Somatostatin / analogs & derivatives. Somatostatin / therapeutic use

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  • (PMID = 17022308.001).
  • [ISSN] 0016-3813
  • [Journal-full-title] Gaceta médica de México
  • [ISO-abbreviation] Gac Med Mex
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Mexico
  • [Chemical-registry-number] 0 / Receptors, Somatotropin; 51110-01-1 / Somatostatin
  • [Number-of-references] 66
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17. Fusco A, Zatelli MC, Bianchi A, Cimino V, Tilaro L, Veltri F, Angelini F, Lauriola L, Vellone V, Doglietto F, Ambrosio MR, Maira G, Giustina A, degli Uberti EC, Pontecorvi A, De Marinis L: Prognostic significance of the Ki-67 labeling index in growth hormone-secreting pituitary adenomas. J Clin Endocrinol Metab; 2008 Jul;93(7):2746-50
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  • [Title] Prognostic significance of the Ki-67 labeling index in growth hormone-secreting pituitary adenomas.
  • OBJECTIVE: The aim of the study was to evaluate the Ki-67 index prognostic relevance in a group of acromegalic patients who underwent transsphenoidal surgery for a GH-secreting pituitary adenoma.
  • The Ki-67 index was determined by immunohistochemistry on tissue samples obtained from each adenoma after surgery.
  • Periodical pituitary magnetic resonance imaging and hormonal evaluation were performed during the follow-up.
  • Pituitary magnetic resonance imaging showed residual/recurrent disease in 25 of 68 patients after 6 months.
  • No correlation was found between Ki-67 index and age, tumor size, GH, or IGF-I plasma levels.
  • We suggest routine Ki-67 evaluation in GH-secreting pituitary adenomas.
  • [MeSH-major] Adenoma / pathology. Growth Hormone-Secreting Pituitary Adenoma / pathology. Ki-67 Antigen / analysis

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  • (PMID = 18460561.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Ki-67 Antigen; 51110-01-1 / Somatostatin
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18. Jezková J, Marek J, Hána V, Krsek M, Weiss V, Vladyka V, Lisák R, Vymazal J, Pecen L: Gamma knife radiosurgery for acromegaly--long-term experience. Clin Endocrinol (Oxf); 2006 May;64(5):588-95
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  • [Title] Gamma knife radiosurgery for acromegaly--long-term experience.
  • OBJECTIVE: The Leksell gamma knife (LGK) is one of the treatment options for pituitary adenomas.
  • We report on our long-term experience treating acromegaly using LGK.
  • DESIGN: Since 1993 we have followed 96 acromegaly patients through periods of from 12 to 120 months.
  • Thirteen patients were irradiated twice, due to persistent activity of the adenoma or its residue.
  • Pituitary functions were tested at 6-month intervals, post-irradiation.
  • RESULTS: Fifty per cent of the patients achieved mean GH < 2.5 microg/l within 42 months, normalized their IGF-I within 54 months, and achieved GH suppression in the oral glucose tolerance test (oGTT) < 1 microg/l with normal IGF-I within 66 months.
  • LGK effectiveness was dependent on initial adenoma hormonal activity (GH and IGF-I serum levels), not on the size of the adenoma.
  • Irradiation arrested all adenoma growth, causing tumour shrinkage in 62.3% of patients.
  • Twenty-six developed hypopituitarism when irradiated by 15 Gy (or more) on functional peritumoral pituitary tissue.
  • CONCLUSIONS: In acromegaly, LGK is a useful adjunct to primary neurosurgery when treating post-surgical residues because it can limit the duration of medical therapy.
  • [MeSH-major] Acromegaly / surgery. Adenoma / surgery. Pituitary Neoplasms / surgery. Radiosurgery / instrumentation
  • [MeSH-minor] Adolescent. Adult. Aged. Blood Glucose / analysis. Combined Modality Therapy. Female. Follow-Up Studies. Growth Hormone / blood. Humans. Insulin-Like Growth Factor I / analysis. Male. Middle Aged. Neurosurgical Procedures. Statistics, Nonparametric. Treatment Outcome

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  • (PMID = 16649981.001).
  • [ISSN] 0300-0664
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Blood Glucose; 67763-96-6 / Insulin-Like Growth Factor I; 9002-72-6 / Growth Hormone
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19. Zada G, Sivakumar W, Fishback D, Singer PA, Weiss MH: Significance of postoperative fluid diuresis in patients undergoing transsphenoidal surgery for growth hormone-secreting pituitary adenomas. J Neurosurg; 2010 Apr;112(4):744-9
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  • [Title] Significance of postoperative fluid diuresis in patients undergoing transsphenoidal surgery for growth hormone-secreting pituitary adenomas.
  • OBJECT: Following successful transsphenoidal surgery in patients with growth hormone (GH)-secreting pituitary adenomas, a characteristic fluid diuresis has been described.
  • In this paper the authors aimed to further analyze the degree of fluid diuresis as it relates to postoperative GH levels.
  • METHODS: Between 2000 and 2008, 85 patients underwent transsphenoidal surgery for a GH-secreting adenoma at the USC University Hospital.
  • Patients with negative fluid balances at 48 hours after surgery were more than twice as likely to have a GH level of < 1.5 ng/ml (55 vs 25%, p = 0.023).
  • At 48 hours after surgery, patients with a negative overall fluid balance had a significantly lower median GH level than those with a positive overall fluid balance (1.3 vs 2.4 ng/ml, p = 0.039).
  • By 48 hours following surgery, patients with postoperative Day 1 GH levels < 1.5 ng/ml had, on average, experienced diuresis of fluid > 1.1 L (median 1.5 L) more than patients with GH levels > 1.5 ng/ml.
  • CONCLUSIONS: Successful resection of GH-secreting adenomas is associated with a more pronounced fluid diuresis and negative overall fluid balance within 48 hours following transsphenoidal surgery.
  • Patients with a negative fluid balance by postoperative Day 2 have a higher likelihood of having significantly reduced postoperative GH levels that may correlate with long-term surgical remission.
  • [MeSH-major] Adenoma / surgery. Diuresis. Growth Hormone-Secreting Pituitary Adenoma / surgery. Postoperative Complications / diagnosis. Water-Electrolyte Balance
  • [MeSH-minor] Acromegaly / surgery. Adolescent. Adult. Aged. Female. Human Growth Hormone / secretion. Humans. Male. Middle Aged. Plasma Volume. Retrospective Studies. Sphenoid Bone / surgery. Young Adult

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  • (PMID = 19698049.001).
  • [ISSN] 1933-0693
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone
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20. Miyoshi T, Otsuka F, Kawabata T, Inagaki K, Mukai T, Kawashima M, Ogura T, Yamamura M, Sei T, Makino H: Manifestation of rheumatoid arthritis after transsphenoidal surgery in a patient with acromegaly. Endocr J; 2006 Oct;53(5):621-5
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  • [Title] Manifestation of rheumatoid arthritis after transsphenoidal surgery in a patient with acromegaly.
  • Acromegalic arthropathy is one of the most frequent manifestations occurring in acromegaly patients.
  • In contrast, rheumatoid arthritis (RA) is a rare clinical complication in acromegaly patients.
  • Here, we report a 70-year-old Japanese woman with acromegaly, who complained of bilateral finger stiffness and polyarthralgia two months after transsphenoidal surgery of a growth hormone (GH)-secreting pituitary adenoma.
  • Postoperative levels of serum GH and insulin-like growth factor-1 (IGF-1) were markedly decreased without any secretory deficiency of other anterior pituitary hormones.
  • Regardless of the levels of GH and IGF-1, acromegaly patients frequently complain about joint-related symptoms even after remission.
  • Therefore, careful observation of bone erosive changes and immunological activity in acromegaly patients is required when joint-related symptoms persist.
  • [MeSH-major] Acromegaly / complications. Arthritis, Rheumatoid / etiology. Sphenoid Bone / surgery
  • [MeSH-minor] Adenoma / complications. Adenoma / radiography. Adenoma / surgery. Aged. Bone Marrow Diseases / complications. Bone Marrow Diseases / radiography. C-Reactive Protein / analysis. Female. Growth Hormone / blood. Growth Hormone-Secreting Pituitary Adenoma / complications. Growth Hormone-Secreting Pituitary Adenoma / radiography. Growth Hormone-Secreting Pituitary Adenoma / surgery. Hand / radiography. Humans. Synovitis / complications. Synovitis / radionuclide imaging


21. Fougner SL, Lekva T, Borota OC, Hald JK, Bollerslev J, Berg JP: The expression of E-cadherin in somatotroph pituitary adenomas is related to tumor size, invasiveness, and somatostatin analog response. J Clin Endocrinol Metab; 2010 May;95(5):2334-42
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  • [Title] The expression of E-cadherin in somatotroph pituitary adenomas is related to tumor size, invasiveness, and somatostatin analog response.
  • CONTEXT: Appropriate cell-to-cell adhesion is fundamental for the epithelial phenotype of pituitary cells.
  • In somatotroph adenomas, a variable and reduced expression of E-cadherin has been demonstrated.
  • In addition, nuclear translocation of E-cadherin was found to correlate with pituitary tumor invasion.
  • OBJECTIVE: The objective was to examine the protein expression of E-cadherin in somatotroph pituitary adenomas in relation to adenoma size, invasiveness, and somatostatin analog (SMS) efficacy.
  • Adenoma E-cadherin protein expression was analyzed by Western blot (61 patients) and immunohistochemistry (IHC) (80 patients) with antibodies directed against both extracellular and intracellular domains (IHC).
  • RESULTS: Membranous E-cadherin was lost in several adenomas.
  • The E-cadherin level correlated positively to tumor reduction after SMS treatment, and adenomas with nuclear E-cadherin staining had lower IGF-I reduction and tumor shrinkage.
  • Preoperatively treated adenomas had reduced E-cadherin protein levels, but the IHC expression was unaltered.
  • CONCLUSION: Reduced E-cadherin expression may correlate to a dedifferentiated phenotype in the somatotroph pituitary adenomas.
  • [MeSH-major] Cadherins / genetics. Peptide Fragments / therapeutic use. Pituitary Neoplasms / genetics. Somatostatin / therapeutic use
  • [MeSH-minor] Acromegaly / complications. Acromegaly / surgery. Adult. Female. Growth Hormone / blood. Humans. Immunohistochemistry. Insulin-Like Growth Factor I / metabolism. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Invasiveness


22. Meij BP, Auriemma E, Grinwis G, Buijtels JJ, Kooistra HS: Successful treatment of acromegaly in a diabetic cat with transsphenoidal hypophysectomy. J Feline Med Surg; 2010 May;12(5):406-10
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  • [Title] Successful treatment of acromegaly in a diabetic cat with transsphenoidal hypophysectomy.
  • Plasma concentrations of growth hormone (GH) (51 microg/l, reference range 0.8-7.2 microg/l) and insulin-like growth factor 1 (IGF-1) (3871 microg/l, reference range 39-590 microg/l) were highly elevated, whereas those of alpha-melanocyte-stimulating hormone, adrenocorticotropic hormone and cortisol were normal.
  • Computed tomography revealed a thick palatum molle and an enlarged pituitary gland, indicating a pituitary neoplasm.
  • Microsurgical transsphenoidal hypophysectomy was performed and microscopic examination of the surgical specimen revealed an acidophilic, infiltrative pituitary adenoma that showed positive immunostaining for GH.
  • One year after hypophysectomy the plasma concentrations of GH and IGF-1 were 2.4 microg/l and 113 microg/l, respectively.
  • PRACTICAL RELEVANCE: This is the first report detailing transsphenoidal hypophysectomy as a feasible and effective treatment for feline acromegaly due to a pituitary somatotroph adenoma.
  • The surgery is discussed in the context of human and other feline therapies for acromegaly.
  • [MeSH-major] Acromegaly / veterinary. Adenocarcinoma / veterinary. Cat Diseases / surgery. Hypophysectomy / veterinary
  • [MeSH-minor] Adrenocortical Hyperfunction / blood. Adrenocortical Hyperfunction / complications. Adrenocortical Hyperfunction / surgery. Adrenocortical Hyperfunction / veterinary. Animals. Blood Glucose / metabolism. Cats. Diabetes Mellitus / blood. Diabetes Mellitus / surgery. Diabetes Mellitus / veterinary. Growth Hormone / blood. Insulin-Like Growth Factor I / metabolism. Male. Sphenoid Bone. Treatment Outcome

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  • [Copyright] Copyright 2010 Elsevier Ltd. All rights reserved.
  • (PMID = 20417901.001).
  • [ISSN] 1532-2750
  • [Journal-full-title] Journal of feline medicine and surgery
  • [ISO-abbreviation] J. Feline Med. Surg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Blood Glucose; 67763-96-6 / Insulin-Like Growth Factor I; 9002-72-6 / Growth Hormone
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23. Xu T, Ye F, Wang B, Tian C, Wang S, Shu K, Guo D, Lei T: Elevation of growth hormone secretagogue receptor type 1a mRNA expression in human growth hormone-secreting pituitary adenoma harboring G protein alpha subunit mutation. Neuro Endocrinol Lett; 2010;31(1):147-54
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  • [Title] Elevation of growth hormone secretagogue receptor type 1a mRNA expression in human growth hormone-secreting pituitary adenoma harboring G protein alpha subunit mutation.
  • OBJECTIVE: The purpose of this study was to investigate the relationship between the ghrelin or GHSR-1a mRNA levels and clinical characteristics and to confirm the effect of gsp mutations on ghrelin/GHSR-1a system in human GH-secreting pituitary adenomas.
  • The gsp mutations in 43 cases of human GH-secreting pituitary adenomas were detected using PCR-DNA direct sequencing analysis.
  • Clinical data were obtained from the medical records of 43 acromegalic patients who had GH and IGF-1 assays in the same laboratory.
  • The expression level of GHSR-1a mRNA was significantly higher in gsp positive adenomas than in negative adenomas (p<0.05).
  • Whereas, there was no significant difference in the expression of ghrelin mRNA between gsp mutation-positive and -negative adenomas (p>0.05).
  • Additionally there was a significant positve correlation between the ghrelin and GHSR-1a mRNA expression levels in gsp-positive (R=0.553, p=0.040) or -negative adenomas (R=0.489, p=0.007).
  • Gsp mutations may upregulate the expression of GHSR-1a mRNA and have no effect on ghrelin mRNA levels in human GH-secreting pituitary adenomas.
  • [MeSH-major] Adenoma / genetics. GTP-Binding Protein alpha Subunits / genetics. Growth Hormone-Secreting Pituitary Adenoma / genetics. Mutation. Receptors, Ghrelin / genetics
  • [MeSH-minor] Acromegaly / etiology. Acromegaly / genetics. Adult. Female. Ghrelin / genetics. Ghrelin / metabolism. Humans. Male. Middle Aged. RNA, Messenger / metabolism. Retrospective Studies. Tumor Burden. Up-Regulation. Young Adult

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  • (PMID = 20150876.001).
  • [ISSN] 0172-780X
  • [Journal-full-title] Neuro endocrinology letters
  • [ISO-abbreviation] Neuro Endocrinol. Lett.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Sweden
  • [Chemical-registry-number] 0 / GTP-Binding Protein alpha Subunits; 0 / Ghrelin; 0 / RNA, Messenger; 0 / Receptors, Ghrelin
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24. Benech F, Perez R, Fontanella MM, Morra B, Albera R, Ducati A: Cystic versus solid vestibular schwannomas: a series of 80 grade III-IV patients. Neurosurg Rev; 2005 Jul;28(3):209-13
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [MeSH-major] Acromegaly / etiology. Acromegaly / therapy. Adenoma / surgery. Human Growth Hormone / metabolism. Neurosurgical Procedures / methods. Pituitary Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Connective Tissue / pathology. Connective Tissue / surgery. Female. Humans. Immunohistochemistry. Male. Microsurgery. Middle Aged. Neoplasm Recurrence, Local. Pituitary Hormones / deficiency

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  • (PMID = 15739069.001).
  • [ISSN] 0344-5607
  • [Journal-full-title] Neurosurgical review
  • [ISO-abbreviation] Neurosurg Rev
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Pituitary Hormones; 12629-01-5 / Human Growth Hormone
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25. Isidro ML, Castro JA, Penín M, Armenta J, Cordido F: The choice of therapy in acromegaly: results of treatment at a tertiary care hospital. Neuro Endocrinol Lett; 2008 Dec;29(6):1038-44
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  • [Title] The choice of therapy in acromegaly: results of treatment at a tertiary care hospital.
  • Demographic, hormonal, visual and imaging data at diagnosis and during follow-up were recorded, as well as the treatments applied.
  • RESULTS: In 73.0% of the patients, acromegaly was due to a pituitary macroadenoma.
  • Considering normal age and sex-matched concentrations of IGF-I as a control criteria, surgery resulted in disease control in 10% of the patients who had surgery, while medical treatment controlled the disease in 76.9% (P <0.05).
  • CONCLUSIONS: Not all centres obtain the results reported in the literature in terms of disease control and morbidity after surgical treatment of growth hormone-secreting tumours.
  • [MeSH-major] Acromegaly / therapy. Adenoma / complications. Insulin-Like Growth Factor I / analysis. Pituitary Neoplasms / complications. Somatostatin / therapeutic use

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  • (PMID = 19112390.001).
  • [ISSN] 0172-780X
  • [Journal-full-title] Neuro endocrinology letters
  • [ISO-abbreviation] Neuro Endocrinol. Lett.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Sweden
  • [Chemical-registry-number] 51110-01-1 / Somatostatin; 67763-96-6 / Insulin-Like Growth Factor I
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26. Mondok A, Aranyi Z, Kovacs GG, Czirjak S, Pusztai P, Varga I, Racz K: Rapid progression of amyotrophic lateral sclerosis in an acromegalic patient after surgical resection of a growth hormone-producing pituitary adenoma. Neurologist; 2010 Sep;16(5):315-8
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  • [Title] Rapid progression of amyotrophic lateral sclerosis in an acromegalic patient after surgical resection of a growth hormone-producing pituitary adenoma.
  • INTRODUCTION: Insulin-like growth factor-1 (IGF-1) promotes the survival of neurons, mediates neuritic growth, and in 1 clinical trial human recombinant IGF-1 delayed the progression of functional impairment and decline of health-related quality of life in patients with amyotrophic lateral sclerosis (ALS).
  • CASE REPORT: We describe a case of a 65-year-old woman with a 2-year history of symptoms and signs of acromegaly because of a pituitary microadenoma.
  • The patient posed a challenging diagnostic dilemma because of the presence of dysarthria, which was initially considered as the consequence of acromegaly.
  • After octreotide long-acting release (LAR) treatment, the patient underwent uneventful pituitary surgery.
  • Although postoperative evaluation indicated a cure of acromegaly, progressive bulbar symptoms developed, which were followed by upper limb weakness and muscle atrophy.
  • Neurologic investigations confirmed the diagnosis of ALS and riluzole therapy was given.
  • One year after surgery growth-hormone deficiency was diagnosed, but a trial with human recombinant growth hormone failed to produce any significant improvement.
  • Histopathologic examination of the brain and spinal cord confirmed the diagnosis of ALS.
  • CONCLUSIONS: This is the first report showing a rapid progression of ALS after a surgical cure of coexisting acromegaly presumably because of cessation of high endogenous IGF-I levels.
  • [MeSH-major] Acromegaly. Amyotrophic Lateral Sclerosis. Disease Progression. Growth Hormone-Secreting Pituitary Adenoma. Pituitary Neoplasms
  • [MeSH-minor] Aged. Antineoplastic Agents, Hormonal / therapeutic use. Fatal Outcome. Female. Human Growth Hormone / deficiency. Human Growth Hormone / therapeutic use. Humans. Insulin-Like Growth Factor I / metabolism. Octreotide / therapeutic use


27. Seda Jr L, Cukiert A, Nogueira KC, Huayllas MK, Liberman B: Intrasellar internal carotid aneurysm coexisting with GH-secreting pituitary adenoma in an acromegalic patient. Arq Neuropsiquiatr; 2008 Mar;66(1):99-100
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  • [Title] Intrasellar internal carotid aneurysm coexisting with GH-secreting pituitary adenoma in an acromegalic patient.
  • [MeSH-major] Acromegaly / complications. Carotid Artery Diseases / complications. Growth Hormone-Secreting Pituitary Adenoma / complications. Intracranial Aneurysm / complications

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  • (PMID = 18392428.001).
  • [ISSN] 0004-282X
  • [Journal-full-title] Arquivos de neuro-psiquiatria
  • [ISO-abbreviation] Arq Neuropsiquiatr
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Brazil
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28. Damjanovic SS, Neskovic AN, Petakov MS, Popovic V, Macut D, Vukojevic P, Joksimovic MM: Clinical indicators of biochemical remission in acromegaly: does incomplete disease control always mean therapeutic failure? Clin Endocrinol (Oxf); 2005 Apr;62(4):410-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinical indicators of biochemical remission in acromegaly: does incomplete disease control always mean therapeutic failure?
  • OBJECTIVE: Correction of GH and IGF-I levels are associated with improvements in insulin secretion, cardiac performance and body composition in patients with acromegaly, but whether these parallel post-treatment levels of GH-IGF-I axis activity is undefined.
  • We investigate whether various biochemical outcomes after transsphenoidal pituitary surgery (TSS) in these patients are associated with clinically relevant differences in cardiac performance, insulin resistance and body composition.
  • DESIGN: Cross-sectional study of consecutive patients with acromegaly admitted to the hospital between 2001 and 2002.
  • PATIENTS AND METHODS: Forty-one patients after TSS for somatotroph pituitary adenoma and 23 patients with naive acromegaly serving as positive controls were enrolled in the study.
  • Mean daily GH levels (mGH), IGF-I, leptin and lipid levels, glucose, insulin and GH concentrations during oral glucose tolerance test (oGTT) were measured in all study participants.
  • RESULTS: We found no difference in cardiac indices, insulin resistance, body composition and leptin levels between patients with complete biochemical remission and those with inadequately controlled disease (P > 0.05 for all) after TSS.
  • A similar decrease in LVM(i) was observed in controlled (108.4 +/- 30.0 g/m(2); P = 0.015) and inadequately controlled disease (108.8 +/- 30.7 g/m(2); P = 0.03) in comparison with naive disease (160.3 +/- 80.6 g/m(2)).
  • In controlled and inadequately controlled disease, R(HOMA) index was lower (2.2 +/- 1.4; P = 0.001 and 3.1 +/- 2.0; P = 0.05 vs. 5.1 +/- 3.1) while leptin concentration was higher (14.9 +/- 8.7 microg/l, P = 0.004 and 12.8 +/- 7.8 microg/l, P = 0.05 vs. 7.4 +/- 3.8 microg/l) than in naive disease.
  • Similar results were obtained if the definition of cure included both normal IGF-I levels and the ability to achieve GH nadir < 1 microg/l during oGTT.
  • CONCLUSION: This study shows that cardiac indices, insulin resistance and body composition were not different between patients with complete biochemical remission and those with discordant GH and IGF-I levels.
  • It appears that even incomplete disease control after TSS can result in improvement of these clinical markers.
  • [MeSH-major] Acromegaly / surgery
  • [MeSH-minor] Absorptiometry, Photon. Adenoma / blood. Adenoma / complications. Adenoma / surgery. Adult. Aged. Area Under Curve. Biomarkers / blood. Blood Glucose / analysis. Body Composition. Echocardiography. Female. Growth Hormone / blood. Humans. Insulin / blood. Insulin-Like Growth Factor I / analysis. Leptin / blood. Lipids / blood. Logistic Models. Male. Middle Aged. Pituitary Neoplasms / blood. Pituitary Neoplasms / complications. Pituitary Neoplasms / surgery. Remission Induction. Treatment Failure

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  • (PMID = 15807870.001).
  • [ISSN] 0300-0664
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers; 0 / Blood Glucose; 0 / Insulin; 0 / Leptin; 0 / Lipids; 67763-96-6 / Insulin-Like Growth Factor I; 9002-72-6 / Growth Hormone
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29. DiGiovanni R, Serra S, Ezzat S, Asa SL: AIP Mutations are not identified in patients with sporadic pituitary adenomas. Endocr Pathol; 2007;18(2):76-8
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  • [Title] AIP Mutations are not identified in patients with sporadic pituitary adenomas.
  • The pathogenesis of pituitary adenomas remains a subject of interest.
  • Recently, mutations in the aryl hydrocarbon receptor-interacting protein (AIP) were identified as germline events leading to pituitary tumor predisposition in Finnish and Italian families with familial growth hormone-secreting pituitary adenomas and acromegaly.
  • We examined the frequency of AIP mutations in pituitary tumors and blood of Canadian patients with sporadic pituitary somatotroph adenomas and sporadic pituitary adenomas of other types.
  • Genomic DNA was extracted from pituitary tumors and white blood cells obtained from peripheral blood.
  • AIP mutations were not detected as germline events in blood or as somatic alterations in tumors of 66 patients with pituitary adenomas.
  • These included 50 acromegalics and 16 patients with other types of pituitary tumor.
  • Our results indicate that mutations in AIP are not identified in sporadic pituitary adenomas of Canadian patients.
  • This rare mechanism of pituitary tumorigenesis appears to be unique to the initial Finnish and Italian families described.
  • [MeSH-major] Adenoma / metabolism. Pituitary Neoplasms / metabolism. Proteins / metabolism
  • [MeSH-minor] Acromegaly / etiology. Canada / epidemiology. Cohort Studies. DNA / biosynthesis. DNA / genetics. DNA, Neoplasm / genetics. Exons / genetics. Gene Frequency. Germ-Line Mutation. Humans. Intracellular Signaling Peptides and Proteins

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  • (PMID = 17916996.001).
  • [ISSN] 1046-3976
  • [Journal-full-title] Endocrine pathology
  • [ISO-abbreviation] Endocr. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA, Neoplasm; 0 / Intracellular Signaling Peptides and Proteins; 0 / Proteins; 0 / aryl hydrocarbon receptor-interacting protein; 9007-49-2 / DNA
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30. Pertuit M, Barlier A, Enjalbert A, Gérard C: Signalling pathway alterations in pituitary adenomas: involvement of Gsalpha, cAMP and mitogen-activated protein kinases. J Neuroendocrinol; 2009 Nov;21(11):869-77
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  • [Title] Signalling pathway alterations in pituitary adenomas: involvement of Gsalpha, cAMP and mitogen-activated protein kinases.
  • Despite extensive research on sporadic pituitary adenomas, it is not yet possible to assign one protein alteration to one specific type of pituitary adenomas.
  • Nevertheless, alterations of the cAMP pathway appear to be molecular hallmarks of most growth hormone (GH)-secreting adenomas.
  • In this review, we summarise the literature regarding signalling alterations observed in GH-secreting adenomas.
  • In the light of results obtained on human somatotroph adenoma cells in primary culture and on models of murine somatotroph cell lines, we postulate a crucial role for ERK1/2 in GH-secreting adenomas downstream of cAMP pathway alterations that might impact the tumoural phenotype.
  • [MeSH-major] Adenoma / metabolism. Cyclic AMP / metabolism. GTP-Binding Protein alpha Subunits, Gs / metabolism. Mitogen-Activated Protein Kinases / metabolism. Pituitary Neoplasms / metabolism. Signal Transduction
  • [MeSH-minor] Growth Hormone / secretion. Humans

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  • (PMID = 19732293.001).
  • [ISSN] 1365-2826
  • [Journal-full-title] Journal of neuroendocrinology
  • [ISO-abbreviation] J. Neuroendocrinol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
  • [Chemical-registry-number] 9002-72-6 / Growth Hormone; E0399OZS9N / Cyclic AMP; EC 2.7.11.24 / Mitogen-Activated Protein Kinases; EC 3.6.5.1 / GTP-Binding Protein alpha Subunits, Gs
  • [Number-of-references] 95
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31. Bush ZM, Vance ML: Management of acromegaly: is there a role for primary medical therapy? Rev Endocr Metab Disord; 2008 Mar;9(1):83-94
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  • [Title] Management of acromegaly: is there a role for primary medical therapy?
  • Acromegaly is a chronic, debilitating disease caused by chronic growth hormone (GH) hypersecretion which results in chronic medical comorbidities, poor quality of life and high mortality rates.
  • Over 95% of acromegaly is caused by a somatotroph adenoma of the pituitary, and the first-line treatment is generally transsphenoidal surgery, which can be curative in 50-60% of patients.
  • Nonetheless, high rates of persistent acromegaly following surgery and the limited efficacy of radiation therapy necessitate chronic medical treatment for many patients.
  • Cabergoline, a dopamine agonist, offers a lower-cost option and may be effective in patients with a pituitary tumor that co-secretes GH and prolactin.
  • Pegvisomant is a GH receptor antagonist that produces exceptional biochemical response rates but lacks any direct effects on the tumor, which may limit its effectiveness as life-long monotherapy.
  • While medical treatment options for acromegaly have significantly improved over the last 30 years, limitations remain, and a multi-specialty team approach is necessary for the effective long-term management of patients with acromegaly.
  • [MeSH-major] Acromegaly / drug therapy
  • [MeSH-minor] Combined Modality Therapy. Dopamine Agonists / therapeutic use. Humans. Neurosurgical Procedures / methods. Radiotherapy / methods. Receptors, Somatotropin / antagonists & inhibitors. Somatostatin / analogs & derivatives

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  • (PMID = 18163213.001).
  • [ISSN] 1389-9155
  • [Journal-full-title] Reviews in endocrine & metabolic disorders
  • [ISO-abbreviation] Rev Endocr Metab Disord
  • [Language] eng
  • [Grant] United States / NIDDK NIH HHS / DK / T32 DK007646
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Dopamine Agonists; 0 / Receptors, Somatotropin; 51110-01-1 / Somatostatin
  • [Number-of-references] 88
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32. Manavela MP, Juri A, Danilowicz K, Bruno OD: [Therapeutic management in 154 acromegalic patients]. Medicina (B Aires); 2010;70(4):328-32
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  • Acromegaly is a chronic, invalidating disease due in over 95% of cases to a growth hormone (GH) secreting pituitary adenoma.
  • Its clinical manifestations are associated to local complications related to the tumor growth and/or to the metabolic consequences of GH excess.
  • In only 14.0% of acromegalics drug therapy with dopaminergic agents was effective in controlling the disease.
  • In summary, multimodal therapy of acromegaly can lead to a global safe control of the disease in 55.2% of the cases.
  • [MeSH-major] Acromegaly / therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Female. Human Growth Hormone / metabolism. Humans. Male. Middle Aged. Retrospective Studies. Young Adult

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  • (PMID = 20679052.001).
  • [ISSN] 0025-7680
  • [Journal-full-title] Medicina
  • [ISO-abbreviation] Medicina (B Aires)
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Argentina
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone
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33. Krzentowska A, Gołkowski F, Bałdys-Waligórska A, Hubalewska-Dydejczyk A: [Gastrointestinal tract polyps in acromegaly patients]. Przegl Lek; 2010;67(12):1266-9
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  • [Title] [Gastrointestinal tract polyps in acromegaly patients].
  • Acromegaly is a rare, chronic disease due to hypersecretion of growth hormone (GH) by pituitary adenoma arising from somatotrophs.
  • The course of the disease is related to long-term organ and systemic complications and malignancies.
  • Colon polyps seem to constitute the most frequent tumours in acromegaly apart from thyroid nodules.
  • The aim of this study was to evaluate the prevalence of colon polyps in patients with acromegaly.
  • Thirty one acromegaly patients, 22 females and 9 males (mean age 46.3 +/- 11.9 yrs), were enrolled to the study.
  • Polyps were histopatologically verified as tubular adenoma with low-grade dysplasia (10 patients, 76.9%) and hyperplastic polyps (3 patients, 23.1%).
  • The prevalence of colon polyps was significantly related to the duration of uncontrolled acromegaly (p < 0.01).
  • Median duration of uncontrolled acromegaly in patients with and without colon polyps were 10.0 (IQR = 2.0) yrs and 6.5 (IQR = 5.0) yrs, respectively.
  • IGF-1, GH basic and in 120 min of OGTT serum concentrations on diagnosis were not significantly related to the prevalence of colon polyps.
  • Our study indicates that duration of uncontrolled acromegaly, contrary to IGF-1, GH basic and in OGTT serum concentrations at diagnosis are essential for the colon polyps development.
  • Colonoscopy is considered to be routine in patients with acromegaly.
  • [MeSH-major] Acromegaly / epidemiology. Colonic Polyps / epidemiology

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  • (PMID = 21591351.001).
  • [ISSN] 0033-2240
  • [Journal-full-title] Przegla̧d lekarski
  • [ISO-abbreviation] Prz. Lek.
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Poland
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34. Sakai N, Kim K, Sanno N, Yoshida D, Teramoto A, Shibasaki T: Elevation of growth hormone-releasing hormone receptor messenger ribonucleic acid expression in growth hormone-secreting pituitary adenoma with Gsalpha protein mutation. Neurol Med Chir (Tokyo); 2008;48(11):481-7; discussion 487-8
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  • [Title] Elevation of growth hormone-releasing hormone receptor messenger ribonucleic acid expression in growth hormone-secreting pituitary adenoma with Gsalpha protein mutation.
  • Growth hormone-releasing hormone (GHRH) stimulates not only the synthesis and secretion of GH but also the proliferation of normal somatotrophs.
  • The expression of GHRH receptor (GHRHR) is regulated by GHRH, both of which are known to be expressed in human GH-secreting pituitary adenoma cells.
  • Somatic mutations in the subunit of Gsalpha protein (gsp), lead to the constitutive activation of adenylyl cyclase in pituitary adenomas that secrete GH.
  • It has not been examined how gsp mutations influence GHRHR expression in GH-secreting adenomas.
  • We therefore analyzed the expression levels of GHRHR messenger ribonucleic acid (mRNA) in GH-secreting pituitary adenomas focusing on a gsp mutation.
  • Furthermore, we investigated the effect of GHRH on the expression of GHRHR mRNA in primary cultures of GH-secreting pituitary adenoma cells.
  • GHRHR mRNA expression levels were significantly elevated in gsp mutation-positive GH-secreting adenomas compared with those in gsp mutation-negative ones.
  • In primary-cultured GH-secreting adenoma cells, the increase of GH secretion in response to GHRH was shown in both gsp mutation-positive and -negative adenoma cells with a significantly higher response in the latter adenoma cells.
  • GHRH increased GHRHR mRNA expression level in gsp mutation-negative adenoma cells while it was not influenced by GHRH in gsp mutation-positive adenoma cells.
  • These results suggest that gsp mutations up-regulate GHRHR mRNA expression in GH-secreting pituitary adenoma cells, and that gsp mutations desensitize the adenoma cells to GHRH in terms of their GHRHR mRNA expression probably because of their saturation of GHRH signaling.
  • [MeSH-major] Adenoma / genetics. GTP-Binding Protein alpha Subunits, Gs / genetics. Growth Hormone-Releasing Hormone / secretion. Mutation, Missense. Neoplasm Proteins / genetics. Nerve Tissue Proteins / genetics. Pituitary Neoplasms / genetics. Point Mutation. RNA, Messenger / biosynthesis. RNA, Neoplasm / biosynthesis. Receptors, Neuropeptide / genetics. Receptors, Pituitary Hormone-Regulating Hormone / genetics
  • [MeSH-minor] Acromegaly / etiology. Acromegaly / surgery. Adult. Amino Acid Substitution. Cell Line, Tumor / drug effects. Cell Line, Tumor / metabolism. Cell Line, Tumor / secretion. Female. Gene Expression Regulation, Neoplastic. Humans. Male. Middle Aged

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  • (PMID = 19029774.001).
  • [ISSN] 1349-8029
  • [Journal-full-title] Neurologia medico-chirurgica
  • [ISO-abbreviation] Neurol. Med. Chir. (Tokyo)
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Neoplasm Proteins; 0 / Nerve Tissue Proteins; 0 / RNA, Messenger; 0 / RNA, Neoplasm; 0 / Receptors, Neuropeptide; 0 / Receptors, Pituitary Hormone-Regulating Hormone; 0 / somatotropin releasing hormone receptor; 9034-39-3 / Growth Hormone-Releasing Hormone; EC 3.6.5.1 / GTP-Binding Protein alpha Subunits, Gs
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35. Mohammed S, Syro L, Abad V, Salehi F, Horvath E, Scheithauer BW, Kovacs K, Cusimano M: Silent somatotroph adenoma of the pituitary in an adolescent. Can J Neurol Sci; 2009 Jan;36(1):123-5
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  • [Title] Silent somatotroph adenoma of the pituitary in an adolescent.
  • [MeSH-major] Adenoma / pathology. Growth Hormone / metabolism. Growth Hormone-Secreting Pituitary Adenoma / pathology. Pituitary Neoplasms / pathology
  • [MeSH-minor] Adolescent. Humans. Magnetic Resonance Imaging / methods. Male. Microscopy, Electron, Transmission / methods. Pituitary Gland / metabolism. Pituitary Gland / pathology. Pituitary Gland / ultrastructure

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  • (PMID = 19294904.001).
  • [ISSN] 0317-1671
  • [Journal-full-title] The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques
  • [ISO-abbreviation] Can J Neurol Sci
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Canada
  • [Chemical-registry-number] 9002-72-6 / Growth Hormone
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36. Ebisawa T, Tojo K, Tajima N, Kamio M, Oki Y, Ono K, Sasano H: Immunohistochemical analysis of 11-beta-hydroxysteroid dehydrogenase type 2 and glucocorticoid receptor in subclinical Cushing's disease due to pituitary macroadenoma. Endocr Pathol; 2008;19(4):252-60
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  • [Title] Immunohistochemical analysis of 11-beta-hydroxysteroid dehydrogenase type 2 and glucocorticoid receptor in subclinical Cushing's disease due to pituitary macroadenoma.
  • Subclinical Cushing's disease (SCD) is characterized by lack of clinically evident Cushingoid features, despite abnormal hypersecretion of ACTH.
  • Impaired glucocorticoid (GC) action may be correlated with the proliferation and development of pituitary macroadenomas causing SCD.
  • In this study, immunohistochemical analysis of the resected tumors were performed to evaluate the expression of 11beta-hydroxysteroid dehydrogenase type 2 (11betaHSD2) and glucocorticoid receptor (GR) in pituitary tissues obtained from two SCD (macroadenomas), eight Cushing's disease (CD) (microadenomas), nine acromegaly, and nine normal pituitary (NP).
  • [MeSH-major] 11-beta-Hydroxysteroid Dehydrogenase Type 2 / metabolism. ACTH-Secreting Pituitary Adenoma / metabolism. Adenoma / metabolism. Pituitary ACTH Hypersecretion / metabolism. Receptors, Glucocorticoid / metabolism
  • [MeSH-minor] Acromegaly / metabolism. Acromegaly / pathology. Adolescent. Adrenocorticotropic Hormone / metabolism. Adult. Aged. Female. Humans. Immunohistochemistry / methods. Male. Middle Aged. Pituitary Gland / metabolism. Pituitary Gland / pathology. Young Adult

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  • (PMID = 19048413.001).
  • [ISSN] 1046-3976
  • [Journal-full-title] Endocrine pathology
  • [ISO-abbreviation] Endocr. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Receptors, Glucocorticoid; 9002-60-2 / Adrenocorticotropic Hormone; EC 1.1.1.146 / 11-beta-Hydroxysteroid Dehydrogenase Type 2
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37. Popovic V: Are there alternative tests for diagnosis of acromegaly? J Endocrinol Invest; 2005;28(11 Suppl International):73-4
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  • [Title] Are there alternative tests for diagnosis of acromegaly?
  • In acromegaly, clinical features are of the utmost importance, and biochemical confirmation is rarely difficult.
  • However, some clinically manifest acromegalics have subtle abnormalities in GH secretion resulting in post-glucose GH nadir in the designated "normal" range with high IGF-I levels.
  • Clinical decision may be based on the probability of the disease and elevated IGF-I levels.
  • The TRH test or the frequent GH sampling test may help confirm acromegaly but on their own have no diagnostic advantage.
  • A TRH-GH response is not specific to acromegaly, while frequent sampling is not practical.
  • Post-treatment assessment of the disease activity and definition of acromegaly cure, by measuring GH secretion, remain problematic.
  • IGF-I levels seem to differentiate normality less clearly and discordance of GH and IGF-I results is frequent.
  • Post-treatment probability for residual disease activity should include more clinical parameters such as insulin sensitivity, leptin and echocardiography.
  • Furthermore, with efforts to achieve tight biochemical control of the disease it is foreseeable that a proportion of patients may be rendered GH deficient, requiring stimulatory testing.
  • Acromegaly is a disfiguring and disabling illness, in which by definition, the disorder is caused by a pituitary GH-secreting adenoma resulting in high circulating levels of GH and IGF-I.
  • The clinical features of acromegaly include those of GH and IGF-I on tissues and the effects of the pituitary tumor itself.
  • There is no single cut-off value for GH with perfect discrimination between acromegaly and normality.
  • The recommended post-glucose GH nadir value of 1 microg/l is now considered to be inappropriately high, and measurement of IGF-I levels although extremely valuable has its limitations.
  • Furthermore, some acromegalics may have subtle abnormalities in GH secretion, resulting in post-glucose GH nadir in the designated "normal" range with elevated IGF-I levels.
  • [MeSH-major] Acromegaly / diagnosis
  • [MeSH-minor] Glucose Tolerance Test. Human Growth Hormone / blood. Human Growth Hormone / secretion. Humans. Insulin-Like Growth Factor I / analysis. Pituitary Neoplasms. Thyrotropin-Releasing Hormone

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  • (PMID = 16625850.001).
  • [ISSN] 0391-4097
  • [Journal-full-title] Journal of endocrinological investigation
  • [ISO-abbreviation] J. Endocrinol. Invest.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 5Y5F15120W / Thyrotropin-Releasing Hormone; 67763-96-6 / Insulin-Like Growth Factor I
  • [Number-of-references] 11
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38. Feelders RA, Hofland LJ, van Aken MO, Neggers SJ, Lamberts SW, de Herder WW, van der Lely AJ: Medical therapy of acromegaly: efficacy and safety of somatostatin analogues. Drugs; 2009 Nov 12;69(16):2207-26
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  • [Title] Medical therapy of acromegaly: efficacy and safety of somatostatin analogues.
  • Acromegaly is a chronic disease with signs and symptoms due to growth hormone (GH) excess.
  • The most frequent cause of acromegaly is a GH-producing pituitary adenoma.
  • Chronic GH excess is accompanied by long-term complications of the locomotor (arthrosis) and cardiovascular (atherosclerosis, cardiomyopathy) systems and is, when untreated, associated with an increased mortality.
  • The aim of treatment of acromegaly is to improve symptoms, to achieve local tumour mass control, and to decrease morbidity and mortality.
  • Primary medical therapy has been increasingly applied in recent years, especially when a priori chances of surgical cure are low (because of adenoma size and localization) and in patients with advanced age and/or serious co-morbidity.
  • In addition, preoperative primary medical therapy may result in tumour shrinkage, facilitating tumour resection, and may reduce perioperative complications due to GH excess.
  • Treatment with somatostatin analogues results in GH control in approximately 60% of patients.
  • The currently available somatostatin analogues, octreotide and lanreotide, seem to be equally effective; however, this should still be evaluated in prospective, randomized trials evaluating efficacy with respect to GH control and tumour shrinkage.
  • In patients with an insufficient clinical and biochemical response to somatostatin analogues, combination therapy with dopamine receptor agonists or the GH receptor antagonist pegvisomant usually leads to disease control.
  • New developments in the medical therapy of acromegaly include the universal somatostatin receptor agonist pasireotide, which has a broader affinity for all somatostatin receptor (sst) subtypes compared with the currently available somatostatin analogues with preferential affinity for the sst2 receptor, and chimeric compounds that interact with both somatostatin and dopamine receptors with synergizing effects on GH secretion.
  • [MeSH-major] Acromegaly / drug therapy. Receptors, Somatostatin / drug effects. Somatostatin / analogs & derivatives
  • [MeSH-minor] Adenoma / complications. Antineoplastic Agents / adverse effects. Antineoplastic Agents / pharmacology. Antineoplastic Agents / therapeutic use. Female. Growth Hormone-Secreting Pituitary Adenoma / complications. Human Growth Hormone / metabolism. Human Growth Hormone / secretion. Humans. Male. Octreotide / adverse effects. Octreotide / pharmacology. Octreotide / therapeutic use. Peptides, Cyclic / adverse effects. Peptides, Cyclic / pharmacology. Peptides, Cyclic / therapeutic use

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  • (PMID = 19852525.001).
  • [ISSN] 1179-1950
  • [Journal-full-title] Drugs
  • [ISO-abbreviation] Drugs
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] New Zealand
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Peptides, Cyclic; 0 / Receptors, Somatostatin; 0G3DE8943Y / lanreotide; 12629-01-5 / Human Growth Hormone; 51110-01-1 / Somatostatin; RWM8CCW8GP / Octreotide
  • [Number-of-references] 130
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39. Mendoza V, Sosa E, Espinosa-de-Los-Monteros AL, Salcedo M, Guinto G, Cheng S, Sandoval C, Mercado M: GSPalpha mutations in Mexican patients with acromegaly: potential impact on long term prognosis. Growth Horm IGF Res; 2005 Feb;15(1):28-32
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  • [Title] GSPalpha mutations in Mexican patients with acromegaly: potential impact on long term prognosis.
  • OBJECTIVE: The frequency of activating mutations of the GSPalpha gene as the etiology of GH-secreting pituitary adenomas has been the subject of important ethnogenetic variability.
  • Whereas up to 40% of Caucasian patients with acromegaly have tumors which harbor these somatic mutations, their prevalence among Asian populations is much lower.
  • In the present study, we investigated the prevalence of GSPalpha mutations in GH-secreting tumors obtained from a genetically homogenous population of Mexican patients with acromegaly.
  • We also sought to establish whether or not the presence of these mutations correlates in any way with the clinical or biochemical characteristics of the disease.
  • STUDY DESIGN AND METHODS: Fifty eight GH-secreting pituitary adenomas were examined for the presence of point mutations in either codon 201 or 227 of the GSPalpha gene, using PCR and direct sequencing of DNA extracted from either fresh or paraffin-embedded tissues.
  • Patients were prospectively followed clinically and biochemically for up to nine years after pituitary surgery.
  • The frequency and severity of the different clinical features of acromegaly did not differ between patients with and without GSPalpha mutations.
  • Patients with and without mutations had pre-operative GH and IGF-I elevations of similar magnitude, and although microadenomas appeared to be more frequent among patients with GSPalpha mutations, this did not reach statistical significance.
  • Upon short-term follow-up, biochemical cure (normal age- and gender-adjusted IGF-I and post-glucose GH below 1 ng/mL) was similarly achieved in both groups.
  • After 3-9 years of post-operative follow up however, a significantly greater proportion of patients with the mutation achieved a "safe" basal GH value (100% vs 33%, p=0.001) as well a lower nadir post-glucose GH (0.53+/-0.5 vs 2.9+/-6.2 ng/mL, p=0.04) although the rate of IGF-1 normalization did not differ between the 2 groups.
  • CONCLUSIONS: Our results show that the prevalence of GSPalpha mutations in Mexican patients with acromegaly is intermediate between that found in Asian and Caucasian populations.
  • In this well-defined genetic population the presence of codon 201 mutations appeared to be associated with a greater probability of achieving a "safe" GH value upon long-term follow-up.
  • [MeSH-major] Acromegaly / genetics. Adenoma / genetics. GTP-Binding Protein alpha Subunits, Gs / genetics. GTP-Binding Protein alpha Subunits, Gs / physiology. Mutation. Pituitary Neoplasms / genetics
  • [MeSH-minor] Adult. Codon. DNA Primers / chemistry. Exons. Female. Growth Hormone / metabolism. Heterozygote. Humans. Male. Mexico. Middle Aged. Point Mutation. Sex Factors. Time Factors. Treatment Outcome

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  • (PMID = 15701569.001).
  • [ISSN] 1096-6374
  • [Journal-full-title] Growth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society
  • [ISO-abbreviation] Growth Horm. IGF Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Scotland
  • [Chemical-registry-number] 0 / Codon; 0 / DNA Primers; 9002-72-6 / Growth Hormone; EC 3.6.1.- / GNAS protein, human; EC 3.6.5.1 / GTP-Binding Protein alpha Subunits, Gs
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40. Nakashima M, Takano K, Matsuno A: Analyses of factors influencing the acute effect of octreotide in growth hormone-secreting adenomas. Endocr J; 2009;56(2):295-304
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  • [Title] Analyses of factors influencing the acute effect of octreotide in growth hormone-secreting adenomas.
  • Somatostatin analogues such as octreotide are used to treat active acromegalic patients by reducing serum growth hormone (GH) levels.
  • However, the acute effect of octreotide on GH secretion differs among patients.
  • To elucidate factors influencing the acute effect of octreotide, we collected data from 56 patients with somatotroph adenoma from two institutions.
  • Monovariate analysis revealed a statistically significant inverse relation of Ki-67 SI with the reduction of GH by octreotide.
  • Post-test revealed that the plasma membrane-dominant staining pattern of SSTR 2A was significantly related to the reduction of GH by octreotide.
  • [MeSH-major] Growth Hormone-Secreting Pituitary Adenoma / secretion. Human Growth Hormone / secretion. Octreotide / therapeutic use. Pituitary Neoplasms / secretion
  • [MeSH-minor] Adult. Aged. Cell Membrane / metabolism. Female. Humans. Ki-67 Antigen / metabolism. Male. Middle Aged. Receptors, Somatostatin / metabolism. Regression Analysis

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  • (PMID = 19164866.001).
  • [ISSN] 1348-4540
  • [Journal-full-title] Endocrine journal
  • [ISO-abbreviation] Endocr. J.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Ki-67 Antigen; 0 / Receptors, Somatostatin; 0 / somatostatin receptor 2; 12629-01-5 / Human Growth Hormone; RWM8CCW8GP / Octreotide
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41. Yin J, Su CB, Xu ZQ, Yang Y, Ma WB, Tao W, Yang Z, Xia XW: Effect of preoperative use of long-acting octreotide on growth hormone secreting pituitary adenoma and transsphenoidal surgery. Chin Med Sci J; 2005 Mar;20(1):23-6
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  • [Title] Effect of preoperative use of long-acting octreotide on growth hormone secreting pituitary adenoma and transsphenoidal surgery.
  • OBJECTIVE: To investigate whether somatostatin analog octreotide long acting release (LAR) shrinks growth hormone (GH) secreting adenomas, and improves the results of subsequent transsphenoidal surgery.
  • METHODS: Seventeen previously untreated active acromegalic patients with pituitary adenomas were treated with LAR (30 mg intramuscular injection every 28 days) for 3 months prior to transsphenoidal surgery.
  • Clinical reaction, mean GH secretion, and tumor volume were measured under basal conditions and after LAR treatment.
  • RESULTS: Presurgical treatment improved acromegaly symptoms and induced a significant reduction of GH under the 5 ng/mL limit in microadenoma (P < 0.05), while only 18.2% (2/11) in macroadenoma.
  • During operation, adenoma was soft in 15 cases, with the exception of 2 cases in which the soft tumor was divided by fibrous septa, but all tumor removal was smooth.
  • CONCLUSIONS: A short term administration of preoperative LAR may induce a significant decrease in GH-secretion level and adenoma volume.

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  • (PMID = 15844307.001).
  • [ISSN] 1001-9294
  • [Journal-full-title] Chinese medical sciences journal = Chung-kuo i hsueh k'o hsueh tsa chih
  • [ISO-abbreviation] Chin. Med. Sci. J.
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Delayed-Action Preparations; 12629-01-5 / Human Growth Hormone; RWM8CCW8GP / Octreotide
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42. Ghostine S, Ghostine MS, Johnson WD: Radiation therapy in the treatment of pituitary tumors. Neurosurg Focus; 2008;24(5):E8
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  • [Title] Radiation therapy in the treatment of pituitary tumors.
  • The treatment of pituitary tumors has progressed into a multidisciplinary approach that involves neurosurgeons, radiation oncologists, and endocrinologists.
  • This has allowed improved outcomes in treatment of pituitary tumors due to a combination of surgical, medical, and radiation therapies.
  • In this study, the authors review the role of radiation therapy in the treatment of pituitary adenomas.
  • [MeSH-major] Adenoma / radiotherapy. Cranial Irradiation. Pituitary Neoplasms / radiotherapy
  • [MeSH-minor] Acromegaly / drug therapy. Acromegaly / etiology. Acromegaly / radiotherapy. Acromegaly / surgery. Brain / radiation effects. Combined Modality Therapy. Cushing Syndrome / etiology. Cushing Syndrome / radiotherapy. Cushing Syndrome / surgery. Humans. Hypophysectomy / methods. Hypopituitarism / etiology. Nelson Syndrome / radiotherapy. Nelson Syndrome / surgery. Postoperative Complications / etiology. Radiation Injuries / etiology. Radiation Injuries / prevention & control. Radiosurgery / adverse effects. Radiotherapy, Adjuvant / adverse effects. Radiotherapy, Computer-Assisted / methods. Treatment Outcome

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  • (PMID = 18447747.001).
  • [ISSN] 1092-0684
  • [Journal-full-title] Neurosurgical focus
  • [ISO-abbreviation] Neurosurg Focus
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 54
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43. Herrmann BL, Severing M, Schmermund A, Berg C, Budde T, Erbel R, Mann K: Impact of disease duration on coronary calcification in patients with acromegaly. Exp Clin Endocrinol Diabetes; 2009 Sep;117(8):417-22
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  • [Title] Impact of disease duration on coronary calcification in patients with acromegaly.
  • It is well established, that the increased mortality in patients with acromegaly is due to cardiac diseases.
  • Cardiomyopathy is the predominant cardiac alteration in patients with acromegaly.
  • There are less data about coronary heart disease or coronary calcifications.
  • The prospective study included 30 patients with acromegaly (mean age 53+/-14 year; 16 females, 14 males; BMI 28.1+/-3.6 kg/m (2); mean+/-SD), 12 patients had active disease (IGF-1 751+/-338 microg/L; GH 25.6+/-36.4 microg/L), 9 were well-controlled (IGF-1 157+/-58 microg/L; GH 1.8+/-1.1 microg/L) under somatostatin analogue octreotide (n=5), dopamine agonists (n=2), and the GH receptor antagonist pegvisomant (n=2; GH levels were not determined in this subgroup) and 9 were cured IGF-1 (148+/-57 microg/L; GH 0.5+/-0.2 microg/L).
  • FRS was related to the CAC score (p=0.008, r (2)=0.22) and the disease duration (p=0.002, r (2)=0.29).
  • The CAC score correlated with LVMI (p=0.02, r (2)=0.17), the disease duration of acromegaly (p=0.004, r (2)=0.36), and the FRS (p=0.008, r (2)=0.22).
  • Patients with a high CAC score had a longer disease duration of 9.6+/-4.7 versus 5.4+/-2.8 years with CAC<75 (th) percentile (p=0.02).
  • In summary, the disease duration and consequently the accompanying metabolic disorders appear to influence the degree of CAC in patients with acromegaly.
  • The observations underline the importance of early and sufficient treatment of acromegaly in high risk patients.
  • [MeSH-major] Acromegaly / complications. Calcinosis / complications. Cardiomyopathies / complications. Coronary Disease / etiology
  • [MeSH-minor] Adenoma / radiography. Adenoma / surgery. Adult. Aged. Female. Human Growth Hormone / blood. Humans. Insulin-Like Growth Factor I / metabolism. Luminescent Measurements. Male. Middle Aged. Pituitary Neoplasms / radiography. Pituitary Neoplasms / surgery. Prospective Studies. Radiosurgery. Risk Factors. Time Factors

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  • [Copyright] J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart.New York.
  • (PMID = 19373755.001).
  • [ISSN] 1439-3646
  • [Journal-full-title] Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association
  • [ISO-abbreviation] Exp. Clin. Endocrinol. Diabetes
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I
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44. Almeida JP, Albuquerque LA, Ferraz CL, Mota I, Gondim J, Ferraz TM: McCune-Albright syndrome and acromegaly: hormonal control with use of cabergoline and long-acting somatostatin--case report. Arq Bras Endocrinol Metabol; 2009 Feb;53(1):102-6
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  • [Title] McCune-Albright syndrome and acromegaly: hormonal control with use of cabergoline and long-acting somatostatin--case report.
  • OBJECTIVES: The use of drug therapy based on cabergoline, octreotide and long-acting release (LAR) octreotide has presented varying results in the treatment of GH excessive production in patients with McCune-Albright Syndrome.
  • METHODS: We report the case of a 29 year-old female patient presenting McCune-Albright Syndrome and complaint of excessive bone growth.
  • RESULTS: The patient presented a pituitary adenoma involving the right internal carotid artery and excessive secretion of growth hormone (no GH suppression was observed after the oral glucose tolerance test).
  • At the one year follow-up, GH and IGF-1 levels were normal and no adverse effects were present.
  • CONCLUSION: The use of drug therapy based on the association of cabergoline and octreotide is safe and able to achieve complete hormonal control in the treatment of acromegaly for McCune-Albright patients.
  • [MeSH-major] Acromegaly / drug therapy. Ergolines / therapeutic use. Facial Bones / drug effects. Fibrous Dysplasia, Polyostotic / drug therapy. Octreotide / therapeutic use
  • [MeSH-minor] Adenoma / complications. Adult. Antineoplastic Agents, Hormonal / therapeutic use. Female. Human Growth Hormone / analysis. Human Growth Hormone / secretion. Humans. Insulin-Like Growth Factor I / analysis. Pituitary Neoplasms / complications. Skull / drug effects

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  • (PMID = 19347192.001).
  • [ISSN] 1677-9487
  • [Journal-full-title] Arquivos brasileiros de endocrinologia e metabologia
  • [ISO-abbreviation] Arq Bras Endocrinol Metabol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Brazil
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Ergolines; 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I; LL60K9J05T / cabergoline; RWM8CCW8GP / Octreotide
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45. Yamazaki M, Sato A, Nishio S, Takeda T, Miyamoto T, Katai M, Hashizume K: Acromegaly accompanied by Turner syndrome with 47,XXX/45,X/46,XX mosaicism. Intern Med; 2009;48(6):447-53
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  • [Title] Acromegaly accompanied by Turner syndrome with 47,XXX/45,X/46,XX mosaicism.
  • A pituitary adenoma with elevated serum levels of growth hormone (GH) and insulin-like growth factor-I (IGF-I) was detected, indicating acromegaly caused by GH-secreting pituitary adenoma.
  • Transsphenoidal resection of the tumor decreased serum GH and IGF-I levels, but the edema was not improved.
  • This case may indicate the important relationships between GH/IGF-I and Turner syndrome.
  • [MeSH-major] Acromegaly / genetics. Chromosomes, Human, X / genetics. Mosaicism. Turner Syndrome / genetics
  • [MeSH-minor] Adenoma / blood. Adenoma / complications. Adenoma / diagnosis. Adult. Diagnosis, Differential. Female. Growth Hormone / blood. Humans. In Situ Hybridization, Fluorescence. Magnetic Resonance Imaging. Pituitary Neoplasms / blood. Pituitary Neoplasms / complications. Pituitary Neoplasms / diagnosis


46. Theodoropoulou M, Labeur M, Paez Pereda M, Haedo M, Perone MJ, Renner U, Arzt E, Stalla GK: Novel medical therapies for pituitary tumors. Front Horm Res; 2010;38:158-64
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  • [Title] Novel medical therapies for pituitary tumors.
  • Despite considerable progress, there is still no medical treatment available for some kinds of pituitary tumors, in particular hormone inactive adenomas and corticotroph pituitary tumors.
  • Moreover, treatment resistance is present in a considerable proportion of patients bearing pituitary tumors, for which medical treatment regimens are already available (prolactinomas, somatotroph adenomas).
  • Here, we summarize preclinical and clinical findings about the hormone and growth-suppressive action of various drugs, which will probably lead to novel future medical treatment concepts for pituitary tumors.
  • [MeSH-major] Pituitary Neoplasms / drug therapy

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  • [Copyright] Copyright (c) 2010 S. Karger AG, Basel.
  • (PMID = 20616507.001).
  • [ISSN] 0301-3073
  • [Journal-full-title] Frontiers of hormone research
  • [ISO-abbreviation] Front Horm Res
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / BIM 23A760; 0 / Dopamine Agonists; 51110-01-1 / Somatostatin; 5688UTC01R / Tretinoin; 82115-62-6 / Interferon-gamma; 98H1T17066 / pasireotide; VTD58H1Z2X / Dopamine
  • [Number-of-references] 32
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47. Drutel A, Caron P, Archambeaud F: [New medical treatments in pituitary adenomas]. Ann Endocrinol (Paris); 2008 Sep;69 Suppl 1:S16-28
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  • [Title] [New medical treatments in pituitary adenomas].
  • Currently, the role of dopaminergic and somatostatinergic agonists in the treatment of pituitary adenomas is quite well established.
  • Nevertheless, a clearer understanding of the expression of dopaminergic and somatostatinergic receptors at the cellular level of pituitary adenomas as well as the development of newer analogues compounds may drastically change current therapeutic modalities.
  • In the midst of GH-secreting pituitary adenomas, a positive correlation exists between the expression of Sst2 mRNA and the inhibition of GH release by somatostatin analogues.
  • The involvement of Sst5 subtype in adenomas resistant to preferential Sst2 agonists has recently been proved.
  • SOM-230 could therefore allow for much more effective methods in treating patients suffering from acromegaly.
  • Besides, the use of a chimeric molecule presenting a binding affinity to both Sst2 and D2 subtypes (BIM-23A287) inhibits the secretion of GH in ways similar to the Sst2 or D2 agonists used alone or concurrently but however in a concentration 50 times lower than that of the latter.
  • The discovery of Sst5 and D2 subtypes at the level of corticotropic adenomas reveals newer therapeutic perspectives with promising preliminary results with the use of SOM-230 ; these finding lead to a rise in interest in cabergoline.
  • In the midst of non-functioning pituitary adenomas, the expression of Sst2, Sst3 and D2 receptors will perhaps allow the use of combined therapies associating the new somatostatin analogues to the dopaminergic agonists or even use dopastatin (BIM-23A760, chimeric molecule Sst2-Sst5-D2).
  • Nevertheless, it seems that adenomas resistant to dopaminergic agonist due to a lack of expression of D2 receptor fail to express Sst5 receptors as well.
  • On the other hand, dopastatin appears to be more efficient than cabergoline in the management of this type of adenomas.
  • Therefore, the growing awareness concerning the mechanisms involved in the control of pituitary secretions as well as cellular proliferation will perhaps allow physicians to treat the pathology of pituitary adenomas, macroadenomas in particular, using solely pharmacological means instead of invasive surgical procedures and/or radiotherapy.
  • [MeSH-major] Adenoma / drug therapy. Pituitary Neoplasms / drug therapy

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  • (PMID = 18954854.001).
  • [ISSN] 0003-4266
  • [Journal-full-title] Annales d'endocrinologie
  • [ISO-abbreviation] Ann. Endocrinol. (Paris)
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Dopamine Agonists; 0 / Peptides, Cyclic; 0 / Receptors, Dopamine; 0 / Receptors, Somatostatin; 118992-92-0 / lanreotide; 51110-01-1 / Somatostatin; RWM8CCW8GP / Octreotide
  • [Number-of-references] 49
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48. Pisarek H, Pawlikowski M, Kunert-Radek J, Winczyk K: Does the response of GH-secreting pituitary adenomas to octreotide depend on the cellular localization of the somatostatin receptor subtypes SSTR2 and SSTR5? Endokrynol Pol; 2010 Mar-Apr;61(2):178-81
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  • [Title] Does the response of GH-secreting pituitary adenomas to octreotide depend on the cellular localization of the somatostatin receptor subtypes SSTR2 and SSTR5?
  • INTRODUCTION: The immunohistochemical examination of somatostatin receptor (SSTR) subtypes expression in different endocrine tumours, including pituitary adenomas, revealed membranous or cytoplasmic distribution of SSTR1-5.
  • In an earlier study a positive correlation between the summarized score of SSTR2A + SSTR2B expressions and growth hormone (GH) response to octreotide administration was found, independently of receptor distribution within the cell.
  • In this study we searched for the relationship between the GH inhibitory response to acute octreotide administration and SSTR2A, SSTR2B, and SSTR5 cellular localization.
  • The drop in GH was defined as the percentage of the basal value.
  • The pituitary adenomas from these patients were immunostained to determine the hormonal phenotype and expression of SSTR subtypes.
  • The drop in GH after octreotide administration varied between 57.1-96.7% (mean 82.1%).
  • Among the patients with the cytoplasmic localization of SSTR5, the decrease in GH was significantly higher (92.0 +/- 7.0%).
  • CONCLUSIONS: It seems that cytoplasmic localization of SSTR5, SSTR2A, and SSTR2B is connected with enhanced GH inhibition after octreotide administration.
  • As a consequence, the SSTR-immunopositivity in cell cytoplasm is increased.
  • [MeSH-major] Adenoma / drug therapy. Adenoma / pathology. Octreotide / pharmacology. Pituitary Neoplasms / drug therapy. Pituitary Neoplasms / pathology. Receptors, Somatostatin / analysis
  • [MeSH-minor] Adult. Aged. Antineoplastic Agents, Hormonal / pharmacology. Chemotherapy, Adjuvant. Cytoplasm / pathology. Female. Growth Hormone / secretion. Humans. Immunohistochemistry. Male. Middle Aged. Tissue Distribution

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  • (PMID = 20464704.001).
  • [ISSN] 0423-104X
  • [Journal-full-title] Endokrynologia Polska
  • [ISO-abbreviation] Endokrynol Pol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Receptors, Somatostatin; 0 / somatostatin receptor 2; 0 / somatostatin receptor 5; 9002-72-6 / Growth Hormone; RWM8CCW8GP / Octreotide
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49. Petersenn S, Buchfelder M, Reincke M, Strasburger CM, Franz H, Lohmann R, Quabbe HJ, Plöckinger U, Participants of the German Acromegaly Register: Results of surgical and somatostatin analog therapies and their combination in acromegaly: a retrospective analysis of the German Acromegaly Register. Eur J Endocrinol; 2008 Nov;159(5):525-32
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  • [Title] Results of surgical and somatostatin analog therapies and their combination in acromegaly: a retrospective analysis of the German Acromegaly Register.
  • BACKGROUND: Data on surgical and medical treatment outcomes in acromegaly mostly originate from specialized centers.
  • We retrospectively analyzed the data on surgery, primary somatostatin analog (SSA) therapy, surgery preceded by SSA, and SSA preceded by surgery in 1485 patients from the German Acromegaly Register.
  • GH and IGF1 normalized in 54.3 and 67.2%.
  • Partial or total pituitary insufficiency occurred in 28.6% initially and 41.2% post-surgery.
  • GH and IGF1 normalized in 36.3 and 30.5%, increasing to 40.8 and 41.5% with longer SSA (>or=360 days) in 54 patients.
  • Pituitary function did not change.
  • Post-surgery GH and IGF1 was normalized in 62.9 and 68.4%.
  • GH improvement was slightly, but significantly better after SSA pretreatment.
  • GH and IGF1 normalized during SSA in 24.1 and 45.5%.
  • Relative GH decrease was significantly larger compared with primary SSA.
  • CONCLUSIONS: Pituitary surgery was more effective to lower GH and IGF1 concentrations than primary SSA.
  • Debulking surgery may result in better final outcome in patients with a high GH concentration and a large tumor.

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  • (PMID = 18755874.001).
  • [ISSN] 1479-683X
  • [Journal-full-title] European journal of endocrinology
  • [ISO-abbreviation] Eur. J. Endocrinol.
  • [Language] ENG
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; RWM8CCW8GP / Octreotide
  • [Investigator] Allolio B; Badenhoop K; Bender G; Biering H; Blossey HC; Blum H; Bogner U; Brabant G; Buchfelder M; Caspar-Bell G; Demtröder F; Diederich S; Droste M; Engelbach M; Faust M; Finke R; Fölsch UR; Gain T; Gräf KJ; Gerbert B; Grussendorf M; Hampel R; Happ J; Heckmann C; Hehrmann R; Heike M; Herrmann BL; Höffken K; Hüfner M; Jacobeit J; Jaursch-Hancke C; Jockenhövel F; Knippert A; Koch C; Kornely E; Krone W; Lehnert H; Levasseur S; Lössner C; Mann K; Matern S; Meuser J; Meyer A; Minnemann T; Mönig Hl; Müller OA; Paschke R; Petersenn S; Pfeiffer A; Plöckinger U; Raue F; Reincke M; Reschke K; Rudorff KH; Rühle H; Santen R; Schöfl C; Schopohl J; Schories M; Schröder F; Schröder HE; Schröder U; Schulte HM; Stamm B; Steinmetz M; Strasburger CJ; Sturmvoll M; Tharandt L; Tuschy U; von Werder K; Weber MM; Wiedenmann B; Wiesner TD; Würl K; Zeuzem S
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50. Taslipinar A, Bolu E, Kebapcilar L, Sahin M, Uckaya G, Kutlu M: Insulin-like growth factor-1 is essential to the increased mortality caused by excess growth hormone: a case of thyroid cancer and non-Hodgkin's lymphoma in a patient with pituitary acromegaly. Med Oncol; 2009;26(1):62-6
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  • [Title] Insulin-like growth factor-1 is essential to the increased mortality caused by excess growth hormone: a case of thyroid cancer and non-Hodgkin's lymphoma in a patient with pituitary acromegaly.
  • The effects of growth hormone are mediated in part by stimulating the production of insulin-like growth factor-1.
  • Insulin-like growth factor-1 has significant effects on cell proliferation and differentiation, it is a potent mitogen, and it is a powerful inhibitor of programmed cell death (apoptosis).
  • Insulin-like growth factor-1 also has a well-established role in the transformation of normal cells to malignant cells.
  • Case reports on a possible association between elevated growth hormone and cancer risk in a variety of patient groups have been published.
  • Here, we describe clinical and laboratory findings for a patient with acromegaly who first developed thyroid cancer, and then, in the follow up period, probably due to poorly controlled insulin-like growth factor-1 levels, developed a large cell non-Hodgkin's lymphoma.
  • [MeSH-major] Acromegaly. Adenoma / metabolism. Insulin-Like Growth Factor I / metabolism. Lymphoma, Non-Hodgkin / metabolism. Neoplasms, Multiple Primary. Thyroid Neoplasms / metabolism
  • [MeSH-minor] Aged. Antineoplastic Agents, Hormonal / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cyclophosphamide / therapeutic use. Ergolines / therapeutic use. Human Growth Hormone / analogs & derivatives. Human Growth Hormone / secretion. Human Growth Hormone / therapeutic use. Humans. Male. Octreotide / therapeutic use. Prednisone / therapeutic use. Thyroidectomy. Thyroxine / therapeutic use. Vincristine / therapeutic use

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  • (PMID = 18663612.001).
  • [ISSN] 1357-0560
  • [Journal-full-title] Medical oncology (Northwood, London, England)
  • [ISO-abbreviation] Med. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Ergolines; 12629-01-5 / Human Growth Hormone; 5J49Q6B70F / Vincristine; 67763-96-6 / Insulin-Like Growth Factor I; 8N3DW7272P / Cyclophosphamide; LL60K9J05T / cabergoline; N824AOU5XV / pegvisomant; Q51BO43MG4 / Thyroxine; RWM8CCW8GP / Octreotide; VB0R961HZT / Prednisone; COP protocol 2
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51. Zatelli MC, Piccin D, Tagliati F, Bottoni A, Ambrosio MR, Margutti A, Scanarini M, Bondanelli M, Culler MD, degli Uberti EC: Dopamine receptor subtype 2 and somatostatin receptor subtype 5 expression influences somatostatin analogs effects on human somatotroph pituitary adenomas in vitro. J Mol Endocrinol; 2005 Oct;35(2):333-41
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  • [Title] Dopamine receptor subtype 2 and somatostatin receptor subtype 5 expression influences somatostatin analogs effects on human somatotroph pituitary adenomas in vitro.
  • Dopamine (DA) and somatostatin (SRIF) receptor agonists inhibit growth hormone (GH) secretion by pituitary adenomas.
  • We investigated DA subtype 2 receptor (DR2) and SRIF receptor (sst) subtypes 2 and 5 expression in 25 GH-secreting pituitary adenomas and tested in primary culture the effects on GH and prolactin (PRL) secretion of sst agonists selectively interacting with sst2 (BIM-23120), sst5 (BIM-23206), and sst2 and sst5 (BIM-23244).
  • All adenomas expressed sst2; eight adenomas expressed both sst5 and DR2, eight sst5 but not DR2, and eight DR2 but not sst5.
  • GH secretion was inhibited by BIM-23120 in all samples, while it was reduced by BIM-23206 only in adenomas not expressing DR2.
  • BIM-23120's inhibitory effects correlated with sst2 and DR2 expression, whereas DR2 expression correlated inversely with BIM-23206 inhibitory effects on GH secretion.
  • In seven mixed GH-/PRL-secreting pituitary adenomas, PRL secretion was inhibited in sst5-expressing tumors by BIM-23206, but not by BIM-23120.
  • BIM-23244 reduced PRL secretion only in adenomas expressing sst2, sst5 and DR2. sst5 and DR2 expression correlated directly with BIM23206 inhibitory effects on PRL secretion.
  • Our results suggest that adenomas expressing DR2 are less likely to respond to clinically available SRIF analogs in terms of GH secretion inhibition.
  • Therefore, drugs interacting also with DR2 might better control secretion of pituitary adenomas.
  • [MeSH-major] Growth Hormone-Secreting Pituitary Adenoma / metabolism. Protein Isoforms / metabolism. Receptors, Dopamine / metabolism. Receptors, Somatostatin / metabolism. Somatostatin / analogs & derivatives
  • [MeSH-minor] Acromegaly / metabolism. Adult. Aged, 80 and over. Dopamine Agonists. Female. Human Growth Hormone / secretion. Humans. Male. Middle Aged. Prolactin / secretion. RNA, Messenger / metabolism

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  • (PMID = 16216913.001).
  • [ISSN] 0952-5041
  • [Journal-full-title] Journal of molecular endocrinology
  • [ISO-abbreviation] J. Mol. Endocrinol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Dopamine Agonists; 0 / Protein Isoforms; 0 / RNA, Messenger; 0 / Receptors, Dopamine; 0 / Receptors, Somatostatin; 0 / somatostatin receptor 2; 0 / somatostatin receptor 5; 12629-01-5 / Human Growth Hormone; 51110-01-1 / Somatostatin; 9002-62-4 / Prolactin
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52. Mai PL, Korde L, Kramer J, Peters J, Mueller CM, Pfeiffer S, Stratakis CA, Pinto PA, Bratslavsky G, Merino M, Choyke P, Linehan WM, Greene MH: A possible new syndrome with growth-hormone secreting pituitary adenoma, colonic polyposis, lipomatosis, lentigines and renal carcinoma in association with familial testicular germ cell malignancy: A case report. J Med Case Rep; 2007 Mar 28;1:9
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  • [Title] A possible new syndrome with growth-hormone secreting pituitary adenoma, colonic polyposis, lipomatosis, lentigines and renal carcinoma in association with familial testicular germ cell malignancy: A case report.
  • BACKGROUND: Germ-cell testicular cancer has not been definitively linked to any known hereditary cancer susceptibility disorder.
  • His evaluation as part of an etiologic study of familial testicular cancer revealed multiple colon polyps (adenomatous, hyperplastic, and hamartomatous) first found in his 50 s, multiple lipomas, multiple hyperpigmented skin lesions, left kidney cancer diagnosed at age 64, and a growth-hormone producing pituitary adenoma with associated acromegaly diagnosed at age 64.
  • Alternatively, this family's phenotype might represent a novel neoplasm susceptibility disorder.

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  • (PMID = 17411461.001).
  • [Journal-full-title] Journal of medical case reports
  • [ISO-abbreviation] J Med Case Rep
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CP / N02CP11019
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1847830
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53. Korbonits M, Carlsen E: Recent clinical and pathophysiological advances in non-functioning pituitary adenomas. Horm Res; 2009 Apr;71 Suppl 2:123-30
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  • [Title] Recent clinical and pathophysiological advances in non-functioning pituitary adenomas.
  • Pituitary adenomas are being recognized and diagnosed with increasing frequency.
  • One of the most common forms of pituitary lesion is the clinically non-functioning pituitary adenoma (NFPA), which is often diagnosed incidentally.
  • The vast majority of pituitary adenomas are sporadic, but familial adenomas can occur in the multiple pituitary adenoma type 1 syndrome, in Carney complex or in familial isolated pituitary adenoma.
  • NFPA often show hormone synthesis on tissue immunostaining without causing clinical symptoms.
  • Most often these are silent gonadotroph adenomas, with silent corticotroph or somatotroph adenomas occurring less frequently.
  • It is unclear why these silent adenomas do not release hormones at a clinically recognizable level, although it is probable that there is a continuum between fully functional and completely silent adenomas.
  • Temozolomide has been successfully used for the treatment of a few aggressive pituitary adenomas, and the response to this drug could be influenced by the expression of the DNA repair enzyme O-6-methylguanine DNA methyltransferase.
  • The early diagnosis, prediction of long-term outcome and treatment of NFPAs remain a challenge for endocrinologists.
  • [MeSH-major] Growth Hormone-Secreting Pituitary Adenoma. Prolactinoma
  • [MeSH-minor] ACTH-Secreting Pituitary Adenoma / diagnosis. ACTH-Secreting Pituitary Adenoma / metabolism. ACTH-Secreting Pituitary Adenoma / pathology. ACTH-Secreting Pituitary Adenoma / therapy. Female. Humans. Male

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  • [Copyright] Copyright 2009 S. Karger AG, Basel.
  • (PMID = 19407508.001).
  • [ISSN] 1423-0046
  • [Journal-full-title] Hormone research
  • [ISO-abbreviation] Horm. Res.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Number-of-references] 58
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54. Hofstetter CP, Mannaa RH, Mubita L, Anand VK, Kennedy JW, Dehdashti AR, Schwartz TH: Endoscopic endonasal transsphenoidal surgery for growth hormone-secreting pituitary adenomas. Neurosurg Focus; 2010 Oct;29(4):E6
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  • [Title] Endoscopic endonasal transsphenoidal surgery for growth hormone-secreting pituitary adenomas.
  • OBJECT: The aim of this study was to determine the preoperative predictors of the extent of resection and endocrinological remission following endonasal endoscopic removal of growth hormone (GH)-secreting pituitary adenomas.
  • Endocrinological remission was defined as normal insulin-like growth factor I (IGFI) serum levels and either a nadir GH level of < 0.4 ng/ml after an oral glucose load or a basal GH serum level < 1 ng/ml.
  • A smaller tumor volume and a postoperative reduction in GH serum levels were associated with a higher rate of biochemical cure (p < 0.05).
  • During a 23-month follow-up period 5 patients (21%) underwent Gamma Knife treatment of any residual disease to further reduce excess GH production.
  • CONCLUSIONS: A purely endoscopic endonasal transsphenoidal adenoma resection leads to a high rate of gross-total tumor resection and endocrinological remission in acromegalic patients, even those harboring macroadenomas with wide suprasellar extension.
  • [MeSH-major] Acromegaly / surgery. Adenoma / surgery. Growth Hormone-Secreting Pituitary Adenoma / surgery. Human Growth Hormone / secretion. Neurosurgical Procedures / methods. Pituitary Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Endoscopy. Female. Humans. Insulin-Like Growth Factor I / analysis. Male. Middle Aged. Minimally Invasive Surgical Procedures / methods. Postoperative Period. Preoperative Period. Remission Induction. Sphenoid Bone. Treatment Outcome. Tumor Burden

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  • (PMID = 20887131.001).
  • [ISSN] 1092-0684
  • [Journal-full-title] Neurosurgical focus
  • [ISO-abbreviation] Neurosurg Focus
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I
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55. Ronchi CL, Ferrante E, Rizzo E, Giavoli C, Verrua E, Bergamaschi S, Lania AG, Beck-Peccoz P, Spada A: Long-term basal and dynamic evaluation of hypothalamic-pituitary-adrenal (HPA) axis in acromegalic patients. Clin Endocrinol (Oxf); 2008 Oct;69(4):608-12
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  • [Title] Long-term basal and dynamic evaluation of hypothalamic-pituitary-adrenal (HPA) axis in acromegalic patients.
  • OBJECTIVE: Long-term effects of trans-naso-sphenoidal surgery (TNS) or long-acting somatostatin analogs (SSA) on the function of hypothalamic-pituitary-adrenal (HPA) axis have been poorly investigated.
  • Aim of this study was to evaluate HPA axis integrity during the follow-up in patients with GH-secreting pituitary adenomas and preserved HPA function post-TNS or prior SSA.
  • No significant correlations between HPA axis deterioration and follow-up duration, serum GH/IGF-I levels, occurrence of other pituitary deficiencies, presence of secondary empty sella, changes in tumour or residual volume were observed.
  • [MeSH-major] Acromegaly / physiopathology. Hypothalamo-Hypophyseal System / physiology. Pituitary-Adrenal System / physiology
  • [MeSH-minor] Adenoma / drug therapy. Adenoma / metabolism. Adenoma / physiopathology. Adrenocorticotropic Hormone / blood. Adrenocorticotropic Hormone / metabolism. Adult. Aged. Basal Metabolism / physiology. Delayed-Action Preparations. Disease Progression. Female. Follow-Up Studies. Humans. Hydrocortisone / blood. Hydrocortisone / metabolism. Male. Middle Aged. Pituitary Neoplasms / drug therapy. Pituitary Neoplasms / metabolism. Pituitary Neoplasms / physiopathology. Retrospective Studies. Somatostatin / administration & dosage. Somatostatin / analogs & derivatives. Time Factors

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  • (PMID = 18410544.001).
  • [ISSN] 1365-2265
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Delayed-Action Preparations; 51110-01-1 / Somatostatin; 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone
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56. Müssig K, Gallwitz B, Honegger J, Strasburger CJ, Bidlingmaier M, Machicao F, Bornemann A, Ranke MB, Häring HU, Petersenn S: Pegvisomant treatment in gigantism caused by a growth hormone-secreting giant pituitary adenoma. Exp Clin Endocrinol Diabetes; 2007 Mar;115(3):198-202
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  • [Title] Pegvisomant treatment in gigantism caused by a growth hormone-secreting giant pituitary adenoma.
  • BACKGROUND: Gigantism is rare with the majority of cases caused by a growth hormone (GH)-secreting pituitary adenoma.
  • Treatment options for GH-secreting pituitary adenomas have been widened with the availability of long-acting dopamine agonists, depot preparations of somatostatin analogues, and recently the GH receptor antagonist pegvisomant.
  • CASE REPORT: A 23-year-old male patient presented with continuous increase in height during the past 6 years due to a GH-secreting giant pituitary adenoma.
  • At immunohistochemistry, the tumour showed a marked expression of GH and a sparsely focal expression of prolactin.
  • Conversion from somatostatin analogue to pegvisomant normalized insulin-like-growth-factor-I (IGF-I) levels and markedly improved glucose tolerance.
  • CONCLUSION: Pegvisomant is a potent treatment option in patients with pituitary gigantism.
  • [MeSH-major] Adenoma / secretion. Adenoma / surgery. Gigantism / drug therapy. Gigantism / etiology. Human Growth Hormone / analogs & derivatives. Human Growth Hormone / secretion. Pituitary Neoplasms / secretion. Pituitary Neoplasms / surgery


57. Kajiwara K, Saito K, Yoshikawa K, Kato S, Akimura T, Nomura S, Ishihara H, Suzuki M: Image-guided stereotactic radiosurgery with the CyberKnife for pituitary adenomas. Minim Invasive Neurosurg; 2005 Apr;48(2):91-6
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  • [Title] Image-guided stereotactic radiosurgery with the CyberKnife for pituitary adenomas.
  • Twenty-one patients with pituitary adenomas received image-guided stereotactic radiosurgery with the CyberKnife, and were followed up for more than 18 months.
  • The patients consisted of 14 with non-functioning adenomas, 3 with prolactinomas, 2 with acromegaly, and 2 with ACTH-producing tumors.
  • The mean volumes of the non-functioning and functioning adenomas were 13.3 cm (3) and 7.5 cm (3), respectively.
  • The marginal irradiation dose ranged from 6.4 Gy to 27.7 Gy (mean: non-functioning adenomas 12.6 Gy, functioning adenomas 17.5 Gy), as a dose of a single fraction.
  • Hormonal function improved in all of the 7 functioning adenomas.
  • The hormone level normalized in 1 prolactinoma, and decreased to less than normal in 1 ACTH-producing adenoma.
  • Image-guided stereotactic radiosurgery with the CyberKnife is effective and safe against relatively large pituitary adenomas.
  • [MeSH-major] Adenoma / surgery. Pituitary Neoplasms / surgery. Radiosurgery / instrumentation. Surgery, Computer-Assisted / instrumentation

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  • (PMID = 15906203.001).
  • [ISSN] 0946-7211
  • [Journal-full-title] Minimally invasive neurosurgery : MIN
  • [ISO-abbreviation] Minim Invasive Neurosurg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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58. Losa M, Gioia L, Picozzi P, Franzin A, Valle M, Giovanelli M, Mortini P: The role of stereotactic radiotherapy in patients with growth hormone-secreting pituitary adenoma. J Clin Endocrinol Metab; 2008 Jul;93(7):2546-52
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  • [Title] The role of stereotactic radiotherapy in patients with growth hormone-secreting pituitary adenoma.
  • CONTEXT: Single-session stereotactic radiotherapy (SR) may be a potential adjuvant treatment in acromegaly.
  • INTERVENTION: The patients were treated with SR for residual or recurrent GH-secreting adenoma.
  • MAIN OUTCOME MEASURE: Normalization of age- and sex-adjusted IGF-I levels together with a basal GH level below 2.5 microg/liter without concomitant GH-suppressive drugs was the goal of therapy.
  • Multivariate analysis showed that low basal GH and IGF-I levels were associated with a favorable outcome.
  • This may lead to reconsider the role of SR in the therapeutic algorithm of acromegaly.
  • [MeSH-major] Adenoma / surgery. Growth Hormone-Secreting Pituitary Adenoma / surgery. Radiosurgery
  • [MeSH-minor] Adult. Female. Human Growth Hormone / blood. Humans. Insulin-Like Growth Factor I / analysis. Male. Retrospective Studies

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  • [CommentIn] Nat Clin Pract Endocrinol Metab. 2008 Nov;4(11):592-3 [18762791.001]
  • (PMID = 18413424.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I
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59. Kontogeorgos G, Mourouti G, Kyrodimou E, Liapi-Avgeri G, Parasi E: Ganglion cell containing pituitary adenomas: signs of neuronal differentiation in adenoma cells. Acta Neuropathol; 2006 Jul;112(1):21-8
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  • [Title] Ganglion cell containing pituitary adenomas: signs of neuronal differentiation in adenoma cells.
  • Ganglion cell containing pituitary adenomas are rare.
  • Recently accumulated information suggests a common origin for their neuronal and pituitary constituents.
  • The objective of this study was to report the clinical and morphologic findings of pituitary gangliocytomas and study their immunoprofile using neuronal markers.
  • Seven cases of pituitary gangliocytomas retrieved from 1,322 sellar lesions were studied.
  • All tumors were removed from patients with mild acromegaly.
  • Histologically they were biphasic composed of pituitary adenoma and clusters of ganglion cells embedded in a variably dense neuropil substrate.
  • All adenomas belonged to the category of sparsely granulated somatotroph adenoma and were positive for growth hormone, whereas in five tumors, a few adenoma cells were also positive for prolactin.
  • Interestingly, all tumors contained varying numbers of adenoma cells with NFP-positive, dot-like areas of cytoplasmic reactivity, mostly tiny paranuclear, a finding not previously reported in human pituitary gangliocytomas.
  • The presence of NFP in pituitary adenomas indicates neuronal differentiation in adenoma cells, suggesting a common origin for neuronal and pituitary adenoma cell elements in gangliocytomas.
  • [MeSH-major] Adenoma / classification. Adenoma / pathology. Ganglioneuroma / classification. Ganglioneuroma / pathology. Pituitary Neoplasms / classification. Pituitary Neoplasms / pathology
  • [MeSH-minor] Acromegaly / etiology. Female. Humans. Immunohistochemistry. Male. Middle Aged. Neurofilament Proteins / metabolism. Sella Turcica / pathology

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  • (PMID = 16699777.001).
  • [ISSN] 0001-6322
  • [Journal-full-title] Acta neuropathologica
  • [ISO-abbreviation] Acta Neuropathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Neurofilament Proteins
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60. Swords FM, Monson JP, Besser GM, Chew SL, Drake WM, Grossman AB, Plowman PN: Gamma knife radiosurgery: a safe and effective salvage treatment for pituitary tumours not controlled despite conventional radiotherapy. Eur J Endocrinol; 2009 Dec;161(6):819-28
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  • [Title] Gamma knife radiosurgery: a safe and effective salvage treatment for pituitary tumours not controlled despite conventional radiotherapy.
  • OBJECTIVE: We report the use of 'gamma knife' (GK) radiosurgery in 25 patients with pituitary adenomas not cured despite conventional therapy, including external beam radiotherapy.
  • PATIENTS AND METHODS: All patients had previously received conventional radiotherapy for a mean of 11.8 years prior to receiving GK; 23 out of 25 had also undergone pituitary surgery on at least one occasion.
  • Seventeen had hyperfunctioning adenomas that still required medical therapy without an adequate biochemical control--ten somatotroph adenomas, six corticotroph adenomas and one prolactinoma, while eight patients had non-functioning pituitary adenomas (NFPAs).
  • RESULTS: Following GK, mean GH fell by 49% at 1 year in patients with somatotroph tumours.
  • To date, 80% of the patients with acromegaly have achieved normalisation of IGF1, and 30% have also achieved a mean GH level of <1.8 ng/ml correlating with normalised mortality.
  • A total of 75% NFPAs showed disease stabilisation or shrinkage post GK.
  • The results in corticotroph adenomas were variable.
  • Prior to GK, 72% of the patients were panhypopituitary, and 42% of the remainder have developed new anterior pituitary hormone deficiencies to date.
  • CONCLUSIONS: These data indicate that GK is a safe and effective adjunctive treatment for patients with NFPAs and acromegaly not satisfactorily controlled with surgery and radiotherapy.

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  • (PMID = 19773368.001).
  • [ISSN] 1479-683X
  • [Journal-full-title] European journal of endocrinology
  • [ISO-abbreviation] Eur. J. Endocrinol.
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I
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61. Buchfelder M, Schlaffer S, Droste M, Mann K, Saller B, Brübach K, Stalla GK, Strasburger CJ, German Pegvisomant Observational Study: The German ACROSTUDY: past and present. Eur J Endocrinol; 2009 Nov;161 Suppl 1:S3-S10
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  • Pivotal studies have demonstrated that pharmacotherapy with pegvisomant (Somavert) is a highly effective treatment for acromegaly.
  • Treatment efficacy was monitored by IGF1 levels and the patients symptoms were evaluated by completion of a questionnaire (patient-assessed acromegaly symptom questionnaire).
  • In 71.3% of patients with previously not sufficiently treatable acromegaly, IGF1 levels were normalized by pegvisomant therapy.
  • It did not exceed the expected rate in patients with acromegaly not treated with pegvisomant.

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  • (PMID = 19684061.001).
  • [ISSN] 1479-683X
  • [Journal-full-title] European journal of endocrinology
  • [ISO-abbreviation] Eur. J. Endocrinol.
  • [Language] ENG
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers; 0 / Blood Glucose; 0 / Hemoglobin A, Glycosylated; 0 / Hormone Antagonists; 0 / Receptors, Somatotropin; 0 / pegvisomant; 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I; EC 2.6.1.1 / Aspartate Aminotransferases; EC 2.6.1.2 / Alanine Transaminase
  • [Investigator] Droste M; Stalla GK; Allolio B; Faust M; Brendel M; Finke R; Tuchelt H; Bidlingmaier M; Engelbach M; Santen R; Hampel R; Mann K; Kann PH; Boehm B; Kasperk C; Helios CK; Wallaschofski H; Moenig H; Stumvoll M; Schopohl J; Völz B; Würl K; Ittner J; Reschke K; Jacobeit J; Ramadori G; Schindler A; Zeuzem S; Badenhoop K; Beil FU; Pfeiffer AF; Vogel C; Hofbauer LC; Strasburger CJ; Tuschy U; Plöckinger U; Seidlitz B; Demtröder F; Schmiegel; Gellner R; Gräf KJ; Schröder U; Ball P; Ventzke K; Hensen J; Lux H; Etzrodt H; Alexopoulos A; Spitzweg C; Schnabel D; Dost A; Weber MM; Wiemer K; Omran W; Keuser R; Salzgeber K; Gutekunst R; Terkamp C; Gaissmaier S; Eversmann T; Seufert J; Jaursch-Hancke C; Ritter M; Undeutsch C; Jochum E; Mutterhaus der Borromäerinnen S; Schleiffer T; Karges W; Meuser J; Wildbrett J; Krug J; Buchfelder M; Klingmüller D; Schmitz U; Perras B; Zick R; Leicht E; Manfras B; Schuppert F; Müller OA; Stahmer E; Kajdan U; Gallwitz; Rochlitz H; Heckmann C; Haak E; Weber R; Herrmann BL; Schneider S; Scherbaum WA; Deuss U; Jacobs B; Gerbert B; Wolf M; West T; Lippe J; Biering H
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62. Saveanu A, Gunz G, Guillen S, Dufour H, Culler MD, Jaquet P: Somatostatin and dopamine-somatostatin multiple ligands directed towards somatostatin and dopamine receptors in pituitary adenomas. Neuroendocrinology; 2006;83(3-4):258-63
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Somatostatin and dopamine-somatostatin multiple ligands directed towards somatostatin and dopamine receptors in pituitary adenomas.
  • AIM: We report the comparative efficacy of octreotide, cabergoline and multiple ligands directed towards the different somatostatin subtypes (ssts), such as BIM-23A779 and SOM-230, and of chimeric analogs which bind both somatostatin and the dopamine D2 receptors (D2R), such as BIM-23A760 and BIM-23A781, in cell cultures from human growth hormone (GH)-secreting pituitary adenomas.
  • PROCEDURES: RT-PCR analysis of the quantitative expression of the different ssts and D2R mRNAs was performed on tumor fragments of 22 GH-secreting adenomas collected after surgery.
  • Pharmacological studies, using the different ligands, were performed on cell cultures of such tumors.
  • The levels of expression of sst2 and D2R mRNAs were significantly correlated with the maximal GH suppression by either octreotide or cabergoline (p < 0.001).
  • In each tumor tested, 3 patterns of response, in terms of GH suppression, were observed.
  • GH secretion was preferentially inhibited by the sst2 preferential compound octreotide in 61% of the tumors.
  • In 19% of the tumors, the maximal inhibition of GH release was achieved with the sst5 preferential compound BIM-23268.
  • The dopamine analog cabergoline was the most effective inhibitor of GH secretion in 21% of cases.
  • Among the compounds tested, the most potent inhibitors of GH secretion were the sst2, sst5, D2R chimeric compound BIM-23A760, followed by the sst universal ligand SOM-230.
  • CONCLUSIONS: The variable patterns of response to sst2, sst5 and dopamine D2 analogs may explain the greater efficacy of drugs which bind to the 3 receptors in suppressing GH secretion.
  • The biological potency (EC50) and efficacy of the chimeric compound BIM-23A760 on GH secretion can be partly explained by its high affinity for sst2.
  • The effect of multiple receptor activation on the functions of other pituitary tumor types, such as prolactinomas and corticotropinomas, is not presently analyzed, and the efficacy of multireceptor ligands remains to be elucidated.
  • [MeSH-major] Adenoma / drug therapy. Antineoplastic Agents, Hormonal / therapeutic use. Dopamine / analogs & derivatives. Pituitary Neoplasms / drug therapy. Somatostatin / analogs & derivatives
  • [MeSH-minor] Adult. Drug Screening Assays, Antitumor. Ergolines / therapeutic use. Female. Human Growth Hormone / drug effects. Human Growth Hormone / metabolism. Humans. Ligands. Male. Octreotide / therapeutic use. RNA, Messenger / analysis. Receptors, Dopamine D2 / drug effects. Receptors, Dopamine D2 / genetics. Receptors, Dopamine D2 / metabolism. Receptors, Somatostatin / classification. Receptors, Somatostatin / drug effects. Receptors, Somatostatin / genetics. Receptors, Somatostatin / metabolism. Recombinant Fusion Proteins / therapeutic use. Tumor Cells, Cultured

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  • (PMID = 17047391.001).
  • [ISSN] 0028-3835
  • [Journal-full-title] Neuroendocrinology
  • [ISO-abbreviation] Neuroendocrinology
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / BIM 23268; 0 / Ergolines; 0 / Ligands; 0 / RNA, Messenger; 0 / Receptors, Dopamine D2; 0 / Receptors, Somatostatin; 0 / Recombinant Fusion Proteins; 12629-01-5 / Human Growth Hormone; 51110-01-1 / Somatostatin; LL60K9J05T / cabergoline; RWM8CCW8GP / Octreotide; VTD58H1Z2X / Dopamine
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63. Adamo MA, Drazin D, Popp AJ: Short-lasting, unilateral neuralgiform headache attacks with conjunctival injection and tearing syndrome treated successfully with transsphenoidal resection of a growth hormone-secreting pituitary adenoma. J Neurosurg; 2008 Jul;109(1):123-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Short-lasting, unilateral neuralgiform headache attacks with conjunctival injection and tearing syndrome treated successfully with transsphenoidal resection of a growth hormone-secreting pituitary adenoma.
  • In this paper the authors present a patient with a growth hormone-secreting pituitary adenoma who experienced resolution of SUNCT syndrome after transsphenoidal tumor resection.
  • [MeSH-major] Adenoma / surgery. Growth Hormone-Secreting Pituitary Adenoma / surgery. SUNCT Syndrome / surgery


64. Acunzo J, Thirion S, Roche C, Saveanu A, Gunz G, Germanetti AL, Couderc B, Cohen R, Figarella-Branger D, Dufour H, Brue T, Enjalbert A, Barlier A: Somatostatin receptor sst2 decreases cell viability and hormonal hypersecretion and reverses octreotide resistance of human pituitary adenomas. Cancer Res; 2008 Dec 15;68(24):10163-70
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  • [Title] Somatostatin receptor sst2 decreases cell viability and hormonal hypersecretion and reverses octreotide resistance of human pituitary adenomas.
  • In human somatotroph adenomas, growth hormone (GH) hypersecretion can be inhibited by somatostatin analogues such as octreotide.
  • Unfortunately, serum GH levels reach normal values in only 60% of treated patients.
  • In this present study, the sst2 gene was transferred by an adenoviral vector (Ad-sst2) in human somatotroph (n = 7) and lactotroph (n = 2) adenomas in vitro.
  • Ten days after infection at 20 multiplicity of infection (MOI), sst2 gene transfer decreased cell viability from 19% to 90% by caspase-dependent apoptosis.
  • At low viral doses (5 MOI), Ad-sst2 decreased GH or prolactin (PRL) basal secretion and mRNA expression.
  • Somatotroph tumors were classified in three groups according to their octreotide sensitivity.
  • Four days after infection by 5 MOI Ad-sst2, the maximal GH suppression by octreotide increased from 31% to 57% in the octreotide partially resistant group and from 0% to 27% in the resistant ones.
  • In the octreotide-sensitive group, EC(50) values significantly decreased from 1.3 x 10(-11) to 6.6 x 10(-13) mol/L without improving maximal GH suppression.
  • [MeSH-major] Antineoplastic Agents, Hormonal / pharmacology. Growth Hormone-Secreting Pituitary Adenoma / drug therapy. Human Growth Hormone / secretion. Octreotide / pharmacology. Pituitary Neoplasms / drug therapy. Prolactin / secretion. Prolactinoma / drug therapy
  • [MeSH-minor] Adenoviridae / genetics. Cell Survival / physiology. Drug Resistance, Neoplasm. Humans. Immunohistochemistry. RNA, Messenger / biosynthesis. RNA, Messenger / genetics. Receptors, Somatostatin / biosynthesis. Receptors, Somatostatin / genetics. Transduction, Genetic. Transgenes


65. Manahan MA, Dackiw AP, Ball DW, Zeiger MA: Unusual case of metastatic neuroendocrine tumor. Endocr Pract; 2007 Jan-Feb;13(1):72-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • OBJECTIVE: To report a rare case of metastatic growth hormone (GH)-secreting pituitary carcinoma causing acromegaly.
  • RESULTS: A 68-year-old woman presented with persistent acromegaly after treatment for a GH-secreting pituitary adenoma.
  • After operative treatment including total thyroidectomy, subtotal parathyroidectomy, partial thymectomy, and right modified radical neck dissection, the patient's symptoms diminished, and her GH levels approached the normal range.
  • Surgical pathology findings were consistent with a GH-secreting pituitary carcinoma metastatic to the cervical lymph nodes, multinodular thyroid hyperplasia with a focus of papillary microcarcinoma, and parathyroid hyperplasia.
  • CONCLUSION: Overall, pituitary carcinomas are extremely rare.
  • To date, about 100 cases have been reported in the world's literature, and of these, only 19 cases originated from GH-secreting cells.
  • Our examination of the symptoms, signs, diagnosis, and treatment of our patient, in comparison with the previously reported cases, should enhance awareness of this unusual disease process.
  • [MeSH-major] Adenoma / pathology. Growth Hormone-Secreting Pituitary Adenoma / pathology. Parathyroid Neoplasms / secondary. Thymus Neoplasms / secondary. Thyroid Neoplasms / secondary
  • [MeSH-minor] Acromegaly / etiology. Aged. Female. Humans. Lymphatic Metastasis

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  • (PMID = 17360306.001).
  • [ISSN] 1934-2403
  • [Journal-full-title] Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
  • [ISO-abbreviation] Endocr Pract
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 29
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66. Ebner FH, Kürschner V, Dietz K, Bültmann E, Nägele T, Honegger J: Craniometric changes in patients with acromegaly from a surgical perspective. Neurosurg Focus; 2010 Oct;29(4):E3
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  • [Title] Craniometric changes in patients with acromegaly from a surgical perspective.
  • OBJECT: The objective of this study was to evaluate and analyze morphometric and volumetric changes of the skull due to acromegaly in areas relevant for neurosurgical practice, focusing on the surgical implications.
  • METHODS: On preoperatively acquired CT scans, cephalometric and volumetric measurements were performed on 45 patients with acromegaly (Group A) and 45 control patients (Group B).
  • The morphometric and volumetric CT data of the patients with acromegaly were compared with the data of a control group and correlated with clinical parameters.
  • A correlation of the vault thickness with preoperative human growth hormone, insulin-like growth factor-I levels, and duration of clinical history in acromegaly could not be established.
  • The outer anterior-posterior skull diameter of Group A (18.47 ± 0.94 cm) differed significantly (p = 0.0146) from Group B (17.98 ± 0.93 cm) and correlated significantly with preoperative human growth hormone (r = 0.3277; p = 0.0299) and insulin-like growth factor-–I serum levels (r = 0.3756; p = 0.0120).
  • Measurements of the anterior-posterior diameter of the sphenoidal sinus differed significantly (p = 0.0074) between patients with acromegaly and controls.
  • Volumetric analysis of the frontal sinus resulted in a statistically significant difference (p = 0.0382) between patients with acromegaly (14.89 ± 10.85 cm3) and controls (10.06 ± 6.93 cm3).
  • CONCLUSIONS: Significant craniometric changes and volumetric remodelling of the paranasal sinus occur in acromegaly.
  • Detailed preoperative diagnostic examination and planning as well as selection of appropriate instruments are mandatory for safe and successful pituitary adenoma removal in patients with acromegaly.
  • [MeSH-major] Acromegaly / pathology. Acromegaly / surgery. Cephalometry / statistics & numerical data. Skull / pathology. Skull / surgery
  • [MeSH-minor] Adenoma / pathology. Adenoma / surgery. Cone-Beam Computed Tomography / statistics & numerical data. Human Growth Hormone / blood. Humans. Insulin-Like Growth Factor I / analysis. Maxillary Sinus / pathology. Neurosurgical Procedures / methods. Pituitary Neoplasms / blood. Pituitary Neoplasms / pathology. Pituitary Neoplasms / surgery. Preoperative Care. Sphenoid Sinus / pathology. Tomography, X-Ray Computed

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  • (PMID = 20887128.001).
  • [ISSN] 1092-0684
  • [Journal-full-title] Neurosurgical focus
  • [ISO-abbreviation] Neurosurg Focus
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I
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67. Campbell PG, Kenning E, Andrews DW, Yadla S, Rosen M, Evans JJ: Outcomes after a purely endoscopic transsphenoidal resection of growth hormone-secreting pituitary adenomas. Neurosurg Focus; 2010 Oct;29(4):E5
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  • [Title] Outcomes after a purely endoscopic transsphenoidal resection of growth hormone-secreting pituitary adenomas.
  • OBJECT: Using strict biochemical remission criteria, the authors assessed surgical outcomes after endoscopic transsphenoidal resection of growth hormone (GH)-secreting pituitary adenomas and identified preoperative factors that significantly influence the rate of remission.
  • The authors reviewed cases in which an endoscopic resection of GH-secreting pituitary adenomas was performed.
  • The thresholds of an age-appropriate, normalized insulin-like growth factor-I concentration, a nadir GH level after oral glucose load of less than 1.0 μg/l, and a random GH value of less than 2.5 μg/l were required to establish biochemical cure postoperatively.
  • RESULTS: Overall, in 57.7% of patients undergoing a purely endoscopic transsphenoidal pituitary adenectomy for acromegaly, an endocrinological cure was achieved.
  • CONCLUSIONS: A purely endoscopic transsphenoidal approach to GH-secreting pituitary adenomas leads to similar outcome for noninvasive macroadenomas compared with traditional microsurgical techniques.
  • Furthermore, this approach may often provide maximal visualization of the tumor, the pituitary gland, and the surrounding neurovascular structures.
  • [MeSH-major] Acromegaly / surgery. Endoscopy / methods. Growth Hormone-Secreting Pituitary Adenoma / surgery. Human Growth Hormone / secretion
  • [MeSH-minor] Adenoma / surgery. Adult. Aged. Female. Humans. Insulin-Like Growth Factor I / analysis. Longitudinal Studies. Male. Microsurgery / methods. Middle Aged. Neoplasm Invasiveness. Neurosurgical Procedures / methods. Pituitary Neoplasms / surgery. Remission Induction. Sphenoid Bone. Treatment Outcome

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  • (PMID = 20887130.001).
  • [ISSN] 1092-0684
  • [Journal-full-title] Neurosurgical focus
  • [ISO-abbreviation] Neurosurg Focus
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I
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68. Melmed S, Sternberg R, Cook D, Klibanski A, Chanson P, Bonert V, Vance ML, Rhew D, Kleinberg D, Barkan A: A critical analysis of pituitary tumor shrinkage during primary medical therapy in acromegaly. J Clin Endocrinol Metab; 2005 Jul;90(7):4405-10
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A critical analysis of pituitary tumor shrinkage during primary medical therapy in acromegaly.
  • CONTEXT: Somatostatin analogs have been successfully used to treat patients with GH-secreting pituitary adenomas because they are safe, effective, and usually well tolerated.
  • The results of studies evaluating acromegaly treatment with the somatostatin receptor ligands (SRLs), octreotide and lanreotide, have supported the use of these agents for primary medical therapy before or as an alternative to traditional interventions of surgery and radiotherapy in selected cases.
  • EVIDENCE ACQUISITION: We therefore undertook a systematic literature overview to characterize the results of studies involving primary therapy with somatostatin analogs and their effects on pituitary tumor size.
  • Because most studies in which pituitary tumor shrinkage has been assessed involve uncontrolled, open-label, prospective trials or retrospective case series, the lack of a control arm does not permit pooling of data in a metaanalytic fashion to determine tumor size reduction.
  • EVIDENCE SYNTHESIS: Overall, for patients who experience significant shrinkage, an approximately 50% decrease in pituitary mass is achieved when a somatostatin analog is used exclusively or before surgery or radiotherapy.
  • Fourteen studies (n = 424) provided a definition of significant tumor shrinkage, and the results showed that 36.6% (weighted mean percentage) of patients receiving primary SRL therapy for acromegaly experienced a significant reduction in tumor size.
  • [MeSH-major] Acromegaly / drug therapy. Pituitary Neoplasms / drug therapy. Somatostatin / therapeutic use
  • [MeSH-minor] Clinical Trials as Topic. Dopamine Agonists / therapeutic use. Humans. Insulin-Like Growth Factor I / analysis

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  • (PMID = 15827109.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Dopamine Agonists; 51110-01-1 / Somatostatin; 67763-96-6 / Insulin-Like Growth Factor I
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69. Okinaga H, Takano K, Hayashi S, Yasufuku-Takano J, Teramoto A, Fujita T: Mechanisms of TRH-induced GH release (paradoxical response) in human somatotroph adenoma cells. Endocr J; 2005 Dec;52(6):763-7
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  • [Title] Mechanisms of TRH-induced GH release (paradoxical response) in human somatotroph adenoma cells.
  • The mechanisms of paradoxical TRH response in human somatotroph adenoma cells were investigated using intracellular calcium measurement and static incubation assay.
  • These calcium responses, especially the second phase, was responsible for the TRH-induced GH release.
  • [MeSH-major] Adenoma / secretion. Growth Hormone-Secreting Pituitary Adenoma / secretion. Human Growth Hormone / secretion. Thyrotropin-Releasing Hormone / pharmacology

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  • (PMID = 16410670.001).
  • [ISSN] 0918-8959
  • [Journal-full-title] Endocrine journal
  • [ISO-abbreviation] Endocr. J.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Calcium Channels; 12629-01-5 / Human Growth Hormone; 5Y5F15120W / Thyrotropin-Releasing Hormone; EC 2.7.11.13 / Protein Kinase C; SY7Q814VUP / Calcium
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70. Wasko R, Jankowska A, Waligorska-Stachura J, Andrusiewicz M, Jaskula M, Sowinski J: Survivin expression in pituitary adenomas. Neuro Endocrinol Lett; 2005 Jun;26(3):209-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Survivin expression in pituitary adenomas.
  • Survivin expression has been described to be cell cycle-dependent and restricted to the G2-M checkpoint, where it inhibits apoptosis in proliferating cells.
  • OBJECTIVES: The aim of our study was to determine the survivin expression in different types of pituitary adenomas.
  • METHODS: Tissue samples were obtained during surgical removal of the tumour from 12 patients with diagnosed: acromegaly in seven cases, non-functioning pituitary tumours in four cases and prolactinoma in one case.
  • Six patients with acromegaly received long-acting somatostatin analogues before tumour resection.
  • RESULTS: In agreement with the current view that survivin is a tumor-associated antigen, highly expressed in various tumours, we found the presence of survivin expression as a characteristic feature of human pituitary adenomas.
  • The findings of our study demonstrated the presence of an active survivin gene in all twelve analysed pituitary tumours.
  • CONCLUSIONS: Based on these findings, we conclude that the estimation of survivin expression in human pituitary tumours may help predict tumour growth and prognosis.
  • [MeSH-major] Adenoma / physiopathology. Biomarkers, Tumor / genetics. Gene Expression Regulation, Neoplastic. Microtubule-Associated Proteins / genetics. Neoplasm Proteins / genetics. Pituitary Neoplasms / physiopathology
  • [MeSH-minor] Acromegaly / genetics. Acromegaly / physiopathology. Adult. Aged. Female. HeLa Cells. Humans. Inhibitor of Apoptosis Proteins. Male. Middle Aged. Predictive Value of Tests. Prognosis. Prolactinoma / genetics. Prolactinoma / physiopathology. RNA, Messenger / analysis

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  • (PMID = 15990723.001).
  • [ISSN] 0172-780X
  • [Journal-full-title] Neuro endocrinology letters
  • [ISO-abbreviation] Neuro Endocrinol. Lett.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Sweden
  • [Chemical-registry-number] 0 / BIRC5 protein, human; 0 / Biomarkers, Tumor; 0 / Inhibitor of Apoptosis Proteins; 0 / Microtubule-Associated Proteins; 0 / Neoplasm Proteins; 0 / RNA, Messenger
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71. Gradiser M, Matovinovic M, Vrkljan M: Decrease in growth hormone and insulin-like growth factor (IGF)-1 release and amelioration of acromegaly features after rosiglitazone treatment of type 2 diabetes mellitus a patient with acromegaly. Croat Med J; 2007 Feb;48(1):87-91
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  • [Title] Decrease in growth hormone and insulin-like growth factor (IGF)-1 release and amelioration of acromegaly features after rosiglitazone treatment of type 2 diabetes mellitus a patient with acromegaly.
  • A 28-year-old woman with clinical features of acromegaly and diabetes mellitus was admitted to our Reference Center for Clinical Neuroendocrinology and Pituitary Diseases at Sisters of Mercy University Hospital, Zagreb, Croatia.
  • Magnetic resonance scan of the brain showed pituitary macroadenoma.
  • After transsphenoidal resection, histological analysis confirmed it was a growth hormone (GH)-secreting pituitary adenoma.
  • A month after the surgery, octreotide was introduced because of a further increase in GH and insulin-like growth factor-I (IGF-I), but discontinued after a week due to intolerance.
  • The concentration of GH and IGF-I in the week before rosiglitazone was introduced was 5.96 ng/mL and 990 ng/mL, respectively, and decreased to 2.92 ng/mL and 180.0 ng/mL, respectively, after 90 days of treatment.
  • It is possible that rosiglitazone induced the decrease in GH and IGF-I concentrations and its role in the long-term medical therapy of patients with pituitary tumors should be further investigated.
  • [MeSH-major] Acromegaly / etiology. Diabetes Mellitus, Type 2 / drug therapy. Growth Hormone / drug effects. Insulin-Like Growth Factor I / drug effects. Thiazolidinediones / therapeutic use
  • [MeSH-minor] Adenoma / complications. Adenoma / surgery. Adult. Dose-Response Relationship, Drug. Drug Administration Schedule. Female. Follow-Up Studies. Growth Hormone-Secreting Pituitary Adenoma / complications. Growth Hormone-Secreting Pituitary Adenoma / surgery. Humans


72. Erturk E, Tuncel E, Kiyici S, Ersoy C, Duran C, Imamoglu S: Outcome of surgery for acromegaly performed by different surgeons: importance of surgical experience. Pituitary; 2005;8(2):93-7
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  • [Title] Outcome of surgery for acromegaly performed by different surgeons: importance of surgical experience.
  • Basal or nadir postglucose growth hormone levels of less than 2 ng/ml were accepted as cure criteria.
  • [MeSH-major] Acromegaly / surgery
  • [MeSH-minor] Adenoma / drug therapy. Adenoma / surgery. Adult. Clinical Competence. Female. Human Growth Hormone / blood. Humans. Male. Middle Aged. Octreotide / therapeutic use. Pituitary Neoplasms / drug therapy. Pituitary Neoplasms / surgery. Reoperation. Retrospective Studies. Treatment Outcome

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  • (PMID = 16195777.001).
  • [ISSN] 1386-341X
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; RWM8CCW8GP / Octreotide
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73. Toledo RA, Mendonca BB, Fragoso MC, Soares IC, Almeida MQ, Moraes MB, Lourenço DM Jr, Alves VA, Bronstein MD, Toledo SP: Isolated familial somatotropinoma: 11q13-loh and gene/protein expression analysis suggests a possible involvement of aip also in non-pituitary tumorigenesis. Clinics (Sao Paulo); 2010 Apr;65(4):407-15
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  • [Title] Isolated familial somatotropinoma: 11q13-loh and gene/protein expression analysis suggests a possible involvement of aip also in non-pituitary tumorigenesis.
  • OBJECTIVE: Non-pituitary tumors have been reported in a subset of patients harboring germline mutations in the aryl hydrocarbon receptor-interacting protein (AIP) gene.
  • However, no detailed investigations of non-pituitary tumors of AIP-mutated patients have been reported so far.
  • PATIENTS: We examined a MEN1- and p53-negative mother-daughter pair with acromegaly due to somatotropinoma.
  • Subsequently, the mother developed a large virilizing adrenocortical carcinoma and a grade II B-cell non-Hodgkin's lymphoma.
  • No evidence of LOH was observed in the DNA sample from the mother's B-cell lymphoma, and this tumor displayed normal AIP immunostaining.
  • CONCLUSIONS: Our study presents the first molecular analysis of non-pituitary tumors in AIP-mutated patients.
  • The finding of AIP inactivation in the adrenocortical tumor suggests that further investigation of the potential role of this recently identified tumor suppressor gene in non-pituitary tumors, mainly in those tumors in which the cAMP and the 11q13 locus are implicated, is likely to be worthwhile.
  • [MeSH-major] Acromegaly / genetics. Adenoma / genetics. Adrenocortical Carcinoma / genetics. Growth Hormone-Secreting Pituitary Adenoma / genetics. Intracellular Signaling Peptides and Proteins / genetics. Pituitary Neoplasms / genetics

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  • (PMID = 20454499.001).
  • [ISSN] 1980-5322
  • [Journal-full-title] Clinics (São Paulo, Brazil)
  • [ISO-abbreviation] Clinics (Sao Paulo)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Brazil
  • [Chemical-registry-number] 0 / Intracellular Signaling Peptides and Proteins; 0 / aryl hydrocarbon receptor-interacting protein
  • [Other-IDs] NLM/ PMC2862671
  • [Keywords] NOTNLM ; AIP / Acromegaly / Adrenocortical tumor / FIPA / pituitary tumor
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74. Alons K, Bergé SJ, Rieu PN, Meijer GJ: [Treatment of macroglossia due to acromegaly]. Ned Tijdschr Tandheelkd; 2010 Jun;117(6):321-4
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  • [Title] [Treatment of macroglossia due to acromegaly].
  • A 61-years-old woman had macroglossia due to acromegaly with complaints of dyspneu at a lying sleeping position and complaints of speech and dysphagia.
  • At the age of 55 years she was diagnosed with acromegaly induced by a adenoma of the pituitary gland, which had been removed surgically.
  • Clinically, acromegaly is diagnosed on clinical signs, such as the morphology and the protrusion of the tongue.
  • Often, macroglossia is a secondary symptom of a systemic disease, needing causal treatment.
  • [MeSH-major] Acromegaly / complications. Macroglossia / etiology. Macroglossia / surgery

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  • (PMID = 20614796.001).
  • [ISSN] 0028-2200
  • [Journal-full-title] Nederlands tijdschrift voor tandheelkunde
  • [ISO-abbreviation] Ned Tijdschr Tandheelkd
  • [Language] dut
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Netherlands
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75. Zieliński G, Hendzel P, Szałański P, Gołowicz J, Gryszko L, Podgórski JK: [Severe cardiovascular complications due to the pituitary adenoma with acromegaly. An interdisciplinary approach to the treatment. A case report]. Neurol Neurochir Pol; 2006 Jul-Aug;40(4):354-60
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  • [Title] [Severe cardiovascular complications due to the pituitary adenoma with acromegaly. An interdisciplinary approach to the treatment. A case report].
  • [Transliterated title] Ciezkie powikłania sercowo-naczyniowe w przebiegu guza przysadki powodujacego akromegalie. Propozycja równoczesnego wielospecjalistycznego leczenia. Opis przypadku.
  • Acromegaly reduces life expectancy and leads to 3-5-fold increase in mortality.
  • Successful therapy ought to normalize GH, IGF-I secretion, remove the adenoma mass and its local pressure effects and preserve pituitary functions intact to improve systemic morbidity and normalize mortality.
  • The primary therapy for most patients with acromegaly is still transsphenoidal adenomectomy.
  • The authors present a 64-year-old woman with diagnosed GH-secreting pituitary macroadenoma suffering from severe coronary heart disease and diabetes mellitus.
  • [MeSH-major] Acromegaly / surgery. Adenoma / surgery. Coronary Artery Disease / surgery. Growth Hormone-Secreting Pituitary Adenoma / surgery. Pituitary Neoplasms / surgery

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  • (PMID = 16967359.001).
  • [ISSN] 0028-3843
  • [Journal-full-title] Neurologia i neurochirurgia polska
  • [ISO-abbreviation] Neurol. Neurochir. Pol.
  • [Language] pol
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Poland
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76. D'Amore M, Minenna G, D'Amore S, Scagliusi P, Caprio S: [The strange case of a patient affected by acromegaly with osteoporomalacia without hypogonadism]. Reumatismo; 2005 Dec;57(4):291-4
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  • [Title] [The strange case of a patient affected by acromegaly with osteoporomalacia without hypogonadism].
  • Acromegaly is a rare disease that, in the majority of cases, is due to the presence of a benign growth hormone (GH)-producing tumor of the pituitary.
  • Growth hormone has profound effects on linear bone growth, bone metabolism, and bone mass.
  • In acromegaly, the skeletal effects of chronic GH excess have been mainly addressed by evaluating bone mineral density (BMD).
  • Most data were obtained in patients with active acromegaly, and apparently high or normal BMD was observed in the absence of hypogonadism.
  • The Autors describe a case of patient affected by acromegaly without hypogonadism with serious osteoporosis and biological signs of osteomalacia.
  • [MeSH-major] Acromegaly / diagnosis. Adenoma, Chromophobe / diagnosis. Osteomalacia / diagnosis. Osteoporosis / diagnosis. Pituitary Neoplasms / diagnosis
  • [MeSH-minor] Adult. Androgens / therapeutic use. Bone Density. Human Growth Hormone / blood. Humans. Hypogonadism / diagnosis. Male. Reoperation. Testosterone / therapeutic use. Treatment Outcome

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  • (PMID = 16380758.001).
  • [ISSN] 0048-7449
  • [Journal-full-title] Reumatismo
  • [ISO-abbreviation] Reumatismo
  • [Language] ita
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Androgens; 12629-01-5 / Human Growth Hormone; 3XMK78S47O / Testosterone
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77. Guerrero CA, Krayenbühl N, Husain M, Krisht AF: Ectopic suprasellar growth hormone-secreting pituitary adenoma: case report. Neurosurgery; 2007 Oct;61(4):E879; discussion E879
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Ectopic suprasellar growth hormone-secreting pituitary adenoma: case report.
  • OBJECTIVE: Ectopic pituitary adenomas are rare.
  • We present an unusual case of an ectopic growth hormone-secreting pituitary adenoma in the suprasellar space.
  • CLINICAL PRESENTATION: A 31-year-old man presented with a history of chronic headache and typical clinical signs of acromegaly.
  • Magnetic resonance imaging scans revealed a suprasellar mass not arising from the normal looking pituitary gland.
  • Histological examination showed a growth hormone-secreting pituitary adenoma CONCLUSION: Although uncommon, growth hormone-secreting pituitary adenomas are encountered in the suprasellar region.
  • They should be added to the differential diagnosis of tumors in this location.
  • [MeSH-major] Adenoma / radiography. Choristoma. Growth Hormone-Secreting Pituitary Adenoma / radiography


78. Petersenn S, Schopohl J, Barkan A, Mohideen P, Colao A, Abs R, Buchelt A, Ho YY, Hu K, Farrall AJ, Melmed S, Biller BM, Pasireotide Acromegaly Study Group: Pasireotide (SOM230) demonstrates efficacy and safety in patients with acromegaly: a randomized, multicenter, phase II trial. J Clin Endocrinol Metab; 2010 Jun;95(6):2781-9
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  • [Title] Pasireotide (SOM230) demonstrates efficacy and safety in patients with acromegaly: a randomized, multicenter, phase II trial.
  • Because most GH-secreting pituitary adenomas express sst(2) and sst(5), pasireotide has the potential to be more effective than the sst(2)-preferential somatostatin analogs octreotide and lanreotide.
  • OBJECTIVE: Our objective was to evaluate the efficacy and safety of three different doses of pasireotide in patients with acromegaly.
  • PATIENTS: Sixty patients with acromegaly, defined by a 2-h five-point mean GH level higher than 5 microg/liter, lack of suppression of GH to less than 1 microg/liter after oral glucose tolerance test, and elevated IGF-I for age- and sex-matched controls.
  • MAIN OUTCOME MEASURE: A biochemical response was defined as a reduction in GH to no more than 2.5 microg/liter and normalization of IGF-I to age- and sex-matched controls.
  • After 4 wk of pasireotide 200-600 microg s.c. bid, 19% of patients achieved a biochemical response, which increased to 27% after 3 months of pasireotide; 39% of patients had a more than 20% reduction in pituitary tumor volume.
  • CONCLUSIONS: Pasireotide is a promising treatment for acromegaly.
  • Larger studies of longer duration evaluating the efficacy and safety of pasireotide in patients with acromegaly are ongoing.
  • [MeSH-major] Acromegaly / drug therapy. Somatostatin / analogs & derivatives
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Blood Glucose / metabolism. Cross-Over Studies. Dose-Response Relationship, Drug. Double-Blind Method. Endpoint Determination. Female. Human Growth Hormone / blood. Humans. Insulin-Like Growth Factor I / metabolism. Magnetic Resonance Imaging. Male. Middle Aged. Octreotide / adverse effects. Octreotide / therapeutic use. Pituitary Neoplasms / pathology. Young Adult

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  • [CommentIn] Nat Rev Endocrinol. 2010 Aug;6(8):417 [20681073.001]
  • (PMID = 20410233.001).
  • [ISSN] 1945-7197
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Databank-accession-numbers] ClinicalTrials.gov/ NCT00088582
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Blood Glucose; 12629-01-5 / Human Growth Hormone; 51110-01-1 / Somatostatin; 67763-96-6 / Insulin-Like Growth Factor I; 98H1T17066 / pasireotide; RWM8CCW8GP / Octreotide
  • [Investigator] Brue T; Caron P; Chanson P; Cuneo R; Díaz A; Ghigo E; Gaillard R; Halperin I; Kleinberg D; Rohmer V; Romijn JA; Schlienger JL; Stewart P; Tabarin A; Trainer PJ; van der Lely AJ; Vance ML
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79. Daly AF, Beckers A: Update on the treatment of pituitary adenomas: familial and genetic considerations. Acta Clin Belg; 2008 Nov-Dec;63(6):418-24
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Update on the treatment of pituitary adenomas: familial and genetic considerations.
  • Clinically-relevant pituitary adenomas occur with a prevalence of approximately 1 per 1000 population in Belgium.
  • Pituitary adenomas that occur in families are likely to have an important genetic pathophysiological basis.
  • Currently about 5% of all pituitary adenoma cases have a family history of pituitary adenomas, classically due to multiple endocrine neoplasia type 1 (MEN1) and Carney complex (CNC).
  • Over the last decade we have described non-MEN1/CNC familial pituitary tumours that include all tumour phenotypes, a condition named 'familial isolated pituitary adenoma' (FIPA).
  • Clinical features of FIPA differ from those of sporadic pituitary adenomas in that patients with FIPA are often younger and have larger tumours at diagnosis.
  • In this review we examine new findings on the epidemiology of pituitary adenomas and we review familial causes of pituitary adenomas with a particular emphasis on modern clinical testing.
  • In addition, the clinical and genetic features of FIPA are described as FIPA represents a useful framework to study the features of pituitary adenomas that occur in a familial setting.
  • [MeSH-major] Adenoma / therapy. Pituitary Neoplasms / drug therapy. Pituitary Neoplasms / genetics
  • [MeSH-minor] Acromegaly. Animals. Humans. Intracellular Signaling Peptides and Proteins / genetics. Loss of Heterozygosity. Multiple Endocrine Neoplasia Type 1 / complications. Multiple Endocrine Neoplasia Type 1 / genetics. Mutation. Prolactinoma / drug therapy. Prolactinoma / genetics

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  • (PMID = 19170361.001).
  • [ISSN] 1784-3286
  • [Journal-full-title] Acta clinica Belgica
  • [ISO-abbreviation] Acta Clin Belg
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Belgium
  • [Chemical-registry-number] 0 / Intracellular Signaling Peptides and Proteins; 0 / aryl hydrocarbon receptor-interacting protein
  • [Number-of-references] 54
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80. Dimaraki EV, Chandler WF, Brown MB, Jaffe CA, Kim SY, Taussig R, Padmanabhan V, Barkan AL: The role of endogenous growth hormone-releasing hormone in acromegaly. J Clin Endocrinol Metab; 2006 Jun;91(6):2185-90
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The role of endogenous growth hormone-releasing hormone in acromegaly.
  • CONTEXT: Some indirect evidence suggests hypothalamic control of GH secretion in acromegaly.
  • OBJECTIVE: The objective of the study is to examine whether GH secretion in acromegaly is dependent on endogenous GHRH.
  • PATIENTS AND STUDY DESIGN: We studied eight patients with untreated acromegaly due to a GH-producing pituitary tumor.
  • GH was measured every 10 min for 24 h during the normal saline infusion and on the last day of the GHRH-ant infusion.
  • A group of nine different patients with untreated acromegaly served as the control group and underwent blood sampling for GH every 10 min for two 24-h periods to assess the day-to-day variability of GH secretion.
  • MAIN OUTCOME MEASURE: Twenty-four-hour mean GH was the main outcome measured.
  • RESULTS: In six of eight subjects treated with GHRH-ant, 24-h mean GH decreased by 5.8-30.0% during iv GHRH-ant and, in three subjects, the change in the 24-h mean GH was greater than the upper limit of the 95% confidence interval of the spontaneous day-to-day variability of the mean GH in patients with acromegaly.
  • CONCLUSION: In some patients with acromegaly due to a pituitary adenoma, GH secretion is under partial control by endogenous GHRH.
  • [MeSH-major] Acromegaly / metabolism. Adenoma / secretion. Growth Hormone-Releasing Hormone / physiology. Human Growth Hormone / secretion. Pituitary Neoplasms / secretion
  • [MeSH-minor] Adult. Female. GTP-Binding Protein alpha Subunits, Gs / genetics. Glucose Tolerance Test. Humans. Insulin-Like Growth Factor I / analysis. Male. Middle Aged. Mutation

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  • (PMID = 16537684.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Grant] United States / NIDDK NIH HHS / DK / 5P60 DK20572; United States / NCRR NIH HHS / RR / M01-RR00042; United States / NIDDK NIH HHS / DK / R0-1-DK38449
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I; 9034-39-3 / Growth Hormone-Releasing Hormone; EC 3.6.5.1 / GTP-Binding Protein alpha Subunits, Gs
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81. Takano K, Yasufuku-Takano J, Morita K, Mori S, Takei M, Osamura RY, Teramoto A, Fujita T: Evidence that PKA activity is constitutively activated in human GH-secreting adenoma cells in a patient with Carney complex harbouring a PRKAR1A mutation. Clin Endocrinol (Oxf); 2009 May;70(5):769-75
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Evidence that PKA activity is constitutively activated in human GH-secreting adenoma cells in a patient with Carney complex harbouring a PRKAR1A mutation.
  • CONTEXT: The GHRH-protein kinase A (PKA) signalling pathway is essential for cell proliferation and GH synthesis/secretion in somatotrophs.
  • The basal PKA activity of somatotroph adenoma cells from CNC has not been evaluated because of a limited amount of available tissue.
  • Primary cultured adenoma cells were subjected to electrophysiological experiments to evaluate PKA signalling in individual cells.
  • RESULTS: GHRH did not increase the nonselective cation current or the voltage-gated calcium current in these adenoma cells, in contrast to nonadenomatous somatotroph cells in which these currents increase through the PKA pathway.
  • Application of a PKA inhibitor inhibited the basal currents in these adenoma cells, results that were not observed in nonadenomatous somatotrophs.
  • CONCLUSIONS: The results demonstrate that PKA is activated at the basal state in these adenoma cells.
  • The data also show that both the nonselective cation current and the voltage-gated calcium current, vital regulators of GH secretion downstream of PKA, are maximally increased in these cells.
  • These maximally increased currents probably account for the excessive GH secretion.
  • [MeSH-major] Cyclic AMP-Dependent Protein Kinase RIalpha Subunit / genetics. Cyclic AMP-Dependent Protein Kinases / metabolism. Growth Hormone-Secreting Pituitary Adenoma / enzymology. Growth Hormone-Secreting Pituitary Adenoma / genetics. Lentigo / enzymology. Lentigo / genetics. Multiple Endocrine Neoplasia / enzymology. Multiple Endocrine Neoplasia / genetics. Mutation

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  • (PMID = 19178533.001).
  • [ISSN] 1365-2265
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Calcium Channels; 0 / Codon, Nonsense; 0 / Cyclic AMP-Dependent Protein Kinase RIalpha Subunit; 0 / DNA, Neoplasm; 0 / PRKAR1A protein, human; EC 2.7.11.11 / Cyclic AMP-Dependent Protein Kinases
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82. Sasaki A, Horikawa Y, Suwa T, Enya M, Kawachi S, Takeda J: Case report of familial Carney complex due to novel frameshift mutation c.597del C (p.Phe200LeufsX6) in PRKAR1A. Mol Genet Metab; 2008 Nov;95(3):182-7
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  • Carney complex is an autosomal dominantly inherited disease characterized by skin pigmentation, myxoma, primary pigmented nodular adrenocortical disease (PPNAD), and acromegaly.
  • However, only a few incidences of PPNAD combined with acromegaly are observed in patients.
  • Here, we report a female patient diagnosed with Cushing's syndrome and a GH-producing pituitary adenoma without otherwise evident acromegaly that could be diagnosed only by specialized endocrinological tests.
  • Based on family history of acromegaly (mother and sister) and the fact that the combination of both diseases is very rare, genetic diagnosis involving Carney complex was considered to be appropriate.
  • Even family members with the same mutation can show distinct phenotypes, suggesting that Carney complex is a multifactorial disorder comprising various genetic and environmental factors.
  • Genetic diagnosis makes it possible to prepare more effective therapeutic strategies for patients and gene carriers and to avoid unnecessary tests for non-carriers in the family of the patient.

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  • (PMID = 18760947.001).
  • [ISSN] 1096-7206
  • [Journal-full-title] Molecular genetics and metabolism
  • [ISO-abbreviation] Mol. Genet. Metab.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Cyclic AMP-Dependent Protein Kinase RIalpha Subunit; 0 / PRKAR1A protein, human
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83. Melmed S: Acromegaly pathogenesis and treatment. J Clin Invest; 2009 Nov;119(11):3189-202
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  • [Title] Acromegaly pathogenesis and treatment.
  • Dysregulated growth hormone (GH) hypersecretion is usually caused by a GH-secreting pituitary adenoma and leads to acromegaly - a disorder of disproportionate skeletal, tissue, and organ growth.
  • High GH and IGF1 levels lead to comorbidities including arthritis, facial changes, prognathism, and glucose intolerance.
  • This Review discusses acromegaly pathogenesis and management options.
  • Somatostatin receptor (SSTR) ligands inhibit GH release, control tumor growth, and attenuate peripheral GH action, while GH receptor antagonists block GH action and effectively lower IGF1 levels.
  • Effective control of GH and IGF1 hypersecretion and ablation or stabilization of the pituitary tumor mass lead to improved comorbidities and lowering of mortality rates for this hormonal disorder.

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  • (PMID = 19884662.001).
  • [ISSN] 1558-8238
  • [Journal-full-title] The Journal of clinical investigation
  • [ISO-abbreviation] J. Clin. Invest.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / R01 CA075979; United States / NCI NIH HHS / CA / CA 075979
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 67763-96-6 / Insulin-Like Growth Factor I; 9002-72-6 / Growth Hormone
  • [Number-of-references] 125
  • [Other-IDs] NLM/ PMC2769196
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84. Saeger W: [Effects of irradiation therapy and inhibiting drugs on the pituitary and its adenomas]. Pathologe; 2006 Feb;27(1):57-60
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  • [Title] [Effects of irradiation therapy and inhibiting drugs on the pituitary and its adenomas].
  • Radiation therapies of pituitary adenomas induce an increase in fibroses and nuclear pleomorphism.
  • Most growth hormone (GH) secreting pituitary adenomas react to somatostatin analogues by a distinct decrease of GH secretion.
  • Some cases show a shrinkage of adenomas that correlates with fibrosis of the tumor.
  • With these drugs, thyroid stimulating hormone secreting adenomas can also be treated.
  • Prolactin secreting adenomas are mostly treated primarily with dopamine agonists.
  • Up to 90% of cases show a strong decrease in hormone secretion and a distinct shrinkage of the adenomas based on strong decrease in adenoma cell volume.
  • Long-term medication with high doses of glucocorticoids induces Crooke's cells in the anterior pituitary.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Antineoplastic Agents / therapeutic use. Pituitary Gland / pathology. Pituitary Neoplasms / drug therapy. Pituitary Neoplasms / radiotherapy. Radiotherapy / adverse effects

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  • (PMID = 16362259.001).
  • [ISSN] 0172-8113
  • [Journal-full-title] Der Pathologe
  • [ISO-abbreviation] Pathologe
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Dopamine Agonists; 0 / Glucocorticoids
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85. Tunici P, Yu JS: Pituitary adenoma stem cells. Methods Mol Biol; 2009;568:195-201
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  • [Title] Pituitary adenoma stem cells.
  • The identification of a subpopulation of brain tumor cells with potent tumorigenic capacity strengthens the cancer stem cell hypothesis of the origin of the tumors that has recently attracted the attention of many researchers.
  • These cells express stem cell markers, and when differentiated they express glial and neuronal markers.
  • More recently we have isolated tumor stem-like cells also from benign tumors like pituitary adenomas.
  • Cells derived from pituitary adenomas are able to grow as floating aggregates resembling the neurospheres (typical of normal stem cells) in a medium supplemented by growth factors (EGF and bFGF).
  • The immunocytochemical analysis revealed that pituitary tumor stem-like cells are positives for nestin and, when grown for ten days in differentiation medium they express GFAP, BIII tubulin, and S-100.
  • In vitro tumor stem-like cells derived from a patient with a somatotroph adenoma showed high production of growth hormone and prolactin, while cells derived from the same patient but grown in presence of fetal bovine serum showed no production of hormones.
  • [MeSH-major] Cell Culture Techniques / methods. Neoplastic Stem Cells / pathology. Pituitary Neoplasms / pathology
  • [MeSH-minor] Human Growth Hormone / metabolism. Humans. Immunohistochemistry. Prolactin / metabolism

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  • (PMID = 19582428.001).
  • [ISSN] 1064-3745
  • [Journal-full-title] Methods in molecular biology (Clifton, N.J.)
  • [ISO-abbreviation] Methods Mol. Biol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 9002-62-4 / Prolactin
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86. Lonser RR, Kindzelski BA, Mehta GU, Jane JA Jr, Oldfield EH: Acromegaly without imaging evidence of pituitary adenoma. J Clin Endocrinol Metab; 2010 Sep;95(9):4192-6
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  • [Title] Acromegaly without imaging evidence of pituitary adenoma.
  • CONTEXT: GH-secreting pituitary adenomas are nearly always visible on conventional magnetic resonance (MR) imaging.
  • However, management and outcome of acromegalic patients lacking imaging evidence of GH-secreting pituitary adenomas are undefined.
  • OBJECTIVE: The aim was to evaluate surgical exploration for MR-invisible GH-secreting pituitary adenomas.
  • PATIENTS OR OTHER PARTICIPANTS: Consecutive acromegalic patients without imaging evidence of a pituitary adenoma on pre- and postcontrast, spin echo T1-weighted MR imaging and who lacked evidence of an ectopic (nonpituitary) source causing GH excess were included.
  • INTERVENTIONS: Surgical exploration with identification and resection of a pituitary adenoma was performed.
  • MAIN OUTCOME MEASURES: Laboratory values (GH, IGF-I), surgical findings, and clinical outcome were analyzed.
  • RESULTS: Six patients (three males, three females; 3% of all patients) with suspected GH-secreting adenomas did not demonstrate imaging evidence of pituitary adenoma on conventional MR imaging.
  • Three patients underwent a postcontrast, volumetric interpolated breath-hold examination MR-imaging sequence (1.2-mm slice thickness), which revealed a 4-mm pituitary adenoma not seen on the spin echo T1-weighted MR imaging in one patient.
  • A pituitary adenoma was identified and removed in all patients (mean diameter, 5.6 mm; range, 5 to 6.7 mm).
  • Histological analysis confirmed that the lesions were GH-secreting adenomas.
  • CONCLUSION: Acromegaly can be caused by GH-secreting pituitary adenomas that are not evident on conventional MR imaging.
  • Adenomas in some of these patients become evident using volumetric interpolated breath-hold examination MR imaging.
  • Surgical exploration of the pituitary gland in acromegalic patients with endocrine findings consistent with a GH-secreting adenoma but negative MR imaging can lead to identification and removal of an adenoma.


87. Bondanelli M, Bonadonna S, Ambrosio MR, Doga M, Gola M, Onofri A, Zatelli MC, Giustina A, degli Uberti EC: Cardiac and metabolic effects of chronic growth hormone and insulin-like growth factor I excess in young adults with pituitary gigantism. Metabolism; 2005 Sep;54(9):1174-80
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cardiac and metabolic effects of chronic growth hormone and insulin-like growth factor I excess in young adults with pituitary gigantism.
  • Chronic growth hormone (GH)/insulin-like growth factor I (IGF-I) excess is associated with considerable mortality in acromegaly, but no data are available in pituitary gigantism.
  • The aim of the study was to evaluate the long-term effects of early exposure to GH and IGF-I excess on cardiovascular and metabolic parameters in adult patients with pituitary gigantism.
  • Six adult male patients with newly diagnosed gigantism due to GH secreting pituitary adenoma were studied and compared with 6 age- and sex-matched patients with acromegaly and 10 healthy subjects.
  • Disease duration was significantly longer (P<.05) in patients with gigantism than in patients with acromegaly, whereas GH and IGF-I concentrations were comparable.
  • Left ventricular mass was increased both in patients with gigantism and in patients with acromegaly, as compared with controls.
  • Left ventricular hypertrophy was detected in 2 of 6 of both patients with gigantism and patients with acromegaly, and isolated intraventricular septum thickening in 1 patient with gigantism.
  • Inadequate diastolic filling (ratio between early and late transmitral flow velocity<1) was detected in 2 of 6 patients with gigantism and 1 of 6 patients with acromegaly.
  • Impaired glucose metabolism occurrence was higher in patients with acromegaly (66%) compared with patients with gigantism (16%).
  • In conclusion, our data suggest that GH/IGF-I excess in young adult patients is associated with morphologic and functional cardiac abnormalities that are similar in patients with gigantism and in patients with acromegaly, whereas occurrence of impaired glucose metabolism appears to be higher in patients with acromegaly, although patients with gigantism are exposed to GH excess for a longer period.
  • [MeSH-major] Gigantism / complications. Gigantism / metabolism. Human Growth Hormone / blood. Hypertrophy, Left Ventricular / etiology. Hypertrophy, Left Ventricular / metabolism. Insulin-Like Growth Factor I / metabolism
  • [MeSH-minor] Acromegaly / complications. Acromegaly / metabolism. Adult. Blood Pressure. Echocardiography, Doppler. Electrocardiography. Glucose / metabolism. Glucose Intolerance / etiology. Glucose Intolerance / metabolism. Humans. Male. Ventricular Dysfunction, Left / etiology. Ventricular Dysfunction, Left / metabolism. Ventricular Dysfunction, Left / ultrasonography

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  • (PMID = 16125529.001).
  • [ISSN] 0026-0495
  • [Journal-full-title] Metabolism: clinical and experimental
  • [ISO-abbreviation] Metab. Clin. Exp.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I; IY9XDZ35W2 / Glucose
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88. Morita K, Takano K, Yasufuku-Takano J, Yamada S, Teramoto A, Takei M, Osamura RY, Sano T, Fujita T: Expression of pituitary tumour-derived, N-terminally truncated isoform of fibroblast growth factor receptor 4 (ptd-FGFR4) correlates with tumour invasiveness but not with G-protein alpha subunit (gsp) mutation in human GH-secreting pituitary adenomas. Clin Endocrinol (Oxf); 2008 Mar;68(3):435-41
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Expression of pituitary tumour-derived, N-terminally truncated isoform of fibroblast growth factor receptor 4 (ptd-FGFR4) correlates with tumour invasiveness but not with G-protein alpha subunit (gsp) mutation in human GH-secreting pituitary adenomas.
  • OBJECTIVE: Apart from the constitutively activating mutation of the G-protein alpha subunit (Gsalpha) (gsp mutation), factors involved in tumorigenesis or those in tumour behaviour remain elusive in sporadic GH-secreting pituitary adenomas.
  • Recently, the N-terminally truncated form of fibroblast growth factor receptor-4 (ptd-FGFR4) was identified in pituitary adenomas.
  • This aberrant receptor has transforming activity, and causes pituitary adenomas in transgenic mice.
  • MATERIALS AND METHODS: mRNA was extracted from excised adenomas of 45 Japanese acromegalic patients. ptd-FGFR4 expression and gsp mutations were determined by reverse transcription polymerase chain reaction (RT-PCR) and direct sequencing.
  • Preoperative clinical data were collected by reviewing medical charts and pituitary magnetic resonance imaging (MRI) scans.
  • The presence of ptd-FGFR4 did not correlate with age at operation, sex, preoperative serum GH or IGF-1 levels.
  • CONCLUSIONS: We found that ptd-FGFR4 expression and gsp mutations occur independently of each other, and that ptd-FGFR4 expression is associated with more invasive tumours in patients with GH-secreting pituitary adenomas.
  • [MeSH-major] GTP-Binding Protein alpha Subunits / genetics. Gene Expression. Growth Hormone-Secreting Pituitary Adenoma / genetics. Mutation. Neoplasm Invasiveness. Pituitary Neoplasms / genetics. Receptor, Fibroblast Growth Factor, Type 4 / genetics

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  • (PMID = 18070145.001).
  • [ISSN] 1365-2265
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / GTP-Binding Protein alpha Subunits; 0 / Protein Isoforms; EC 2.7.10.1 / Receptor, Fibroblast Growth Factor, Type 4
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89. Colao A, Cappabianca P, Caron P, De Menis E, Farrall AJ, Gadelha MR, Hmissi A, Rees A, Reincke M, Safari M, T'Sjoen G, Bouterfa H, Cuneo RC: Octreotide LAR vs. surgery in newly diagnosed patients with acromegaly: a randomized, open-label, multicentre study. Clin Endocrinol (Oxf); 2009 May;70(5):757-68
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  • [Title] Octreotide LAR vs. surgery in newly diagnosed patients with acromegaly: a randomized, open-label, multicentre study.
  • Efficacy was assessed by changes in mean GH and IGF-I serum concentrations, at weeks 12, 24 and 48.
  • Patients uncontrolled after surgery received octreotide LAR 20 mg, increased to 30 mg if acromegaly was still uncontrolled.
  • CONCLUSION: This first randomized study in unselected patients indicates that the 48-week treatment outcome of octreotide LAR as first-line treatment of acromegaly does not significantly differ from surgery.
  • As a complete response to surgery in GH-secreting macro-adenomas can be difficult, first-line therapy with octreotide LAR can be considered as a viable alternative for most patients with acromegaly, due to its low complication rate.
  • [MeSH-major] Acromegaly / drug therapy. Acromegaly / surgery. Octreotide / therapeutic use
  • [MeSH-minor] Adult. Aged. Female. Growth Hormone-Secreting Pituitary Adenoma / blood. Growth Hormone-Secreting Pituitary Adenoma / complications. Growth Hormone-Secreting Pituitary Adenoma / drug therapy. Growth Hormone-Secreting Pituitary Adenoma / surgery. Human Growth Hormone / blood. Humans. Insulin-Like Growth Factor I / metabolism. Magnetic Resonance Imaging. Male. Middle Aged. Treatment Outcome. Young Adult

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  • [CommentIn] Clin Endocrinol (Oxf). 2010 Jul;73(1):134; author reply 135-6 [20039884.001]
  • (PMID = 19178516.001).
  • [ISSN] 1365-2265
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I; RWM8CCW8GP / Octreotide
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90. Zatelli MC, Minoia M, Filieri C, Tagliati F, Buratto M, Ambrosio MR, Lapparelli M, Scanarini M, Degli Uberti EC: Effect of everolimus on cell viability in nonfunctioning pituitary adenomas. J Clin Endocrinol Metab; 2010 Feb;95(2):968-76
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Effect of everolimus on cell viability in nonfunctioning pituitary adenomas.
  • CONTEXT: Pituitary adenomas can cause specific syndromes due to hormone excess and/or determine sellar mass symptoms.
  • Pituitary cell growth can sometimes be influenced by medical therapy, such as for somatotroph adenomas treated with somatostatin analogs or prolactinomas treated with dopaminergic drugs.
  • However, nonfunctioning pituitary adenomas (NFAs) are still orphans of medical therapy.
  • Cell viability and apoptosis were evaluated after 48 h, and vascular endothelial growth factor (VEGF) secretion was assessed after an 8-h incubation.
  • RESULTS: In 28 cultures (70%), Everolimus significantly reduced cell viability (by approximately 40%; P < 0.05 vs. control), promoted apoptosis (+30%; P < 0.05 vs. control), inhibited p70S6K activity (-20%), and blocked IGF-I proliferative and antiapoptotic effects.
  • CONCLUSIONS: Everolimus reduced NFA cell viability by inducing apoptosis, with a mechanism likely involving IGF-I signaling but not VEGF secretion, suggesting that it might represent a possible medical treatment of invasive/recurrent NFAs.
  • [MeSH-major] Adenoma / drug therapy. Immunosuppressive Agents / pharmacology. Pituitary Neoplasms / drug therapy. Sirolimus / analogs & derivatives
  • [MeSH-minor] Aged. Apoptosis / drug effects. Cell Line, Tumor. Cell Survival / drug effects. Ergolines / pharmacology. Everolimus. Female. Humans. Male. Middle Aged. Receptors, Somatostatin / physiology. Ribosomal Protein S6 Kinases, 70-kDa / metabolism. Somatostatin / analogs & derivatives. Somatostatin / pharmacology. Vascular Endothelial Growth Factor A / secretion

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  • (PMID = 19965918.001).
  • [ISSN] 1945-7197
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Ergolines; 0 / Immunosuppressive Agents; 0 / Receptors, Somatostatin; 0 / Vascular Endothelial Growth Factor A; 0 / somatostatin receptor 2; 51110-01-1 / Somatostatin; 98H1T17066 / pasireotide; 9HW64Q8G6G / Everolimus; EC 2.7.11.1 / Ribosomal Protein S6 Kinases, 70-kDa; LL60K9J05T / cabergoline; W36ZG6FT64 / Sirolimus
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91. Mao ZG, He DS, Zhou J, Yao B, Xiao WW, Chen CH, Zhu YH, Wang HJ: Differential expression of microRNAs in GH-secreting pituitary adenomas. Diagn Pathol; 2010 Dec 07;5:79
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Differential expression of microRNAs in GH-secreting pituitary adenomas.
  • BACKGROUND: The purpose of this study was to (1) identify specific miRNAs in growth hormones (GH)-secreting pituitary adenomas;.
  • METHODS: Fifteen GH-secreting adenomas patients were treated with lanreotide for 4 months before surgery.
  • Patients with 50% reduction of GH secretion by lanreotide were considered as SSA responders, while patients with less than 50% of GH reduction were considered as SSA nonresponders.
  • We analyzed the miRNAs in 21 GH-secreting pituitary adenomas and 6 normal pituitaries by miRCURY™ LNA array and some differentially expressed miRNAs were validated by quantitative real-time PCR.
  • RESULTS: Fifty-two miRNAs were differentially expressed between GH-secreting pituitary adenomas and normal pituitaries.
  • Differential expression of 9 miRNAs was observed between micro- and macro-adenomas.
  • Seven miRNAs were differentially expressed between SSA responders or GH nonresponders.
  • Several identified miRNAs may be involved in cell proliferation, apoptosis, cancer development and progression.
  • CONCLUSIONS: Our results indicate that altered miRNAs expression is involved in GH-secreting pituitary adenomas transformation, which will shed light on the mechanisms for the treatment of acromegaly by SSA.
  • Identification and characterization of the targets of altered miRNAs genes may elucidate molecular mechanisms involved in the pathogenesis of pituitary adenoma.
  • [MeSH-major] Adenoma / genetics. Gene Expression Profiling. Growth Hormone-Secreting Pituitary Adenoma / genetics. MicroRNAs / analysis


92. Lee YH, Noh TW, Lee MK, Jameson JL, Lee EJ: Absence of activating mutations of CXCR4 in pituitary tumours. Clin Endocrinol (Oxf); 2010 Feb;72(2):209-13
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Absence of activating mutations of CXCR4 in pituitary tumours.
  • OBJECTIVE: Mutations of the gsp oncogene are responsible for 30-40% of GH-producing pituitary adenomas and 10% of nonfunctioning pituitary adenomas (NFPAs).
  • However, the pathogenetic mechanism of the remaining pituitary tumours still remains to be identified.
  • Recently, the interaction between the chemokine stromal cell-derived factor 1 and its receptor CXCR4 was found to play an important role in GH production and cell proliferation in various pituitary adenoma cell lines.
  • As CXCR4 is a Gi-coupled chemokine receptor, its constitutive activating mutations may be involved in pituitary tumour formation by cyclic adenosine monophosphate (cAMP)-independent, ERK-related pathways.
  • PATIENTS AND METHODS: We investigated whether somatic activating-mutations of CXCR4 might be a possible tumourigenic mechanism for gsp-negative GH-secreting pituitary adenomas and NFPAs.
  • Direct sequencing of polymerase chain reaction-amplified products for coding exons of CXCR4 were performed using genomic deoxyribonucleic acid samples from 37 GH-producing pituitary tumour tissues that were negative for the gsp mutation and 14 CXCR4 expressing NFPAs.
  • RESULTS: Immunohistochemical analyses and double immunofluorescent staining of sectioned paraffin-embedded pituitary tissues revealed that CXCR4 is highly expressed in GH-producing pituitary adenomas and NFPAs.
  • Direct sequencing showed that two synonymous mutations in exon 2 (87 C > T and 414 C > T) were detected in 4 out of 51 pituitary tumours.
  • CONCLUSION: Our results indicate that an activating mutation of the CXCR4 may not be a common pathogenetic mechanism in GH-producing pituitary tumours and NFPAs.
  • [MeSH-major] Pituitary Neoplasms / genetics. Pituitary Neoplasms / metabolism. Receptors, CXCR4 / genetics. Receptors, CXCR4 / metabolism
  • [MeSH-minor] Growth Hormone-Secreting Pituitary Adenoma / genetics. Growth Hormone-Secreting Pituitary Adenoma / metabolism. Humans. Immunohistochemistry. Mutation. Polymerase Chain Reaction

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  • (PMID = 19473177.001).
  • [ISSN] 1365-2265
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Receptors, CXCR4
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93. Scacchi M, Cavagnini F: Acromegaly. Pituitary; 2006;9(4):297-303
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  • [Title] Acromegaly.
  • Acromegaly is a slowly progressive disease characterized by 30% increase of mortality rate for cardiovascular disease, respiratory complications and malignancies.
  • The estimated prevalence of the disease is 40 cases/1000000 population with 3-4 new cases/1000000 population per year.
  • The biochemical diagnosis is based upon the demonstration of high circulating levels of GH and IGF-I.
  • A random GH level lower than 0.4 microg/l and an IGF-I value in the age- and sex-matched normal range makes the diagnosis of acromegaly unlikely.
  • In doubtful cases, the lack of GH suppressibility below 1 microg/l (0.3 microg/l according to recent reports) after an oral glucose load will confirm the diagnosis.
  • A pituitary adenoma is demonstrated in most cases by CT scan or MRI.
  • A negative X-ray finding or the presence of empty sella do not exclude the diagnosis.
  • At the moment of diagnosis all patients should undergo colonscopy.
  • Surgery, radiotherapy and medical treatment represent the therapeutic options for acromegaly.
  • The outcome of transsphenoidal surgery is far better for microadenomas (80-90%) than for macroadenomas (less than 50%), which unluckily represent more than 70% of all GH-secreting pituitary tumours.
  • Therefore, pituitary surgery is the first line treatment for microadenomas.
  • Medical therapy is based on GH-lowering drugs (somatostatin receptor agonists and, in some cases, dopaminergic agents) and GH receptor antagonists (pegvisomant).
  • However, GH-lowering drugs are also used as primary therapy when surgery is contraindicated or in the case of large GH-secreting macroadenomas which are not likely to be completely removed by surgery.
  • For the moment pegvisomant is indicated for patients resistant to the GH-lowering drugs and there is no evidence for drug-induced enlargement of the pituitary tumour.
  • In order to avoid this possibility, however, a combination of pegvisomant and GH-lowering compound can also be conceived.
  • It is indicated after unsuccessful surgical and/or medical treatment and allows the control of hormonal secretion and tumour growth in approx.
  • Acromegaly is defined as controlled when, in the absence of clinical activity, IGF-I levels are in the age- and sex-matched normal range and GH is normally suppressible by the oral glucose load.
  • [MeSH-major] Acromegaly / etiology. Adenoma / complications. Growth Hormone-Secreting Pituitary Adenoma / complications
  • [MeSH-minor] Algorithms. Biomarkers / blood. Cardiovascular Diseases / etiology. Combined Modality Therapy. Dopamine Agonists / therapeutic use. Glucose Tolerance Test. Hormone Antagonists / therapeutic use. Human Growth Hormone / blood. Humans. Hypophysectomy. Insulin-Like Growth Factor I / analysis. Radiotherapy, Adjuvant. Respiration Disorders / etiology. Sleep Apnea Syndromes / etiology. Somatostatin / analogs & derivatives. Somatostatin / therapeutic use. Treatment Outcome. Up-Regulation

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  • (PMID = 17077948.001).
  • [ISSN] 1573-7403
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers; 0 / Dopamine Agonists; 0 / Hormone Antagonists; 12629-01-5 / Human Growth Hormone; 51110-01-1 / Somatostatin; 67763-96-6 / Insulin-Like Growth Factor I
  • [Number-of-references] 23
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94. Jaquet P, Gunz G, Saveanu A, Barlier A, Dufour H, Taylor J, Dong J, Kim S, Moreau JP, Culler MD: BIM-23A760, a chimeric molecule directed towards somatostatin and dopamine receptors, vs universal somatostatin receptors ligands in GH-secreting pituitary adenomas partial responders to octreotide. J Endocrinol Invest; 2005;28(11 Suppl International):21-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] BIM-23A760, a chimeric molecule directed towards somatostatin and dopamine receptors, vs universal somatostatin receptors ligands in GH-secreting pituitary adenomas partial responders to octreotide.
  • We report the comparative efficacy of a somatostatin receptor 1 and 5 subtypes (SSTR2 and SSTR5), and dopamine D2 (DAD2) compound, BIM-23A760, in suppressing GH secretion, in cell culture from human GH-secreting tumors, from patients partially responsive to long-term treatments with octreotide or lanreotide.
  • The SSTR2-selective analog, BIM-23197, the SSTR5-selective analog, BIM-23268, and the dopamine (DA) analog, BIM-53097, produced a mean maximal suppression of GH secretion (24 +/- 3, 20 +/- 3, and 20 +/- 3%, respectively) that was similar to that obtained with octreotide (23 +/- 3%).
  • Among a series of new chimeric compounds that bind the SSTR2, SSTR5, and DAD2 receptors with variable affinities, BIM-23A760 produced greater maximal suppression of GH secretion than octreotide (38 +/- 2 vs 24 +/- 2%; p<0.03).
  • In the presence of sulpride, the dose response inhibition of GH secretion by the trihybrid molecule, BIM-23A760, was partially reversed.
  • When SSTRs pan inhibitors such as BIM-23A779 (binding affinity for SSTR1, SSTR2, SSTR3, SSTR5, respectively: 2.5, 0.3, 0.6, 0.6 nmol/l) or SOM230 were tested for their suppressive effects on GH secretion, they were less potent than the previous dopastatin hybrid molecule.
  • After a brief exposure to a SSTR2-selective analog, BIM-23197, or to a DA analog, BIM-53097, the maximal GH suppression was achieved during 12 h.
  • Under exposure to BIM-23A760, in the same conditions, maximal suppression of GH secretion lasted for 24 h.
  • As compared to the dopastatin compound, the lower efficacy of the universal somatostatin ligands in the inhibition of GH secretion of GH-secreting tumors argues for the use of drugs targeted, according to specific receptors expression and functionality which may vary among the various classes of tumors.
  • [MeSH-major] Human Growth Hormone / secretion. Octreotide / therapeutic use. Pituitary Neoplasms / drug therapy. Pituitary Neoplasms / secretion. Receptors, Dopamine / metabolism. Receptors, Somatostatin / metabolism
  • [MeSH-minor] Acromegaly / drug therapy. Adult. Female. Gene Expression. Humans. Male. Oligopeptides / pharmacology. Piperazines / pharmacology. Prolactin / secretion. RNA, Messenger / analysis. Receptors, Dopamine D2 / genetics

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  • (PMID = 16625841.001).
  • [ISSN] 0391-4097
  • [Journal-full-title] Journal of endocrinological investigation
  • [ISO-abbreviation] J. Endocrinol. Invest.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / BIM 23197; 0 / Oligopeptides; 0 / Piperazines; 0 / RNA, Messenger; 0 / Receptors, Dopamine; 0 / Receptors, Dopamine D2; 0 / Receptors, Somatostatin; 0 / somatostatin receptor 2; 0 / somatostatin receptor 5; 12629-01-5 / Human Growth Hormone; 9002-62-4 / Prolactin; RWM8CCW8GP / Octreotide
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95. Chanson P: [Acromegaly]. Presse Med; 2009 Jan;38(1):92-102
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  • [Title] [Acromegaly].
  • Acromegaly is a rare disease usually caused by growth hormone (GH) hypersecretion, due to a pituitary adenoma; in very rare cases, acromegaly is due to ectopic secretion of GHRH, responsible for pituitary hyperplasia.
  • Owing to its insidious onset, acromegaly is often diagnosed late (4 to > 10 years after onset), at an average age of about 40 years, in front of an acquired, slowly progressing disfigurement mainly involving the face and extremities.
  • Acromegaly has also rheumatologic, cardiovascular, respiratory and metabolic consequences which determine its prognosis.
  • The diagnosis is based on an increased serum GH concentration unsuppressed following an oral glucose load (oral glucose tolerance test -OGTT-) and an increased insulin-like growth factor-I (IGF-I); according to a 2000 Consensus statement, if the basal serum GH is above 0,4microg/L (1.2mIU/L) and/or if the IGF-I is elevated, an OGTT must be performed.
  • If the lowest GH value (nadir) during OGTT remains above 1microg/L (3mIU/L), acromegaly is confirmed.
  • Treatment is aimed at correcting (or preventing) tumor compression by excising the culprit lesion, and at reducing GH and IGF-I levels to normal values (or at least to a "safe" GH level of < 2microg/L or < 6mIU/L).
  • A stepwise therapeutic strategy is used: transsphenoidal surgery is often the first-line treatment; when surgery fails to correct GH/IGF-I hypersecretion, medical treatment with somatostatin analogs and/or radiotherapy can be used, somatostatin analogs being generally preferred; the GH antagonist (pegvisomant) is used in patients that are resistant or intolerant to somatostatin analogs.
  • Prognosis of acromegaly has improved in the recent years: adequate hormonal disease control is achieved in most cases, allowing life expectancy similar to that of the general population.
  • [MeSH-major] Acromegaly / etiology
  • [MeSH-minor] Adenoma / complications. Adenoma / surgery. Age Factors. Glucose Tolerance Test. Human Growth Hormone / antagonists & inhibitors. Human Growth Hormone / blood. Human Growth Hormone / secretion. Humans. Insulin-Like Growth Factor I / analysis. Pituitary Neoplasms / complications. Pituitary Neoplasms / surgery. Prognosis. Risk Factors

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  • (PMID = 19004612.001).
  • [ISSN] 2213-0276
  • [Journal-full-title] Presse medicale (Paris, France : 1983)
  • [ISO-abbreviation] Presse Med
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I
  • [Number-of-references] 34
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96. Pollock BE: Radiosurgery for pituitary adenomas. Prog Neurol Surg; 2007;20:164-71
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Radiosurgery for pituitary adenomas.
  • Stereotactic radiosurgery has been used to manage patients with pituitary adenomas for over 30 years.
  • Numerous studies have documented that more than 95% of pituitary adenoma patients have either tumor shrinkage or stabilization after radiosurgery.
  • Biochemical remission is possible in approximately 80% of properly selected patients with hormone-producing pituitary adenomas.
  • Factors associated with endocrine cure include the absence of pituitary suppressive medications at the time of radiosurgery and higher radiation doses.
  • Delayed anterior pituitary deficits occur in 20-50% of patients depending on the length and quality of the endocrine follow-up.
  • Since the effects of radiosurgery are gradual compared to surgical removal of pituitary adenomas, surgical resection remains the primary therapy for the majority of patients with large tumors causing visual loss or for patients with symptomatic acromegaly or Cushing's disease.
  • However, radiosurgery is effective for pituitary adenoma patients with persistent or recurrent tumors after prior surgery, or for patients considered high risk for open surgical procedures due to coexisting medical conditions.
  • [MeSH-major] Adenoma / surgery. Pituitary Neoplasms / surgery. Radiosurgery / methods
  • [MeSH-minor] Human Growth Hormone / blood. Humans. Insulin-Like Growth Factor I / metabolism. Magnetic Resonance Imaging. Radiotherapy Dosage. Retrospective Studies. Survivors. Treatment Outcome

  • MedlinePlus Health Information. consumer health - Pituitary Tumors.
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  • (PMID = 17317984.001).
  • [ISSN] 0079-6492
  • [Journal-full-title] Progress in neurological surgery
  • [ISO-abbreviation] Prog Neurol Surg
  • [Language] eng