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1. 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
NCI CPTC Antibody Characterization Program. NCI CPTC Antibody Characterization Program .

  • [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

  • ClinicalTrials.gov. clinical trials - ClinicalTrials.gov .
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  • (PMID = 21138567.001).
  • [ISSN] 1746-1596
  • [Journal-full-title] Diagnostic pathology
  • [ISO-abbreviation] Diagn Pathol
  • [Language] eng
  • [Databank-accession-numbers] ClinicalTrials.gov/ NCT00993356
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / MicroRNAs; 0 / Peptides, Cyclic; 0G3DE8943Y / lanreotide; 51110-01-1 / Somatostatin
  • [Other-IDs] NLM/ PMC3017030
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2. Kim MS, Jang HD, Kim OL: Surgical results of growth hormone-secreting pituitary adenoma. J Korean Neurosurg Soc; 2009 May;45(5):271-4

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Surgical results of growth hormone-secreting pituitary adenoma.
  • OBJECTIVE: We retrospectively analyzed the surgical outcomes of 42 patients with growth hormone (GH)-secreting pituitary adenoma to evaluate the clinical manifestations and to determine which preoperative factors that significantly influence the remission.
  • METHODS: Forty-two patients with GH-secreting pituitary adenoma underwent transsphenoidal surgery (TSS) between 1995 and 2007.
  • For comparable radiological criteria, we classified parasellar growth into five grades according to the Knosp classification.
  • There was a significant relationship between preoperative mean GH concentration and early postoperative outcome, with most patients in remission having a lower preoperative GH concentration.
  • CONCLUSION: TSS is thought to be an effective primary treatment for GH-secreting pituitary adenomas according to the most recent criteria of cure.
  • Because the remission rate in cases with cavernous sinus invasion is very low, early detection of the tumor before it extends into the cavernous sinus and a long-term endocrinological and radiological follow-up are necessary in order to improve the remission rate of acromegaly.

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  • (PMID = 19516943.001).
  • [ISSN] 2005-3711
  • [Journal-full-title] Journal of Korean Neurosurgical Society
  • [ISO-abbreviation] J Korean Neurosurg Soc
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2693785
  • [Keywords] NOTNLM ; Cavernous sinus / Growth hormone-secreting pituitary adenoma / Remission induction
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3. 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
MedlinePlus Health Information. consumer health - Pituitary Tumors.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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

  • Genetic Alliance. consumer health - Pituitary adenoma, growth hormone-secreting.
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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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4. Bhatoe HS, Kotwal N, Badwal S: Clival pituitary adenoma with acromegaly: case report and review of literature. Skull Base; 2007 Jul;17(4):265-8

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clival pituitary adenoma with acromegaly: case report and review of literature.
  • The pituitary develops as a result of complex, intricate, and precise neuro-embryological events in the sixth to eighth weeks of gestation.
  • Some ectopic cell rests can become adenomatous.
  • Rarely, these cell rests in the clivus can be the site of formation of adenoma.
  • Our patient, a 35-year-old parous woman, was being treated for acromegaly, and imaging studies revealed a clival mass lesion.
  • Trans-sphenoidal excision was done and immunohistochemistry revealed the tumor to be a growth hormone-secreting tumor.

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  • (PMID = 18174927.001).
  • [ISSN] 1531-5010
  • [Journal-full-title] Skull base : official journal of North American Skull Base Society ... [et al.]
  • [ISO-abbreviation] Skull Base
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC2039716
  • [Keywords] NOTNLM ; Acromegaly / clivus / pituitary tumor
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5. Yasufuku-Takano J, Takano K, Morita K, Takakura K, Teramoto A, Fujita T: Does the prevalence of gsp mutations in GH-secreting pituitary adenomas differ geographically or racially? Prevalence of gsp mutations in Japanese patients revisited. Clin Endocrinol (Oxf); 2006 Jan;64(1):91-6
MedlinePlus Health Information. consumer health - Pituitary Tumors.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Does the prevalence of gsp mutations in GH-secreting pituitary adenomas differ geographically or racially? Prevalence of gsp mutations in Japanese patients revisited.
  • OBJECTIVE: The prevalence of gsp mutations in GH-secreting pituitary adenomas was thought to differ geographically or racially, given its exceptionally lower incidence among Japanese patients (4.4-9.3%) compared to other regions (30-50%).
  • However, this notion is now being challenged after a recent paper reported a 53.3% incidence among Japanese with acromegaly.
  • PATIENTS: One hundred Japanese acromegaly patients with surgically confirmed GH-secreting pituitary adenomas were enrolled.
  • METHODS: mRNAs from primary cultured adenomas were used for reverse transcriptase-polymerase chain reaction and direct sequencing of the Gsalpha subunit.
  • Age at operation, sex ratio, basal serum GH and IGF-I levels were no different with or without the mutations.
  • In contrast, patients responded differently to most dynamic tests with statistical significance: serum GH levels in gsp-positive patients had blunted response to GHRH, were well suppressed by bromocriptine, and had higher rates of paradoxical response to TRH.
  • Octreotide suppressed GH levels strongly regardless of gsp status.
  • CONCLUSION: We conclude that the prevalence of gsp mutations in Japanese acromegaly patients is comparable to those of other reports from various regions.
  • Therefore, Japanese patients do not stand as an example for geographical or racial difference in the prevalence of gsp mutations in GH-secreting pituitary adenomas.
  • [MeSH-major] Adenoma / genetics. GTP-Binding Protein alpha Subunits, Gs / genetics. Pituitary Neoplasms / genetics. Point Mutation
  • [MeSH-minor] Acromegaly / ethnology. Acromegaly / metabolism. Adult. Asian Continental Ancestry Group. DNA Mutational Analysis. Female. Growth Hormone / blood. Growth Hormone / secretion. Growth Hormone-Releasing Hormone. Humans. Insulin-Like Growth Factor I / analysis. Japan. Male. Middle Aged. Prevalence. Reverse Transcriptase Polymerase Chain Reaction. Sequence Analysis, DNA. Statistics, Nonparametric

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  • (PMID = 16402935.001).
  • [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] 67763-96-6 / Insulin-Like Growth Factor I; 9002-72-6 / Growth Hormone; 9034-39-3 / Growth Hormone-Releasing Hormone; EC 3.6.5.1 / GTP-Binding Protein alpha Subunits, Gs
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6. Maiza JC, Vezzosi D, Matta M, Donadille F, Loubes-Lacroix F, Cournot M, Bennet A, Caron P: Long-term (up to 18 years) effects on GH/IGF-1 hypersecretion and tumour size of primary somatostatin analogue (SSTa) therapy in patients with GH-secreting pituitary adenoma responsive to SSTa. Clin Endocrinol (Oxf); 2007 Aug;67(2):282-9
MedlinePlus Health Information. consumer health - Pituitary Tumors.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term (up to 18 years) effects on GH/IGF-1 hypersecretion and tumour size of primary somatostatin analogue (SSTa) therapy in patients with GH-secreting pituitary adenoma responsive to SSTa.
  • CONTEXT: The role of somatostatin analogues (SSTa) in the treatment of acromegaly.
  • OBJECTIVE: To evaluate the antihormonal and antitumour efficacy of long-term (up to 18 years) primary treatment with SSTa in patients with GH-secreting pituitary adenoma responsive to SSTa.
  • PATIENTS: Thirty-six acromegalic patients, aged 17-75 years (postoral glucose tolerance test GH > 1 microg/l, increased IGF-1 for age and sex), were monitored in a single centre and treated with SSTa as first-line therapy.
  • The mean pretreatment GH level was 13.5 +/- 3.1 microg/l, and IGF-1 (as a percentage of the value over the normal range) was 302 +/- 26%.
  • RESULTS: After 1 year, the mean GH and IGF-1 levels had reduced considerably (GH: 2.4 +/- 0.3 microg/l; IGF-1; 174 +/- 14%, P < 0.01), and they continued to decrease over 10 years, with a mean GH level of 1.6 +/- 0.1 microg/l and IGF-1 of 123 +/- 18% (P = 0.02).
  • GH < 2 microg/l, normal IGF-1, or both were observed in 25 (70%), 24 (67%) and 21 (58%) patients, respectively.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Growth Hormone / blood. Growth Hormone-Secreting Pituitary Adenoma / drug therapy. Insulin-Like Growth Factor I / analysis. Pituitary Neoplasms / drug therapy. Somatostatin / analogs & derivatives

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  • (PMID = 17524029.001).
  • [ISSN] 0300-0664
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Dopamine Agonists; 0 / Peptides, Cyclic; 118992-92-0 / lanreotide; 51110-01-1 / Somatostatin; 67763-96-6 / Insulin-Like Growth Factor I; 9002-72-6 / Growth Hormone; RWM8CCW8GP / Octreotide
  • [Other-IDs] NLM/ PMC1974833
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7. Kobayashi T, Mori Y, Uchiyama Y, Kida Y, Fujitani S: Long-term results of gamma knife surgery for growth hormone-producing pituitary adenoma: is the disease difficult to cure? J Neurosurg; 2005 Jan;102(s_supplement):119-123

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term results of gamma knife surgery for growth hormone-producing pituitary adenoma: is the disease difficult to cure?
  • OBJECT: The authors conducted a study to determine the long-term results of gamma knife surgery for residual or recurrent growth hormine (GH)-producing pituitary adenomas and to compare the results with those after treatment of other pituitary adenomas.
  • Growth hormone normalization (GH < 1.0 ng/ml) was found in 4.8%, nearly normal (< 2.0 ng/ml) in 11.9%, significantly decreased (< 5.0 ng/ml) in 23.8%, decreased in 21.4%, unchanged in 21.4%, and increased in 16.7%.
  • Serum insulin-like growth factor (IGF)-1 was significantly decreased (IGF-1 < 400 ng/ml) in 40.7%, decreased in 29.6%, unchanged in 18.5%, and increased in 11.1%, which was almost parallel to the GH changes.
  • CONCLUSIONS: Gamma knife surgery was effective and safe for the control of tumors; however, normalization of GH and IGF-1 secretion was difficult to achieve in cases with large tumors and low-dose radiation.

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  • (PMID = 28306435.001).
  • [ISSN] 1933-0693
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Keywords] NOTNLM ; gamma knife surgery / growth hormone—producing pituitary adenoma / insulin-like growth factor
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8. 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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9. 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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10. 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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11. Koutourousiou M, Seretis A, Kontogeorgos G: Intra-sellar schwannoma co-existing with GH-secreting pituitary adenoma. Acta Neurochir (Wien); 2009 Dec;151(12):1693-7
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  • [Title] Intra-sellar schwannoma co-existing with GH-secreting pituitary adenoma.
  • BACKGROUND: We present a unique example of an intra-sellar schwannoma co-existing with a growth hormone (GH)-secreting pituitary adenoma.
  • METHOD AND FINDINGS: The patient presented with acromegaly and magnetic resonance imaging (MRI) revealed an intra-sellar mass.
  • Histopathology demonstrated the presence of a GH-secreting adenoma as well as a schwannoma at the periphery of the adenoma.
  • After surgical excision, remission of the acromegaly occurred.
  • Follow-up monitoring showed no evidence of recurrence of the adenoma two years after surgery.
  • CONCLUSION: To the best of our knowledge, this is the first example of an intra-sellar schwannoma co-existing with a GH-secreting pituitary adenoma.
  • [MeSH-major] Adenoma / pathology. Neoplasms, Multiple Primary / pathology. Neurilemmoma / pathology. Pituitary Neoplasms / pathology. Sella Turcica / pathology
  • [MeSH-minor] Adult. Humans. Neoplasm Recurrence, Local / diagnosis. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / surgery

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  • (PMID = 19350200.001).
  • [ISSN] 0942-0940
  • [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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12. 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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13. Chang HP, Tseng YC, Chou TM: An enlarged sella turcica on cephalometric radiograph. Dentomaxillofac Radiol; 2005 Sep;34(5):308-12

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  • A 28-year-old male presented to the Orthodontic clinic for correction of his anterior crossbite due to mandibular prognathism as a result of pituitary adenoma with acromegaly.
  • We discuss the radiographic diagnosis of an enlarged sella turcica in intrasellar tumours and also emphasise the dentist's important role in the initial diagnosis of pituitary adenoma cases.
  • [MeSH-major] Acromegaly / radiography. Cephalometry. Sella Turcica / radiography
  • [MeSH-minor] Adenoma / complications. Adult. Humans. Male. Malocclusion, Angle Class III / etiology. Malocclusion, Angle Class III / radiography. Patient Care Planning. Pituitary Neoplasms / complications. Prognathism / etiology. Prognathism / radiography. Radiographic Magnification. Radiography, Panoramic

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  • (PMID = 16120882.001).
  • [ISSN] 0250-832X
  • [Journal-full-title] Dento maxillo facial radiology
  • [ISO-abbreviation] Dentomaxillofac Radiol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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14. 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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15. Jaquet P, Gunz G, Saveanu A, Dufour H, Taylor J, Dong J, Kim S, Moreau JP, Enjalbert A, Culler MD: Efficacy of chimeric molecules directed towards multiple somatostatin and dopamine receptors on inhibition of GH and prolactin secretion from GH-secreting pituitary adenomas classified as partially responsive to somatostatin analog therapy. Eur J Endocrinol; 2005 Jul;153(1):135-41
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  • [Title] Efficacy of chimeric molecules directed towards multiple somatostatin and dopamine receptors on inhibition of GH and prolactin secretion from GH-secreting pituitary adenomas classified as partially responsive to somatostatin analog therapy.
  • OBJECTIVE: This study compared the potency of a somatostatin receptor (sstr)2-sstr5 analog, BIM-23244, of an sstr2-dopamine D2 receptor (sstr2-DAD2) molecule, BIM-23A387 and of new somatostatin-dopamine chimeric molecules with differing, enhanced affinities for sstr2, sstr5 and DAD2, BIM-23A758, BIM-23A760 and BIM-23A761, to suppress GH and prolactin (PRL) from 18 human GH adenomas that are partially responsive to octreotide or lanreotide.
  • The effect of drugs was tested in cell cultures at various concentrations.
  • In 13 tumors, the maximal suppression of GH secretion produced by BIM-23A387 (30+/-3%) and BIM-23244 (28+/-3%) was greater than that produced by octreotide (23+/-3%).
  • In six out of 13 tumors, BIM-23A758, BIM-23A760 and BIM- 23A761 produced greater maximal suppression of GH secretion than octreotide (33+/-5, 38+/-2 and 41+/-2 vs 24+/-2%).
  • BIM-23A761 was more effective than BIM-23A387 in GH suppression (41+/-2 vs 32+/-4%).
  • CONCLUSIONS: Novel dopamine-somatostatin chimeric molecules with differing, enhanced activity at sstr2, sstr5 and DAD2, consistently produced significatly greater suppression of GH and PRL than either octreotide or single-receptor-interacting ligands in tumors from patients classified as only partially responsive to octreotide therapy.
  • The other mechanisms by which such molecules produce an enhanced inhibition of GH remain to be elucidated.

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  • (PMID = 15994755.001).
  • [ISSN] 0804-4643
  • [Journal-full-title] European journal of endocrinology
  • [ISO-abbreviation] Eur. J. Endocrinol.
  • [Language] ENG
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / BIM 23A760; 0 / BIM-23244; 0 / BIM-23A761; 0 / RNA, Messenger; 0 / Receptors, Dopamine D2; 0 / Receptors, Somatostatin; 0 / Recombinant Fusion Proteins; 0 / somatostatin receptor 2; 0 / somatostatin receptor 5; 12629-01-5 / Human Growth Hormone; 51110-01-1 / Somatostatin; 9002-62-4 / Prolactin; RWM8CCW8GP / Octreotide; VTD58H1Z2X / Dopamine
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16. 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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17. Oshino S, Saitoh Y, Kasayama S, Arita N, Ohnishi T, Kohara H, Izumoto S, Yoshimine T: Short-term preoperative octreotide treatment of GH-secreting pituitary adenoma: predictors of tumor shrinkage. Endocr J; 2006 Feb;53(1):125-32
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  • [Title] Short-term preoperative octreotide treatment of GH-secreting pituitary adenoma: predictors of tumor shrinkage.
  • We reviewed the cases of 32 patients with growth hormone (GH)-secreting macroadenoma who underwent short-term octreotide treatment before transsphenoidal surgery to determine which types of adenoma the preoperative treatment were sensitive and whether predictors of tumor shrinkage could be identified.
  • At a daily dose of 300 microg for 2-3 weeks, octreotide reduced serum GH and insulin-like growth factor-1 (IGF-1) levels to 31.9 % and 51.6% of pretreatment values, respectively, and led to a mean tumor volume of 68% of pretreatment volume in 52% of the patients.
  • Preoperative short-term octreotide treatment is effective for GH-secreting macroadeomas of Knosp grades 1-2 and a good response to both octreotide and bromocriptine challenge tests is a predictor of subsequent tumor shrinkage.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Growth Hormone-Secreting Pituitary Adenoma / drug therapy. Growth Hormone-Secreting Pituitary Adenoma / pathology. Octreotide / therapeutic use. Pituitary Neoplasms / drug therapy. Pituitary Neoplasms / pathology
  • [MeSH-minor] Acromegaly / etiology. Adult. Aged. Combined Modality Therapy. Dose-Response Relationship, Drug. Female. Growth Hormone / blood. Humans. Insulin-Like Growth Factor I / analysis. Magnetic Resonance Imaging. Male. Middle Aged. Patient Selection. Predictive Value of Tests. Preoperative Care / methods. Time Factors. Tumor Burden / drug effects

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  • (PMID = 16543682.001).
  • [ISSN] 0918-8959
  • [Journal-full-title] Endocrine journal
  • [ISO-abbreviation] Endocr. J.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 67763-96-6 / Insulin-Like Growth Factor I; 9002-72-6 / Growth Hormone; RWM8CCW8GP / Octreotide
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18. Curto L, Squadrito S, Almoto B, Longo M, Granata F, Salpietro F, Torre ML, Marini F, Trimarchi F, Cannavo S: MRI finding of simultaneous coexistence of growth hormone-secreting pituitary adenoma with intracranial meningioma and carotid artery aneurysms: report of a case. Pituitary; 2007;10(3):299-305
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  • [Title] MRI finding of simultaneous coexistence of growth hormone-secreting pituitary adenoma with intracranial meningioma and carotid artery aneurysms: report of a case.
  • Coexistence of pituitary adenoma, intracranial meningioma and cerebral aneurysm has never been described.
  • We report on a patient with GH-secreting pituitary macroadenoma associated with a right frontal meningioma and with two intracavernous asymptomatic aneurisms.
  • A 61-year-old woman was referred to our Endocrine Unit 13 years after a right frontal craniotomy for a pituitary tumour.
  • Endocrine investigation showed high levels of IGF-1 (560 ng/ml) and increased basal serum GH (56 ng/ml) levels, not suppressed after OGTT.
  • MRI showed persistence of a homogeneously enhancing intra- and suprasellar lesion, compressing the visual pathways, with bilateral intracavernous invasion and simultaneous coexistence of a right intracavernous internal carotid artery (ICA) aneurysm in direct contact with the pituitary tumour.
  • Somatostatin analog treatment normalized GH and IGF-1 levels.
  • One year later, a new MRI confirmed the presence of the pituitary mass showing also a right intracranial frontal meningioma and a new ICA aneurysm on the left side.
  • Previous studies have suggested that prolonged GH hypersecretion could play a role in the genesis of intracranial aneurysms, inducing atherosclerotic and/or degenerative modification of the arterial walls.
  • Other aetiological factors include a mechanical effect due to a direct contact between adenoma and aneurysm.
  • Coexistence of pituitary adenoma and intracranial meningioma is a rare event, but also for this association it has been suggested that GH or other growth factors could play a role in appearance or in growth of meningioma.
  • In our case, meningioma appeared and grew, despite the effective treatment of acromegaly.
  • [MeSH-major] Carotid Artery Diseases / complications. Carotid Artery Diseases / diagnosis. Growth Hormone-Secreting Pituitary Adenoma / complications. Growth Hormone-Secreting Pituitary Adenoma / diagnosis. Intracranial Aneurysm / complications. Intracranial Aneurysm / diagnosis. Meningioma / complications. Meningioma / diagnosis. Pituitary Neoplasms / complications. Pituitary Neoplasms / diagnosis
  • [MeSH-minor] Cerebral Angiography. Female. Hormones / blood. Human Growth Hormone / secretion. Humans. Magnetic Resonance Angiography. Magnetic Resonance Imaging. Middle Aged. Neurosurgical Procedures

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  • (PMID = 17334927.001).
  • [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 / Hormones; 12629-01-5 / Human Growth Hormone
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19. 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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20. Stapleton CJ, Liu CY, Weiss MH: The role of stereotactic radiosurgery in the multimodal management of growth hormone-secreting pituitary adenomas. Neurosurg Focus; 2010 Oct;29(4):E11

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The role of stereotactic radiosurgery in the multimodal management of growth hormone-secreting pituitary adenomas.
  • Growth hormone (GH)-secreting pituitary adenomas represent a common source of GH excess in patients with acromegaly.
  • Whereas surgical extirpation of the culprit lesion is considered first-line treatment, as many as 19% of patients develop recurrent symptoms due to regrowth of previously resected adenomatous tissue or to continued growth of the surgically inaccessible tumor.
  • Although medical therapies that suppress GH production can be effective in the management of primary and recurrent acromegaly, these therapies are not curative, and lifelong treatment is required for hormonal control.
  • The authors reviewed the growing body of literature concerning the role of radiosurgical procedures in the treatment armamentarium of acromegaly, and identified more than 1350 patients across 45 case series.
  • In this review, the authors report that radiosurgery offers true hormonal normalization in 17% to 82% of patients and tumor growth control in 37% to 100% of cases across all series, while minimizing adverse complications.
  • As a result, stereotactic radiosurgery represents a safe and effective treatment option in the multimodal management of primary or recurrent acromegaly secondary to GH-secreting pituitary adenomas.
  • [MeSH-major] Acromegaly / surgery. Adenoma / surgery. Growth Hormone-Secreting Pituitary Adenoma / surgery. Radiosurgery / methods. Radiotherapy, Adjuvant / methods
  • [MeSH-minor] Combined Modality Therapy. Human Growth Hormone / antagonists & inhibitors. Human Growth Hormone / secretion. Humans. Pituitary Neoplasms / blood. Pituitary Neoplasms / radiotherapy. Pituitary Neoplasms / surgery. Treatment Outcome. Tumor Burden

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  • (PMID = 20887121.001).
  • [ISSN] 1092-0684
  • [Journal-full-title] Neurosurgical focus
  • [ISO-abbreviation] Neurosurg Focus
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone
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21. 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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22. Melmed S: Acromegaly pathogenesis and treatment. J Clin Invest; 2009 Nov;119(11):3189-202
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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23. 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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24. 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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  • [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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25. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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26. 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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27. 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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28. Georgitsi M, Raitila A, Karhu A, van der Luijt RB, Aalfs CM, Sane T, Vierimaa O, Mäkinen MJ, Tuppurainen K, Paschke R, Gimm O, Koch CA, Gündogdu S, Lucassen A, Tischkowitz M, Izatt L, Aylwin S, Bano G, Hodgson S, De Menis E, Launonen V, Vahteristo P, Aaltonen LA: Germline CDKN1B/p27Kip1 mutation in multiple endocrine neoplasia. J Clin Endocrinol Metab; 2007 Aug;92(8):3321-5
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  • OBJECTIVE: Our objective was to evaluate the role of CDKN1B/p27(Kip1) in human tumor predisposition in patients clinically suspected of MEN1 but testing negative for MEN1 germline mutation as well as in familial and sporadic acromegaly/pituitary adenoma patients.
  • In addition, 19 familial and 50 sporadic acromegaly/pituitary adenoma patients from Europe and the United States were included in the study.
  • MAIN OUTCOME MEASURES: We analyzed germline CDKN1B/p27(Kip1) mutations in individuals with pituitary adenoma and MEN1-like features.
  • RESULTS: A heterozygous 19-bp duplication (c.59_77dup19) leading to a truncated protein product was identified in one Dutch patient with suspected MEN1 phenotype, pituitary adenoma, carcinoid tumor, and hyperparathyroidism (one of 36, 2.8%).
  • No mutations were detected in either familial or sporadic acromegaly/pituitary adenoma patients.
  • CONCLUSIONS: Our results support the previous finding that germline CDKN1B/p27(Kip1) mutations predispose to a human MEN1-like condition.
  • However, such mutations appear uncommon in suspected MEN1 cases and rare or nonexistent in familial or sporadic acromegaly/pituitary adenoma patients.

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  • (PMID = 17519308.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Databank-accession-numbers] GENBANK/ EF474465
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / CDKN1B protein, human; 0 / Intracellular Signaling Peptides and Proteins; 147604-94-2 / Cyclin-Dependent Kinase Inhibitor p27; 9007-49-2 / DNA
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29. Fracassi F, Gandini G, Diana A, Preziosi R, Ingh TS, Famigli-Bergamini P, Kooistra HS: Acromegaly due to a somatroph adenoma in a dog. Domest Anim Endocrinol; 2007 Jan;32(1):43-54
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Acromegaly due to a somatroph adenoma in a dog.
  • The basal serum growth hormone (GH) concentration was markedly elevated (23microg/l) and did not decrease during a glucose tolerance test or after somatostatin administration.
  • The serum insulin-like growth factor-1 concentration was also markedly elevated (1254microg/l).
  • CT scanning of the skull showed an enlarged pituitary gland with normal enhancement pattern.
  • The pituitary gland contained an acidophilic adenoma that immunostained positively for GH (and negatively for ACTH and alpha-MSH).
  • In conclusion, this Dalmatian dog with acromegaly and insulin resistance represents the first case of GH hypersecretion proven to be due to a somatotroph adenoma.
  • [MeSH-major] Acromegaly / veterinary. Adenoma / veterinary. Dog Diseases / pathology. Pituitary Neoplasms / veterinary
  • [MeSH-minor] Animals. Dogs. Fatal Outcome. Growth Hormone / blood. Insulin Resistance. Male. Spinal Osteophytosis / complications. Spinal Osteophytosis / pathology. Spinal Osteophytosis / veterinary

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  • (PMID = 16472961.001).
  • [ISSN] 0739-7240
  • [Journal-full-title] Domestic animal endocrinology
  • [ISO-abbreviation] Domest. Anim. Endocrinol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 9002-72-6 / Growth Hormone
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30. El-Bilbeisi H, Ghannam M, Nimri CF, Ahmad AT: Craniopharyngioma in a patient with acromegaly due to a pituitary macroadenoma. Ann Saudi Med; 2010 Nov-Dec;30(6):485-8
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  • [Title] Craniopharyngioma in a patient with acromegaly due to a pituitary macroadenoma.
  • We present the first reported case of a craniopharyngioma as a second primary tumor in a patient with acromegaly due to a growth hormone (GH)-secreting pituitary adenoma.
  • The patient was lost for follow-up for 18 years after trans-sphenoidal pituitary surgery for a GH-secreting pituitary adenoma.
  • She presented with headaches and decreased visual acuity, and showed unsuppressed GH in an oral glucose load test with high IGF-1 levels.
  • Biopsy of the mass confirmed the diagnosis of a craniopharyngioma.
  • We stress the need for close follow-up of patients with acromegaly with adequate control of GH and IGF-1 levels.
  • [MeSH-major] Acromegaly / etiology. Adenoma / pathology. Craniopharyngioma / pathology. Growth Hormone / secretion. Neoplasms, Second Primary / pathology. Pituitary Neoplasms / pathology

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  • (PMID = 20864785.001).
  • [ISSN] 0975-4466
  • [Journal-full-title] Annals of Saudi medicine
  • [ISO-abbreviation] Ann Saudi Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Saudi Arabia
  • [Chemical-registry-number] 9002-72-6 / Growth Hormone
  • [Other-IDs] NLM/ PMC2994169
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31. Taguchi T, Takao T, Iwasaki Y, Oyama K, Yamada S, Inoue M, Terada Y: Diagnostic value of 18F-dihydroxyphenylalanine positron emission tomography for growth hormone-producing pituitary adenoma. Pituitary; 2010;13(1):78-9

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Diagnostic value of 18F-dihydroxyphenylalanine positron emission tomography for growth hormone-producing pituitary adenoma.
  • A 55-year-old woman with signs of acromegaly was referred to our hospital.
  • Endocrinological examinations showed that she had high levels of growth hormone (GH; 5.54 ng ml(-1); normal range: 0.66-3.68 ng ml(-1)) and insulin-like growth factor-I (IGF-I; 508 ng ml(-1); normal range: 37-266 ng ml(-1)) levels, incomplete suppression of serum GH following a 75-gram oral glucose tolerance test (oGTT; trough GH 3.66 ng ml(-1)), and paradoxical GH responses to a TRH provocation test (peak GH 38.9 ng ml(-1)).
  • Dynamic magnetic resonance imaging (MRI) suggested the presence of an intrasellar mass lesion (5.9 x 2.8 mm) in the left part of her pituitary gland (Fig.
  • Subsequent histological analysis confirmed the diagnosis of a GH-producing pituitary adenoma.
  • After removal, serum IGF-I levels decreased to a normal range (178 ng ml(-1)), and serum GH was appropriately suppressed during oGTT (trough GH 0.30 ng ml(-1)), suggesting that complete resection was obtained [1].
  • PET scans are reported to be a valuable tool for the detection of pituitary adenomas [2-4].
  • This case clearly showed that FDG-PET is also useful for re-evaluation of the disease after surgery.
  • PET scans are recommended for patients with equivocal pituitary mass lesions on conventional MRI, and for follow-up examinations after surgery.
  • [MeSH-major] Dihydroxyphenylalanine. Fluorine Radioisotopes. Growth Hormone-Secreting Pituitary Adenoma / diagnosis. Positron-Emission Tomography / methods

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  • (PMID = 19915981.001).
  • [ISSN] 1573-7403
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Case Reports; Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Fluorine Radioisotopes; 63-84-3 / Dihydroxyphenylalanine
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32. 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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33. Buchfelder M, Weigel D, Droste M, Mann K, Saller B, Brübach K, Stalla GK, Bidlingmaier M, Strasburger CJ, Investigators of German Pegvisomant Observational Study: Pituitary tumor size in acromegaly during pegvisomant treatment: experience from MR re-evaluations of the German Pegvisomant Observational Study. Eur J Endocrinol; 2009 Jul;161(1):27-35
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  • [Title] Pituitary tumor size in acromegaly during pegvisomant treatment: experience from MR re-evaluations of the German Pegvisomant Observational Study.
  • In treatment-resistant patients with acromegaly, pharmacotherapy with pegvisomant (Somavert) is a highly effective option.
  • All three patients had undergone pituitary surgery as primary treatment, but had not been pre-treated with radiotherapy.
  • It was reported in between 2 and 3% of patients treated, and did not exceed the expected rate in patients with acromegaly not treated with pegvisomant.
  • As from this presently largest database of acromegalic patients treated with pegvisomant, tumor-growth rate appears not to be different from patients on other treatment modalities.
  • Although these data are reassuring with regard to the concern of somatotroph adenoma growth under peripheral GH receptor blockade, further study is required.

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  • (PMID = 19411302.001).
  • [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 / pegvisomant; 12629-01-5 / Human Growth Hormone
  • [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 H; Boehm B; Kasperk C; Kerber C; 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; 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; 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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34. Pawlikowski M, Pisarek H, Kunert-Radek J, Radek M: Somatostatin receptors in GH-secreting pituitary adenomas--their relationship to the response to octreotide. Endokrynol Pol; 2008 May-Jun;59(3):196-9

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Somatostatin receptors in GH-secreting pituitary adenomas--their relationship to the response to octreotide.
  • Twenty pituitary adenomas, surgically removed from patients suffering from acromegaly, were studied.
  • The tumours were immunostained with anti-GH and anti-PRL antibodies and with antibodies raised against particular subtypes of somatostatin receptors (rsst1-5).
  • In 15 patients in whom the GH response to the acute administration of 200 ug octreotide was tested the correlation between the expression of rsst and the percentage of GH drop was estimated.
  • All the tumours were GH-immunopositive and in the majority (14/20) co-expression of PRL was also found.
  • All the adenomas examined expressed rsst2A (20/20) and rsst5 (12/12) receptor proteins.
  • The mixed (GH/PRL) adenomas showed a tendency to a higher expression of rsst2A + + rsst2B and a greater response to octreotide administration.
  • A significant positive correlation was found between rsst2A + rsst2B expressions and a drop in GH after octreotide.
  • To conclude, the GH-inhibiting effect of octreotide depends on the intensity of expression of both rsst2A and rsst2B.
  • Both isoforms of rsst2 mediate the same biological response (inhibition of GH secretion) in GH-secreting and GH/PRL-secreting adenomas.
  • [MeSH-major] Adenoma / drug therapy. Adenoma / metabolism. Growth Hormone-Secreting Pituitary Adenoma / drug therapy. Growth Hormone-Secreting Pituitary Adenoma / metabolism. Octreotide / therapeutic use. Receptors, Somatostatin / metabolism
  • [MeSH-minor] Acromegaly / etiology. Antineoplastic Agents / therapeutic use. Growth Hormone / drug effects. Growth Hormone / secretion. Humans. Immunohistochemistry

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  • (PMID = 18615392.001).
  • [ISSN] 0423-104X
  • [Journal-full-title] Endokrynologia Polska
  • [ISO-abbreviation] Endokrynol Pol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Receptors, Somatostatin; 9002-72-6 / Growth Hormone; RWM8CCW8GP / Octreotide
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35. 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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36. Sekizawa N, Hayakawa E, Tsuchiya K, Yoshimoto T, Akashi T, Fujii T, Yamada S, Hirata Y: Acromegaly associated with multiple tumors. Intern Med; 2009;48(15):1273-8
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  • [Title] Acromegaly associated with multiple tumors.
  • A 56-year-old man was admitted to our hospital for the surgical removal of renal cell carcinoma (RCC).
  • He was diagnosed with acromegaly due to his characteristic clinical features, endocrine data, and the presence of pituitary tumor.
  • Pathological examination of the pituitary tumor after transsphenoidal surgery was compatible with growth hormone (GH)-secreting pituitary adenoma.
  • We also detected the transcripts and/or immunoreactivity of GH/insulin-like growth factor I components in the tumor specimen.
  • This is a rare case of acromegaly associated with multiple tumors, including RCC, colon cancer and thyroid tumor.
  • [MeSH-major] Acromegaly / etiology. Neoplasms, Multiple Primary / complications
  • [MeSH-minor] Base Sequence. Carcinoma, Renal Cell / complications. Carcinoma, Renal Cell / genetics. Carcinoma, Renal Cell / metabolism. Colonic Neoplasms / complications. Colonic Neoplasms / genetics. Colonic Neoplasms / metabolism. DNA Primers / genetics. Gene Expression. Humans. Immunohistochemistry. Insulin-Like Growth Factor I / genetics. Insulin-Like Growth Factor I / metabolism. Kidney Neoplasms / complications. Kidney Neoplasms / genetics. Kidney Neoplasms / metabolism. Male. Middle Aged. Pituitary Neoplasms / complications. Pituitary Neoplasms / genetics. Pituitary Neoplasms / metabolism. Receptor, IGF Type 1 / genetics. Receptor, IGF Type 1 / metabolism. Receptors, Somatotropin / genetics. Receptors, Somatotropin / metabolism. Thyroid Neoplasms / complications. Thyroid Neoplasms / genetics. Thyroid Neoplasms / metabolism

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  • (PMID = 19652429.001).
  • [ISSN] 1349-7235
  • [Journal-full-title] Internal medicine (Tokyo, Japan)
  • [ISO-abbreviation] Intern. Med.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / DNA Primers; 0 / Receptors, Somatotropin; 67763-96-6 / Insulin-Like Growth Factor I; EC 2.7.10.1 / Receptor, IGF Type 1
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37. Kobayashi T, Mori Y, Uchiyama Y, Kida Y, Fujitani S: Long-term results of gamma knife surgery for growth hormone-producing pituitary adenoma: is the disease difficult to cure? J Neurosurg; 2005 Jan;102 Suppl:119-23
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  • [Title] Long-term results of gamma knife surgery for growth hormone-producing pituitary adenoma: is the disease difficult to cure?
  • OBJECT: The authors conducted a study to determine the long-term results of gamma knife surgery for residual or recurrent growth hormine (GH)-producing pituitary adenomas and to compare the results with those after treatment of other pituitary adenomas.
  • Growth hormone normalization (GH < 1.0 ng/ml) was found in 4.8%, nearly normal (< 2.0 ng/ml) in 11.9%, significantly decreased (< 5.0 ng/ml) in 23.8%, decreased in 21.4%, unchanged in 21.4%, and increased in 16.7%.
  • Serum insulin-like growth factor (IGF)-1 was significantly decreased (IGF-1 < 400 ng/ml) in 40.7%, decreased in 29.6%, unchanged in 18.5%, and increased in 11.1%, which was almost parallel to the GH changes.
  • CONCLUSIONS: Gamma knife surgery was effective and safe for the control of tumors; however, normalization of GH and IGF-1 secretion was difficult to achieve in cases with large tumors and low-dose radiation.
  • [MeSH-major] Adenoma / secretion. Adenoma / surgery. Human Growth Hormone / secretion. Pituitary Neoplasms / secretion. Pituitary Neoplasms / surgery. Radiosurgery / instrumentation
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Recurrence, Local. Outcome Assessment (Health Care). Pituitary ACTH Hypersecretion / pathology. Pituitary ACTH Hypersecretion / surgery. Prolactinoma / pathology. Prolactinoma / surgery

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  • (PMID = 15662793.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone
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38. Lania AG, Ferrero S, Pivonello R, Mantovani G, Peverelli E, Di Sarno A, Beck-Peccoz P, Spada A, Colao A: Evolution of an aggressive prolactinoma into a growth hormone secreting pituitary tumor coincident with GNAS gene mutation. J Clin Endocrinol Metab; 2010 Jan;95(1):13-7
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  • [Title] Evolution of an aggressive prolactinoma into a growth hormone secreting pituitary tumor coincident with GNAS gene mutation.
  • CONTEXT: Mixed PRL- and GH-secreting pituitary adenomas are relatively common because somatotrophs and lactotrophs share the common somato-mammotroph progenitor lineage.
  • Conversely, the occurrence of a prolactinoma evolving into clinically and biochemically active acromegaly is a rare phenomenon.
  • OBJECTIVE AND RESULTS: We report a patient with a prolactinoma who after 15 yr of disease control by bromocriptine became resistant to dopaminergic drugs and due to the rapid tumor growth was submitted to four neurosurgeries and two stereotactic radiotherapies in the subsequent 5 yr.
  • Unexpectedly, in the last 1.5 yr, after the fourth neurosurgery and second gamma-knife, she complained of signs and symptoms of acromegaly that was biochemically confirmed.
  • Although samples from the initial surgery were positive for prolactin and negative for GH, about 10% of GH-positive cells were detected in tissue from the last surgery, consistent with the observed clinical shift to acromegaly.
  • CONCLUSIONS: These observations suggest that 1)treatment of prolactinomas resistant to dopaminergic drugs is still a challenge, and 2) the appearance of gsp oncogene in a prolactinoma evolving into acromegaly might be the underlying mechanism of this rare transition, further confirming that this mutational change is associated with somatotroph growth and transformation.
  • [MeSH-major] GTP-Binding Protein alpha Subunits, Gs / genetics. Growth Hormone-Secreting Pituitary Adenoma / genetics. Growth Hormone-Secreting Pituitary Adenoma / pathology. Pituitary Neoplasms / pathology. Prolactinoma / pathology
  • [MeSH-minor] DNA Mutational Analysis. Disease Progression. Female. Follow-Up Studies. Humans. Middle Aged. Mutation / physiology. Neoplasm Invasiveness

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  • (PMID = 19890024.001).
  • [ISSN] 1945-7197
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] EC 3.6.1.- / GNAS protein, human; EC 3.6.5.1 / GTP-Binding Protein alpha Subunits, Gs
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39. 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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  • [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


40. 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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  • [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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41. 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.

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  • (PMID = 20610592.001).
  • [ISSN] 1945-7197
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] ENG
  • [Grant] United States / Intramural NIH HHS / /
  • [Publication-type] Case Reports; Journal Article; Multicenter Study; Research Support, N.I.H., Intramural
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC2936064
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42. 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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43. Scacchi M, Cavagnini F: Acromegaly. Pituitary; 2006;9(4):297-303
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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44. Kawamata T, Kubo O, Hori T: Surgical removal of growth hormone-secreting pituitary adenomas with intensive microsurgical pseudocapsule resection results in complete remission of acromegaly. Neurosurg Rev; 2005 Jul;28(3):201-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Surgical removal of growth hormone-secreting pituitary adenomas with intensive microsurgical pseudocapsule resection results in complete remission of acromegaly.
  • Although some investigators recommended surgical removal of the borders between pituitary adenoma and the surrounding normal pituitary gland, there is so far little documentation of how intensive dissection of the border zone affects the actual clinical remission rate of pituitary adenomas.
  • We investigated the precise histological characteristics of the boundary, using surgical specimens from patients who underwent intensive resection of "microsurgical pseudocapsule" of growth hormone (GH)-secreting pituitary adenomas.
  • Furthermore, we compared the remission rate of acromegaly between subjects with (Group 1) and without (Group 2) intensive resection of microsurgical pseudocapsule in order to correlate the histological complete resection and endocrinological remission.
  • Histologically, most adenomas were in direct contact with normal pituitary gland that formed an increased fibrous component facing the adenoma, without a true histological pseudocapsule.
  • It was impossible to dissect the tumor at exactly the tumor--normal pituitary interface for the whole extent of the pituitary adenoma during surgery, and complete removal of the tumor inevitably included a portion of normal tissue (microsurgical pseudocapsule).
  • The biochemical remission rate was significantly higher in Group 1 than in Group 2 (90.0 vs 61.1%), and Group 1 showed no additional postoperative pituitary hypofunction.
  • The present results suggested that intensive resection of the microsurgical pseudocapsule is essential to accomplish histological and endocrinological total resection of the GH-secreting pituitary adenomas for remission of acromegaly.

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45. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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

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  • (PMID = 17427111.001).
  • [ISSN] 0947-7349
  • [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] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / pegvisomant; 12629-01-5 / Human Growth Hormone
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46. Chanson P, Salenave S: Acromegaly. Orphanet J Rare Dis; 2008;3:17
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Acromegaly.
  • Acromegaly is an acquired disorder related to excessive production of growth hormone (GH) and characterized by progressive somatic disfigurement (mainly involving the face and extremities) and systemic manifestations.
  • Due to insidious onset and slow progression, acromegaly is often diagnosed four to more than ten years after its onset.
  • The disease also has rheumatologic, cardiovascular, respiratory and metabolic consequences which determine its prognosis.
  • In the majority of cases, acromegaly is related to a pituitary adenoma, either purely GH-secreting (60%) or mixed.
  • In very rare cases, acromegaly is due to ectopic secretion of growth-hormone-releasing hormone (GHRH) responsible for pituitary hyperplasia.
  • The clinical diagnosis is confirmed biochemically by an increased serum GH concentration following an oral glucose tolerance test (OGTT) and by detection of increased levels of insulin-like growth factor-I (IGF-I).
  • Echocardiography and sleep apnea testing are used to determine the clinical impact of acromegaly.
  • Treatment is aimed at correcting (or preventing) tumor compression by excising the disease-causing lesion, and at reducing GH and IGF-I levels to normal values.
  • When surgery fails to correct GH/IGF-I hypersecretion, medical treatment with somatostatin analogs and/or radiotherapy can be used.
  • The GH antagonist (pegvisomant) is used in patients that are resistant to somatostatin analogs.
  • Adequate hormonal disease control is achieved in most cases, allowing a life expectancy similar to that of the general population.
  • [MeSH-major] Acromegaly. Human Growth Hormone / secretion
  • [MeSH-minor] Adult. Female. Humans. Male. Middle Aged. Pituitary Neoplasms / metabolism. Pituitary Neoplasms / radiography. Prevalence

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  • (PMID = 18578866.001).
  • [ISSN] 1750-1172
  • [Journal-full-title] Orphanet journal of rare diseases
  • [ISO-abbreviation] Orphanet J Rare Dis
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone
  • [Number-of-references] 103
  • [Other-IDs] NLM/ PMC2459162
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47. 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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48. Fougner SL, Bollerslev J, Latif F, Hald JK, Lund T, Ramm-Pettersen J, Berg JP: Low levels of raf kinase inhibitory protein in growth hormone-secreting pituitary adenomas correlate with poor response to octreotide treatment. J Clin Endocrinol Metab; 2008 Apr;93(4):1211-6
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  • [Title] Low levels of raf kinase inhibitory protein in growth hormone-secreting pituitary adenomas correlate with poor response to octreotide treatment.
  • CONTEXT: Excessive GH production by pituitary tumors causes acromegaly.
  • Medical treatment of acromegaly with somatostatin analogs (SMSs), like octreotide, is well established, but the clinical effect is variable.
  • OBJECTIVE: Our objective was to study RKIP levels in pituitary somatotroph adenomas, and relate them to clinical characteristics and response to octreotide treatment in patients with acromegaly.
  • PATIENTS AND METHODS: RKIP level was analyzed by Western blot of proteins extracted from somatotroph tumors frozen a short time after surgery in 51 patients with active acromegaly.
  • RESULTS: The adenoma RKIP level correlated significantly to both the acute and the long-term octreotide responses on serum levels of GH and IGF-I, respectively.
  • In multiple regression analyses, the RKIP level was a significant determinant for both the GH reduction in the acute test and the IGF-I reduction after approximately 6 months.
  • CONCLUSION: The RKIP level in somatotroph adenomas seems to be important for the clinical effect of SMS treatment, in which low levels of RKIP correlate to poor clinical response to SMSs.
  • [MeSH-major] Adenoma / chemistry. Antineoplastic Agents, Hormonal / therapeutic use. Growth Hormone-Secreting Pituitary Adenoma / chemistry. Octreotide / therapeutic use. Phosphatidylethanolamine Binding Protein / analysis

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  • (PMID = 18230656.001).
  • [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; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / PEBP1 protein, human; 0 / Phosphatidylethanolamine Binding Protein; 0 / Receptors, Somatostatin; 0 / somatostatin receptor 2; RWM8CCW8GP / Octreotide
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49. Chesnokova V, Melmed S: Pituitary senescence: the evolving role of Pttg. Mol Cell Endocrinol; 2010 Sep 15;326(1-2):55-9
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  • [Title] Pituitary senescence: the evolving role of Pttg.
  • Despite the high prevalence of pituitary adenomas they are invariably benign, indicative of unique intrinsic mechanisms controlling pituitary cell proliferation.
  • Cellular senescence is characterized by a largely irreversible cell cycle arrest and constitutes a strong anti-proliferative response, which can be triggered by DNA damage, chromosomal instability and aneuploidy, loss of tumor suppressive signaling or oncogene activation.
  • Here we discuss prospective mechanisms underlying senescence-associated molecular pathways activated in benign pituitary adenomas.
  • Both deletion and over-expression of pituitary tumor transforming gene (Pttg) promote chromosomal instability and aneuploidy.
  • Abundant PTTG in GH-secreting pituitary adenomas also triggers p21-dependent senescence.
  • Pituitary p21 may therefore safeguard against further chromosomal instability by constraining pituitary tumor growth.
  • These observations point to senescence as a target for effective therapy for both tumor silencing and growth restraint towards development of pituitary malignancy.

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  • [Copyright] 2010 Elsevier Ireland Ltd. All rights reserved.
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  • (PMID = 20153804.001).
  • [ISSN] 1872-8057
  • [Journal-full-title] Molecular and cellular endocrinology
  • [ISO-abbreviation] Mol. Cell. Endocrinol.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / CA075979-11A1; United States / NCI NIH HHS / CA / R01 CA075979; United States / NCI NIH HHS / CA / R01 CA075979-11A1
  • [Publication-type] Journal Article; Review
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Neoplasm Proteins; 0 / Securin; 0 / pituitary tumor-transforming protein 1, human
  • [Other-IDs] NLM/ NIHMS185500; NLM/ PMC2906651
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50. 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

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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51. 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

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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52. Mantovani G, Lania AG, Spada A: GNAS imprinting and pituitary tumors. Mol Cell Endocrinol; 2010 Sep 15;326(1-2):15-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] GNAS imprinting and pituitary tumors.
  • Evidence from in vitro studies and naturally occurring human diseases indicate that several endocrine cells, and particularly somatotrophs, recognize cAMP as a growth factor.
  • Accordingly, mutations of the alpha subunit of the stimulatory G protein gene (GNAS) leading to the constitutive activation of adenylyl cyclase (the so-called gsp oncogene) have been found in a significant proportion of GH-secreting pituitary adenomas.
  • This complex tissue-specific imprinting control results in a near-exclusive expression of Gsalpha from the maternal allele in specific endocrine tissues, including the pituitary.
  • Due to the monoallelic origin of Gsalpha in normal pituitary gsp mutations occur on a maternal allele in order to have a phenotypic effect in both sporadic GH-secreting adenomas and those associated with the McCune-Albright syndrome.
  • Therefore, genetic and epigenetic alterations of the GNAS gene, with subsequent dysregulation of the cAMP pathway, appear, to date, the only molecular hallmark of most GH-secreting adenomas.
  • [MeSH-major] GTP-Binding Protein alpha Subunits, Gs / genetics. Pituitary Neoplasms / genetics
  • [MeSH-minor] Animals. Cyclic AMP-Dependent Protein Kinases / metabolism. Fibrous Dysplasia, Polyostotic / genetics. Genomic Imprinting. Growth Hormone-Secreting Pituitary Adenoma / genetics. Humans. Mice. Pituitary Gland / pathology

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  • [Copyright] 2010 Elsevier Ireland Ltd. All rights reserved.
  • (PMID = 20398730.001).
  • [ISSN] 1872-8057
  • [Journal-full-title] Molecular and cellular endocrinology
  • [ISO-abbreviation] Mol. Cell. Endocrinol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Ireland
  • [Chemical-registry-number] EC 2.7.11.11 / Cyclic AMP-Dependent Protein Kinases; EC 3.6.1.- / GNAS protein, human; EC 3.6.1.- / Gnas protein, mouse; EC 3.6.5.1 / GTP-Binding Protein alpha Subunits, Gs
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53. 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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54. 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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55. 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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56. 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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57. 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

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  • (PMID = 19293545.001).
  • [ISSN] 1349-7235
  • [Journal-full-title] Internal medicine (Tokyo, Japan)
  • [ISO-abbreviation] Intern. Med.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 9002-72-6 / Growth Hormone
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58. Donangelo I, Marcos HP, Araújo PB, Marcondes J, Filho PN, Gadelha M, Chimelli L: Expression of retinoblastoma protein in human growth hormone-secreting pituitary adenomas. Endocr Pathol; 2005;16(1):53-62
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  • [Title] Expression of retinoblastoma protein in human growth hormone-secreting pituitary adenomas.
  • Its role in the pathogenesis of pituitary tumors has not been fully clarified.
  • Conversely, lack of expression of pRB was observed in one fourth of GH-secreting pituitary adenomas (GH-tumors).
  • In order to further study the expression of pRB in GH-tumors, we evaluated this protein in 49 tumors from patients with acromegaly (20 noninvasive, 25 invasive, and 4 with no information) and 8 normal pituitaries using immunohistochemistry (IHC).
  • In conclusion, pRB is underexpressed in a subgroup of GH-tumors, and this may represent an early event in the pathogenesis of this tumor subtype.
  • [MeSH-major] Adenoma / secretion. Human Growth Hormone / secretion. Pituitary Gland, Anterior / secretion. Pituitary Neoplasms / secretion. Retinoblastoma Protein / metabolism
  • [MeSH-minor] Acromegaly / etiology. Acromegaly / metabolism. Acromegaly / pathology. Adult. Aged. Cell Count. Child. Female. Fluorescent Antibody Technique, Indirect. Humans. Male. Middle Aged

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  • (PMID = 16000847.001).
  • [ISSN] 1046-3976
  • [Journal-full-title] Endocrine pathology
  • [ISO-abbreviation] Endocr. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Retinoblastoma Protein; 12629-01-5 / Human Growth Hormone
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59. Kurosaki M, Saegert W, Abe T, Lüdecke DK: Expression of vascular endothelial growth factor in growth hormone-secreting pituitary adenomas: special reference to the octreotide treatment. Neurol Res; 2008 Jun;30(5):518-22
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  • [Title] Expression of vascular endothelial growth factor in growth hormone-secreting pituitary adenomas: special reference to the octreotide treatment.
  • OBJECTIVE: The present study was designed to investigate the localization of VEGF in GH-secreting pituitary adenomas and to evaluate the characteristic differences of VEGF expression in relation to the clinical effect of preoperative treatment with octreotide.
  • METHODS: Fifty-six cases of GH-secreting adenomas, which were divided into three groups and three normal pituitary glands, were studied using immunohistochemistry for expression of VEGF.
  • VEGF staining was strongly seen in the cytoplasm in normal pituitary glands.
  • The staining pattern differs statistically between the octreotide and control group, typically in densely granulated GH cell adenomas.
  • Age, gender, tumor size, tumor invasiveness and adenoma type did not influence VEGF expression.
  • [MeSH-major] Adenoma / drug therapy. Antineoplastic Agents, Hormonal / therapeutic use. Octreotide / therapeutic use. Pituitary Neoplasms / drug therapy. Vascular Endothelial Growth Factor A / metabolism
  • [MeSH-minor] Adolescent. Adult. Aged. Child. Female. Humans. Male. Middle Aged. Pituitary Gland / drug effects. Pituitary Gland / metabolism. Pituitary Gland / pathology. Retrospective Studies. Statistics, Nonparametric. Technology, Radiologic / methods

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  • (PMID = 18953743.001).
  • [ISSN] 0161-6412
  • [Journal-full-title] Neurological research
  • [ISO-abbreviation] Neurol. Res.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Vascular Endothelial Growth Factor A; RWM8CCW8GP / Octreotide
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60. 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


61. Petrossians P, Borges-Martins L, Espinoza C, Daly A, Betea D, Valdes-Socin H, Stevenaert A, Chanson P, Beckers A: Gross total resection or debulking of pituitary adenomas improves hormonal control of acromegaly by somatostatin analogs. Eur J Endocrinol; 2005 Jan;152(1):61-6
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  • [Title] Gross total resection or debulking of pituitary adenomas improves hormonal control of acromegaly by somatostatin analogs.
  • INTRODUCTION: Invasive GH-secreting pituitary adenomas are rarely cured by surgery and although long-term therapy with somatostatin analogs (SSAs) may be employed, hormonal control is achieved in only 60% of cases.
  • The impact of tumor debulking on subsequent control of acromegaly with SSAs has not been studied previously.
  • A case review identified 24 acromegalic patients who had received SSA therapy for > or = 1 month before and after gross total resection or debulking of adenomas.
  • GH and IGV-I responses to SSAs were recorded pre- and postoperatively.
  • RESULTS: Before preoperative SSA treatment, 24/24 (100%) patients had elevated GH levels and IGF-I levels were elevated in 19/21 (90.5%) patients with recorded values.
  • During preoperative SSA treatment, GH and IGF-I levels were normalized in 7/24 (29.2%) and 11/24 (45.8%) patients respectively.
  • Following postoperative washout, GH was controlled in only 3/24 (12.5%) patients, while IGF-I was controlled in 8/19 (42.1%) patients with available data.
  • During the second SSA treatment period, normal GH levels were seen in 13/24 (54.2%) patients, while IGF-I control was noted in 18/23 (78.3%).
  • CONCLUSION: Gross total tumor resection or debulking increases the likelihood of achieving biochemical disease control with SSAs in acromegalic patients with adenomas that were not amenable to complete surgical resection and in whom primary SSA therapy was unable to achieve good biochemical control.

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  • [CommentIn] Eur J Endocrinol. 2005 May;152(5):693-4 [15879353.001]
  • (PMID = 15762188.001).
  • [ISSN] 0804-4643
  • [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; 51110-01-1 / Somatostatin; 67763-96-6 / Insulin-Like Growth Factor I; RWM8CCW8GP / Octreotide
  • [Number-of-references] 18
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62. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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63. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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64. 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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  • [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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65. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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66. Picard C, Silvy M, Gerard C, Buffat C, Lavaque E, Figarella-Branger D, Dufour H, Gabert J, Beckers A, Brue T, Enjalbert A, Barlier A: Gs alpha overexpression and loss of Gs alpha imprinting in human somatotroph adenomas: association with tumor size and response to pharmacologic treatment. Int J Cancer; 2007 Sep 15;121(6):1245-52

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Gs alpha overexpression and loss of Gs alpha imprinting in human somatotroph adenomas: association with tumor size and response to pharmacologic treatment.
  • Gs alpha is paternally silenced in normal pituitary, but Gs alpha imprinting relaxation is found in some tumoral tissue.
  • In addition, Gs alpha mRNA levels are high in some somatotroph adenomas not bearing the active Gs alpha mutant, the gsp oncogene.
  • We compared the expression and imprinting of 4 transcripts of GNAS locus (NESP55, XL alpha s, exon 1A, Gs alpha) of 60 somatotroph adenomas with those of 23 lactotroph adenomas.
  • [MeSH-major] Adenoma / genetics. Drug Resistance, Neoplasm / genetics. GTP-Binding Protein alpha Subunits, Gs / genetics. Genomic Imprinting. Growth Hormone-Secreting Pituitary Adenoma / genetics

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  • [Copyright] (c) 2007 Wiley-Liss, Inc.
  • (PMID = 17514647.001).
  • [ISSN] 0020-7136
  • [Journal-full-title] International journal of cancer
  • [ISO-abbreviation] Int. J. Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / RNA, Messenger; EC 3.6.5.1 / GTP-Binding Protein alpha Subunits, Gs; RWM8CCW8GP / Octreotide
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67. Chanson P: Emerging drugs for acromegaly. Expert Opin Emerg Drugs; 2008 Jun;13(2):273-93
Genetic Alliance. consumer health - Acromegaly.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Emerging drugs for acromegaly.
  • BACKGROUND: Acromegaly is due to growth hormone (GH) hypersecretion by a benign pituitary tumor (adenoma).
  • Treatments include surgical removal of the adenoma (often incomplete when the tumor is large and/or invasive), radiotherapy of the pituitary region (sometimes effective only after > 10 years, and potentially causing cerebrovascular disease), and medical therapy.
  • RESULTS/CONCLUSION: Somatostatin analogs (first octreotide and then lanreotide) have been used for 20 years to treat patients in whom surgery and/or radiotherapy has failed, and also as first-line therapy when other modalities are contraindicated or are unlikely to control GH and insulin-like growth factor-I (IGF-I) hypersecretion.
  • GH/IGF-I hypersecretion is controlled by these drugs in about 50% of patients, but the remaining patients require another treatment.
  • Pegvisomant, a drug belonging to a totally different therapeutic class (GH-receptor antagonists) with a different mode of action, is effective in most of these patients.
  • [MeSH-major] Acromegaly / drug therapy. Drug Delivery Systems
  • [MeSH-minor] Drug Design. Human Growth Hormone / analogs & derivatives. Human Growth Hormone / pharmacology. Human Growth Hormone / therapeutic use. Humans. Octreotide / pharmacology. Octreotide / therapeutic use. Peptides, Cyclic / pharmacology. Peptides, Cyclic / therapeutic use. Somatostatin / analogs & derivatives. Somatostatin / pharmacology. Somatostatin / therapeutic use

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  • (PMID = 18537521.001).
  • [ISSN] 1744-7623
  • [Journal-full-title] Expert opinion on emerging drugs
  • [ISO-abbreviation] Expert Opin Emerg Drugs
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Peptides, Cyclic; 0 / pegvisomant; 118992-92-0 / lanreotide; 12629-01-5 / Human Growth Hormone; 51110-01-1 / Somatostatin; RWM8CCW8GP / Octreotide
  • [Number-of-references] 156
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68. Horvath E, Kovacs K: Pathology of acromegaly. Neuroendocrinology; 2006;83(3-4):161-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pathology of acromegaly.
  • This review summarizes current knowledge on pituitary changes in patients with acromegaly.
  • The histologic, immunohistochemical and electron microscopic study provided conclusive evidence that a marked diversity exists between the tumors which secrete growth hormone (GH) in excess, such as densely and sparsely granulated GH cell adenoma, the mixed GH prolactin cell adenoma and the mammosomatotrope adenoma.
  • The latter two tumors produce GH and prolactin simultaneously.
  • Densely granulated GH cell tumors may produce thyrotropin and alpha subunit as well.
  • Somatotrope carcinomas are extremely rare.
  • GH cell hyperplasia can also be associated with acromegaly in patients with extrapituitary GH-releasing hormone secreting tumors.
  • The medical therapy of acromegaly is reviewed briefly, including long-acting somatostatin analogs and pegvisomant, a GH receptor blocker.
  • [MeSH-major] Acromegaly / pathology. Human Growth Hormone / metabolism. Pituitary Gland / pathology. Pituitary Neoplasms / pathology
  • [MeSH-minor] Adenoma / metabolism. Adenoma / pathology. Adenoma / therapy. Adenoma / ultrastructure. Carcinoma / metabolism. Carcinoma / pathology. Carcinoma / therapy. Carcinoma / ultrastructure. Humans. Immunohistochemistry

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  • (PMID = 17047379.001).
  • [ISSN] 0028-3835
  • [Journal-full-title] Neuroendocrinology
  • [ISO-abbreviation] Neuroendocrinology
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone
  • [Number-of-references] 22
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69. Cordero RA, Barkan AL: Current diagnosis of acromegaly. Rev Endocr Metab Disord; 2008 Mar;9(1):13-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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70. 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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71. 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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72. Isidro ML, Iglesias Díaz P, Matías-Guiu X, Cordido F: Acromegaly due to a growth hormone-releasing hormone-secreting intracranial gangliocytoma. J Endocrinol Invest; 2005 Feb;28(2):162-5
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  • [Title] Acromegaly due to a growth hormone-releasing hormone-secreting intracranial gangliocytoma.
  • In more than 95% of cases acromegaly is due to GH hypersecretion by a pituitary adenoma.
  • GHRH hypersecretion accounts for about 0.5% of cases of acromegaly.
  • Intracranial GHRH-secreting tumors are extremely rare and only a few well-documented cases have been reported.
  • The clinical features of acromegaly due to intracranial GHRH-secreting tumor are indistinguishable from those of other patients with "classical acromegaly".
  • In cases of intrasellar gangliocytomas, not even radiological findings help to make the correct diagnosis, which can only be made with the hystological study.
  • We present the case of a woman with acromegaly; the magnetic resonance demonstrated a 2x1.8x1.2 cm mass in the jugum sphenoidalis region, associated with a partial empty sella.
  • Histopathological diagnosis was consistent with gangliocytoma, and immunostaining in the ganglionic cells was positive for GHRH.
  • After surgery, hormone hypersecretion persisted, so medical treatment was reintroduced.
  • In summary, we report a well-documented case of an intracranial GHRH-secreting gangliocytoma, an exceedingly rare cause of acromegaly.
  • Clinical and biochemical data did not allow to make the correct diagnosis, which was only made on the pathological study.
  • This case underscores that acromegaly can be due to causes other than a GH-secreting adenoma, and underlines that finding an image not typical of a pituitary adenoma should raise the suspicion that an unusual cause subsides the acromegaly.
  • [MeSH-major] Acromegaly / etiology. Brain Neoplasms / complications. Brain Neoplasms / secretion. Ganglioneuroma / complications. Ganglioneuroma / secretion. Growth Hormone-Releasing Hormone / secretion. Somatostatin / analogs & derivatives

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  • (PMID = 15887863.001).
  • [ISSN] 0391-4097
  • [Journal-full-title] Journal of endocrinological investigation
  • [ISO-abbreviation] J. Endocrinol. Invest.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Peptides, Cyclic; 0G3DE8943Y / lanreotide; 51110-01-1 / Somatostatin; 9034-39-3 / Growth Hormone-Releasing Hormone
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73. Nasr C, Mason A, Mayberg M, Staugaitis SM, Asa SL: Acromegaly and somatotroph hyperplasia with adenomatous transformation due to pituitary metastasis of a growth hormone-releasing hormone-secreting pulmonary endocrine carcinoma. J Clin Endocrinol Metab; 2006 Dec;91(12):4776-80
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  • [Title] Acromegaly and somatotroph hyperplasia with adenomatous transformation due to pituitary metastasis of a growth hormone-releasing hormone-secreting pulmonary endocrine carcinoma.
  • CONTEXT: GHRH excess from extracranial endocrine tumors is known to cause somatotroph hyperplasia and acromegaly.
  • Hypothalamic gangliocytomas producing GHRH are also known to be associated with pituitary adenomas causing acromegaly.
  • OBJECTIVES: The objective of this study was to describe a case of acromegaly due to a pulmonary GHRH-secreting endocrine carcinoma with metastasis to the pituitary gland and to look at the peculiar histological features of this case.
  • Her disease was clinically stable for 7 yr until she developed bitemporal hemianopia.
  • She had symptoms and signs of acromegaly.
  • Endocrine studies showed elevated serum levels of GH, prolactin, alpha-subunit of glycoprotein hormones, IGF-I, chromogranin A, and GHRH.
  • Postoperatively, she noted an improvement in symptoms of acromegaly.
  • Histological examination confirmed metastatic endocrine carcinoma to the pituitary, and immunohistochemistry localized GHRH to the tumor cells.
  • The adjacent pituitary exhibited somatotroph hyperplasia with abundant reactivity for GH and alpha-subunit.
  • In addition, there was focal neoplastic transformation to a sparsely granulated somatotroph phenotype with fibrous bodies.
  • CONCLUSION: This is the first report of a GHRH-producing endocrine tumor metastasizing to the pituitary and causing local hyperstimulation with somatotroph hyperplasia and adenomatous transformation.
  • [MeSH-major] Acromegaly / complications. Acromegaly / etiology. Adenoma / etiology. Carcinoma / complications. Growth Hormone-Releasing Hormone / secretion. Lung Neoplasms / complications. Paraneoplastic Endocrine Syndromes / complications. Pituitary Neoplasms / secondary. Somatotrophs / pathology

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  • (PMID = 16968791.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Hormones, Ectopic; 0 / Indium Radioisotopes; 9034-39-3 / Growth Hormone-Releasing Hormone
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74. Katznelson L: An update on treatment strategies for acromegaly. Expert Opin Pharmacother; 2008 Sep;9(13):2273-80
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] An update on treatment strategies for acromegaly.
  • BACKGROUND: Acromegaly is an insidious disease due to growth hormone (GH) hypersecretion from a pituitary adenoma, and is associated with multiple comorbidities and risk of premature mortality.
  • OBJECTIVES: To review the therapeutic goals and options for acromegaly.
  • The GH receptor antagonist is also used and may be considered in addition to the somatostatin analogs, or as second line therapy.
  • [MeSH-major] Acromegaly / drug therapy. Acromegaly / surgery. Receptors, Somatotropin / antagonists & inhibitors. Somatostatin / analogs & derivatives. Somatostatin / therapeutic use

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  • (PMID = 18710352.001).
  • [ISSN] 1744-7666
  • [Journal-full-title] Expert opinion on pharmacotherapy
  • [ISO-abbreviation] Expert Opin Pharmacother
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Receptors, Somatotropin; 51110-01-1 / Somatostatin
  • [Number-of-references] 58
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75. 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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76. 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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77. Metzler M, Luedecke DK, Saeger W, Grueters A, Haberl H, Kiess W, Repp R, Rascher W, Doetsch J: Low prevalence of Gs alpha mutations in śomatotroph adenomas of children and adolescents. Cancer Genet Cytogenet; 2006 Apr 15;166(2):146-51

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  • [Title] Low prevalence of Gs alpha mutations in śomatotroph adenomas of children and adolescents.
  • Mutations in the gene coding for the alpha-subunit of the heterotrimeric stimulatory G protein Gs are the most frequently identified molecular events in the development of somatotroph adenomas in adults.
  • In children and adolescents, somatotroph adenomas are rare, and only two cases with the Gs alpha mutation have been reported so far.
  • In this study, we therefore investigated the prevalence of activating Gs alpha mutations in 17 patients younger than 20 years with pituitary growth hormone-secreting adenomas and examined the characteristics of mutation-positive cases.
  • Interestingly, in contrast to the remaining cases, the adenomas positive for the Gs alpha mutation proved to be nonsporadic, but part of a syndrome associated with endocrine tumors in both individuals.
  • In contrast to the findings in adult cases, somatotroph adenomas in young patients seem to carry somatic Gs alpha mutations at a lower frequency, and germ-line or early postzygotic mutational events may be responsible for the shortened latency of tumorigenesis.
  • [MeSH-major] GTP-Binding Protein alpha Subunits, Gs / genetics. Growth Hormone-Secreting Pituitary Adenoma / genetics. Mutation / genetics

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  • (PMID = 16631471.001).
  • [ISSN] 0165-4608
  • [Journal-full-title] Cancer genetics and cytogenetics
  • [ISO-abbreviation] Cancer Genet. Cytogenet.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] EC 3.6.5.1 / GTP-Binding Protein alpha Subunits, Gs
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78. 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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79. Daly AF, Tichomirowa MA, Beckers A: Update on familial pituitary tumors: from multiple endocrine neoplasia type 1 to familial isolated pituitary adenoma. Horm Res; 2009 Jan;71 Suppl 1:105-11
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  • [Title] Update on familial pituitary tumors: from multiple endocrine neoplasia type 1 to familial isolated pituitary adenoma.
  • BACKGROUND: Pituitary adenomas occur in a familial setting in about 5% of all cases and over half of these are due to multiple endocrine neoplasia type 1 (MEN1) and Carney complex (CNC).
  • Since the late 1990s, we have described non-MEN1/CNC familial pituitary tumors that include all tumor phenotypes and have named this condition '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 tumors at diagnosis.
  • CONCLUSIONS: Clinically relevant pituitary adenomas are more common than previously thought and occur in a familial setting in about 5% of cases overall.
  • Therefore, specific questioning regarding family history of pituitary disease should be part of the workup of all patients with pituitary adenomas, not just those with acromegaly.
  • FIPA is a useful clinical framework to study the features of pituitary adenomas that occur in a familial setting since it encompasses all tumor phenotypes and heterogeneous/homogeneous expression among affected family members.
  • [MeSH-major] Adenoma / etiology. Multiple Endocrine Neoplasia Type 1 / complications. Pituitary Neoplasms / etiology


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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  • [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. Mohammed S, Cusimano MD, Scheithauer BW, Rotondo F, Horvath E, Kovacs K: O-methylguanine-DNA methyltransferase immunoexpression in a double pituitary adenoma: case report. Neurosurgery; 2010 Feb;66(2):E421-2; discussion E422
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  • [Title] O-methylguanine-DNA methyltransferase immunoexpression in a double pituitary adenoma: case report.
  • OBJECTIVE: Double pituitary adenomas in surgical cases are rarely reported.
  • We present a treatment dilemma of a double adenoma that had differential O-methylguanine-DNA methyltransferase (MGMT) reactivity.
  • CLINICAL PRESENTATION: A 48-year-old man presented with acromegaly and a recurrent pituitary adenoma.
  • He had elevated growth hormone (GH) and elevated insulin-like growth factor blood levels and hyperprolactinemia.
  • Morphologic examination disclosed 2 histologically distinct tumors, including a GH adenoma and a prolactin adenoma.
  • Of significant note was MGMT immunopositivity in the GH adenoma and lack of staining in the prolactin adenoma.
  • CONCLUSION: This is the first clinical instance in which MGMT was assessed in double adenomas of the pituitary.
  • The adenomas underwent recurrence, a feature that reflects their invasive nature and the possibility that chemotherapeutic intervention may be required in the future.
  • Response to temozolomide use is anticipated with respect to the prolactin adenoma but would likely not benefit the GH cell adenoma of our patient.
  • [MeSH-major] Adenoma / enzymology. DNA Modification Methylases / metabolism. DNA Repair Enzymes / metabolism. Pituitary Neoplasms / enzymology. Tumor Suppressor Proteins / metabolism
  • [MeSH-minor] Growth Hormone / blood. Humans. Hyperprolactinemia / etiology. Insulin-Like Growth Factor Binding Proteins / blood. Ki-67 Antigen / metabolism. Male. Middle Aged

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  • (PMID = 20087113.001).
  • [ISSN] 1524-4040
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Insulin-Like Growth Factor Binding Proteins; 0 / Ki-67 Antigen; 0 / Tumor Suppressor Proteins; 9002-72-6 / Growth Hormone; EC 2.1.1.- / DNA Modification Methylases; EC 2.1.1.63 / MGMT protein, human; EC 6.5.1.- / DNA Repair Enzymes
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82. 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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83. 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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  • [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

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  • (PMID = 18590441.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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84. Mondok A, Tóth M, Patócs A, Szücs N, Igaz P, Pusztai P, Czirják S, Beko G, Gláz E, Rácz K, Tulassay Z: [Outcome of somatostatin analogue treatment in acromegaly]. Orv Hetil; 2009 Aug 2;150(31):1457-62
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  • [Title] [Outcome of somatostatin analogue treatment in acromegaly].
  • During the past decade the importance of medical therapy, especially treatment with somatostatin analogues has increased significantly in patients with active acromegaly.
  • PATIENTS AND METHODS: Changes in serum growth hormone (GH) and insulin-like growth factor-1 (IGF-1) concentration, as well as morphologic changes of pituitary adenomas followed by MRI scans were evaluated and compared in 32 acromegalic patients (26 women, 6 men) during long-term somatostatin analogue treatment (mean+/-SE, 3.1+/-0.3 years, range, 1-7 years).
  • Primary somatostatin analogue treatment was applied in 10 patients (7 women and 3 men), whereas 15 patients (14 women and 1 man) had pituitary surgery and 7 patients (5 women and 2 men) underwent both pituitary surgery and irradiation therapy prior to somatostatin analogue treatment.
  • RESULTS: After a 3-month treatment with somatostatin analogues, both serum GH and IGF-1 levels decreased significantly and they remained around the same decreased levels throughout the treatment period.
  • Serum GH decreased from 15.7+/-4.9 to 5.5+/-1.4 ng/ml, and serum IGF-1, expressed as a percentage of the upper limit of age- and sex-adjusted reference value, decreased from 204+/-14% to 135+/-12% at the end of treatment.
  • At the end of treatment 36.7% of patients had safe serum GH (<2.5 ng/ml), while serum IGF-1 returned below the upper limit of age- and sex-adjusted reference range in 41.4% of patients.
  • Pituitary MRI showed regression of the adenoma in 46% of patients, and none of the patients had progression of the pituitary adenoma.
  • CONCLUSIONS: Somatostatin analogues are effective therapeutic options for acromegalic patients when primary surgical treatment cannot be performed due to complications and associated disorders, or in patients whose acromegaly remains active after pituitary surgery or after pituitary surgery and irradiation.
  • [MeSH-major] Acromegaly / drug therapy. Acromegaly / etiology. Adenoma / complications. Adenoma / therapy. Pituitary Neoplasms / complications. Pituitary Neoplasms / therapy. Somatostatin / analogs & derivatives. Somatostatin / therapeutic use
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biomarkers, Tumor / blood. Female. Human Growth Hormone / blood. Humans. Hypophysectomy. Insulin-Like Growth Factor I / metabolism. Magnetic Resonance Imaging. Male. Middle Aged. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 19617182.001).
  • [ISSN] 0030-6002
  • [Journal-full-title] Orvosi hetilap
  • [ISO-abbreviation] Orv Hetil
  • [Language] hun
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Hungary
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 12629-01-5 / Human Growth Hormone; 51110-01-1 / Somatostatin; 67763-96-6 / Insulin-Like Growth Factor I
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85. 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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86. Pollock BE: Radiosurgery for pituitary adenomas. Prog Neurol Surg; 2007;20:164-71
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  • [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

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  • (PMID = 17317984.001).
  • [ISSN] 0079-6492
  • [Journal-full-title] Progress in neurological surgery
  • [ISO-abbreviation] Prog Neurol Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I
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87. Trepp R, Stettler C, Zwahlen M, Seiler R, Diem P, Christ ER: Treatment outcomes and mortality of 94 patients with acromegaly. Acta Neurochir (Wien); 2005 Mar;147(3):243-51; discussion 250-1
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  • [Title] Treatment outcomes and mortality of 94 patients with acromegaly.
  • BACKGROUND: Due to new therapeutic modalities and modified therapeutic goals outcome of patients with acromegaly may change over time and differ by centre.
  • We analysed treatment outcomes and mortality of our patients with acromegaly seen between 1971 and 2003.
  • Remission criteria were a normalized IGF-I concentration, a nadir GH level during oral glucose load of <1.0 microg/l and a random GH value of <2.5 microg/l.
  • FINDINGS: Transsphenoidal surgery achieved remission in 80% of patients with micro-adenomas (<1 cm), 65% with meso-adenomas (> or = 1 cm to <2 cm) and 27% with macro-adenomas (> or = 2 cm).
  • Patients with meso-adenomas operated on after 1995 tended to have a better outcome compared to those operated on before 1995 (Remission in 83% vs. 38%).
  • Radiotherapy resulted in disease control in 22 of 47 patients (47%).
  • Intramuscular depot formulation of octreotide (Sandostatin LAR) led to disease control in 17 of 26 patients (65%).
  • After multimodal therapy persistent acromegalic activity remained in 18% of the patients; only one of them had an adenoma of <2 cm.
  • CONCLUSIONS. Most patients with adenomas of <2 cm can be expected to achieve remission by transsphenoidal surgery alone.
  • Furthermore, virtually all patients with adenomas of <2 cm and more than 80% of patients with adenomas of > or = 2 cm can be expected to achieve remission by adjuvant treatment.
  • Aggressive multimodal therapy is critical in the management of acromegaly reducing mortality risk close to that of the general population.
  • [MeSH-major] Acromegaly / mortality. Acromegaly / therapy. Adenoma / mortality. Adenoma / therapy. Pituitary Gland / surgery. Pituitary Neoplasms / mortality. Pituitary Neoplasms / therapy
  • [MeSH-minor] Adult. Age Factors. Aged. Aged, 80 and over. Antineoplastic Agents, Hormonal / therapeutic use. Cohort Studies. Drug Therapy / statistics & numerical data. Drug Therapy / trends. Female. Growth Hormone / blood. Growth Hormone / secretion. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / epidemiology. Neurosurgical Procedures / statistics & numerical data. Neurosurgical Procedures / trends. Octreotide / therapeutic use. Radiotherapy / statistics & numerical data. Radiotherapy / trends. Remission Induction. Retrospective Studies. Sex Factors. Survival Rate. Treatment Outcome

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  • (PMID = 15627919.001).
  • [ISSN] 0001-6268
  • [Journal-full-title] Acta neurochirurgica
  • [ISO-abbreviation] Acta Neurochir (Wien)
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Austria
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 9002-72-6 / Growth Hormone; RWM8CCW8GP / Octreotide
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88. Saussez S, Mahillon V, Chantrain G, Thill MP, Lequeux T: Acromegaly presented as a cause of laryngeal dyspnea. Auris Nasus Larynx; 2007 Dec;34(4):541-3
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  • [Title] Acromegaly presented as a cause of laryngeal dyspnea.
  • Finally, blood tests and cerebral MRI revealed an acromegaly.
  • The patient underwent a trans-sphenoidal resection of the pituitary adenoma.
  • Vocal cord fixation is probably due to hypopharyngeal and laryngeal soft tissue swelling and can be reversible after successful treatment of the adenoma.
  • [MeSH-major] Acromegaly / complications. Airway Obstruction / etiology. Dyspnea / etiology. Laryngeal Diseases / etiology. Vocal Cord Paralysis / etiology
  • [MeSH-minor] Diagnosis, Differential. Growth Hormone-Secreting Pituitary Adenoma / complications. Growth Hormone-Secreting Pituitary Adenoma / diagnosis. Growth Hormone-Secreting Pituitary Adenoma / surgery. Humans. Hypophysectomy. Laryngoscopy. Male. Middle Aged. Pituitary Neoplasms / complications. Pituitary Neoplasms / diagnosis. Pituitary Neoplasms / surgery. Tomography, X-Ray Computed


89. Manavela MP, Juri A, Danilowicz K, Bruno OD: [Therapeutic management in 154 acromegalic patients]. Medicina (B Aires); 2010;70(4):328-32

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • 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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90. 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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91. Foppiani L, Del Monte P, Ruelle A, Marugo A, Bernasconi D: [Acromegaly: multifaceted clinical presentation of a rare disease of the elderly. Report of two cases with long-term follow-up]. Recenti Prog Med; 2006 Apr;97(4):200-4
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  • [Title] [Acromegaly: multifaceted clinical presentation of a rare disease of the elderly. Report of two cases with long-term follow-up].
  • We report two cases of acromegaly in elderly patients.
  • Both patients had markedly invasive GH-secreting macroadenomas, which caused hugely increased circulating GH levels (over 90 ng/ml).
  • The first patient, 79 year-old, presented with goitre and severe osteoarthrosis, refused surgery and was treated with various somatostatin analogues (ultimately accompanied by cabergoline), without satisfactory control of the disease.
  • However, two transphenoidal operations, radiotherapy and long-term somatostatin agonist therapy were required to control GH hypersecretion satisfactorily.
  • The authors wish to underline that acromegaly is a rare but not negligible disorder in the elderly, which can affect the whole body functions and cause severe morbidities.
  • The prompt discovery (usually through a simple clinical evaluation) of this disease in the elderly, confirmed by hormonal and morphological evaluation, together with a multidisciplinary (medical, surgical, radiotherapeutic) approach can improve their quality of life and increase life expectancy.
  • [MeSH-major] Acromegaly / etiology. Adenoma / complications. Pituitary Neoplasms / complications

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  • (PMID = 16729489.001).
  • [ISSN] 0034-1193
  • [Journal-full-title] Recenti progressi in medicina
  • [ISO-abbreviation] Recenti Prog Med
  • [Language] ita
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 51110-01-1 / Somatostatin
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92. Roberts BK, Ouyang DL, Lad SP, Chang SD, Harsh GR 4th, Adler JR Jr, Soltys SG, Gibbs IC, Remedios L, Katznelson L: Efficacy and safety of CyberKnife radiosurgery for acromegaly. Pituitary; 2007;10(1):19-25
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Efficacy and safety of CyberKnife radiosurgery for acromegaly.
  • OBJECTIVE: Acromegaly is a disease characterized by GH hypersecretion, and is typically caused by a pituitary somatotroph adenoma.
  • The primary mode of therapy is surgery, and radiotherapy is utilized as an adjuvant strategy to treat persistent disease.
  • The aim of this study was to determine the efficacy and tolerability of CyberKnife stereotactic radiosurgery in acromegaly.
  • DESIGN: A retrospective review of biochemical and imaging data for subjects with acromegaly treated with CyberKnife stereotactic radiosurgery between 1998 and 2005 at Stanford University Hospital.
  • PATIENTS: Nine patients with active acromegaly were treated with radiosurgery using the CyberKnife (CK).
  • MEASUREMENTS: Biochemical response based on serum insulin-like growth factor-1 (IGF-1), anterior pituitary hormone function, and tumor size with MRI scans were analyzed.
  • Smaller tumor size was predictive of treatment success: baseline tumor volume was 1.28 cc (+/- 0.81, SD) vs. 3.93 cc (+/- 1.54) in subjects with a normal IGF-1 vs. those with persistent, active disease, respectively (P = 0.02).
  • The mean biologically effective dose (BED) was higher in subjects who achieved a normal IGF-1 vs. those with persistent, active disease, 172 Gy(3) (+/-28) vs. 94 Gy(3) (+/-17), respectively (P < 0.01).
  • At least one new anterior pituitary hormone deficiency was observed after CK in 3 (33%) patients: two developed hypogonadism, and one developed panhypopituitarism.
  • CONCLUSIONS: CK radiosurgery may be a valuable adjuvant therapy for the management of acromegaly.
  • [MeSH-major] Acromegaly / surgery. Growth Hormone-Secreting Pituitary Adenoma / surgery. Radiosurgery
  • [MeSH-minor] Adult. Female. Humans. Insulin-Like Growth Factor I / analysis. Magnetic Resonance Imaging. Male. Middle Aged. Retrospective Studies

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  • [ErratumIn] Pituitary. 2007;10(1):17. Remedios, Lynn [added]
  • [ErratumIn] Pituitary. 2007 Mar;10(1):17 [27519534.001]
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  • (PMID = 17273921.001).
  • [ISSN] 1386-341X
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 67763-96-6 / Insulin-Like Growth Factor I
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93. Goto J, Otsuka F, Inagaki K, Tsukamoto N, Suzuki J, Miyoshi T, Ogura T, Kamada Y, Makino H: Effects of growth hormone reduction in a patient with polycystic ovary syndrome complicated with acromegaly. Endocr J; 2009;56(1):157-60
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  • [Title] Effects of growth hormone reduction in a patient with polycystic ovary syndrome complicated with acromegaly.
  • We report a rare case of polycystic ovary syndrome (PCOS) complicated with acromegaly due to a growth hormone (GH)-producing pituitary adenoma.
  • Complete removal of the pituitary adenoma successfully reduced circulating levels of GH and insulin-like growth factor (IGF)-1, which, in turn, resulted in the amelioration of gonadal dysfunction, hyperandrogenism, lutenizing hormone hypersecretion, and severe insulin resistance.
  • This clinical complication suggests that activation of systemic GH-IGF-1 axis is potentially involved in the development of PCOS.
  • [MeSH-major] Acromegaly / complications. Adenoma / surgery. Growth Hormone / blood. Growth Hormone-Secreting Pituitary Adenoma / surgery. Polycystic Ovary Syndrome / complications

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  • (PMID = 18840925.001).
  • [ISSN] 1348-4540
  • [Journal-full-title] Endocrine journal
  • [ISO-abbreviation] Endocr. J.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 9002-72-6 / Growth Hormone
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94. 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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95. 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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96. Daems T, Verhelst J, Michotte A, Abrams P, De Ridder D, Abs R: Modification of hormonal secretion in clinically silent pituitary adenomas. Pituitary; 2009;12(1):80-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Modification of hormonal secretion in clinically silent pituitary adenomas.
  • BACKGROUND: Silent pituitary adenomas are a subtype of adenomas characterized by positive immunoreactivity for one or more hormones classically secreted by normal pituitary cells but without clinical expression, although in some occasions enhanced or changed secretory activity can develop over time.
  • Silent corticotroph adenomas are the classical example of this phenomenon.
  • PATIENTS AND METHODS: A series of about 500 pituitary adenomas seen over a period of 20 years were screened for modification in hormonal secretion.
  • RESULTS: Two cases were retrieved, one silent somatotroph adenoma and one thyrotroph adenoma, both without specific clinical features or biochemical abnormalities, which presented 20 years after initial surgery with evidence of acromegaly and hyperthyroidism, respectively.
  • While the acromegaly was controlled by a combination of somatostatin analogs and growth hormone (GH) receptor antagonist therapy, neurosurgery was necessary to manage the thyrotroph adenoma.
  • Immunohistochemical examination demonstrated an increase in the number of thyroid stimulating hormone (TSH)-immunoreactive cells compared to the first tissue.
  • Apparently, the mechanisms responsible for the secretory modifications are different, being a change in secretory capacity in the silent somatotroph adenoma and a quantitative change in the silent thyrotroph adenoma.
  • CONCLUSIONS: These two cases, one somatotroph and one thyrotroph adenoma, are an illustration that clinically silent pituitary adenomas may in rare circumstances evolve over time and become active, as previously demonstrated in silent corticotroph adenomas.
  • [MeSH-major] Pituitary Neoplasms / metabolism
  • [MeSH-minor] Acromegaly / drug therapy. Acromegaly / metabolism. Acromegaly / surgery. Adult. Human Growth Hormone / secretion. Humans. Immunohistochemistry. Insulin-Like Growth Factor I / secretion. Male. Thyrotropin / secretion

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  • (PMID = 18350381.001).
  • [ISSN] 1573-7403
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I; 9002-71-5 / Thyrotropin
  • [Number-of-references] 30
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97. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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98. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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99. 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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100. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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