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Items 1 to 62 of about 62
1. Tateno T, Izumiyama H, Doi M, Akashi T, Ohno K, Hirata Y: Defective expression of prohormone convertase 1/3 in silent corticotroph adenoma. Endocr J; 2007 Dec;54(5):777-82
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  • Silent corticotroph adenoma (SCA) is defined as an ACTH-producing pituitary tumor not associated with clinical and endocrine feartures of Cushing's syndrome, but its underlying molecular mechanism(s) remains unknown thus far.
  • We tested the hypothesis that reduced expression of prohormone convertase (PC) 1/3 responsible for proteolytic processing of proopiomelanocortin (POMC) in SCA may lead to production of unprocessed, biologically inactive POMC and/or precursor of ACTH.
  • Among 30 non-functioning pituitary macroadenomas (NFA) examined, we found 6 SCAs by immunohistochemical study using anti-ACTH antibody.
  • Our data suggest that defective PC1/3 expression may lead to preferential production of unprocessed, biologically inactive ACTH variants in SCA.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / genetics. Adenoma / genetics. Proprotein Convertase 1 / genetics

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  • (PMID = 17917309.001).
  • [ISSN] 1348-4540
  • [Journal-full-title] Endocrine journal
  • [ISO-abbreviation] Endocr. J.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Protein Isoforms; 66796-54-1 / Pro-Opiomelanocortin; 9002-60-2 / Adrenocorticotropic Hormone; EC 3.4.21.93 / Proprotein Convertase 1
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2. Vik-Mo EO, Øksnes M, Pedersen PH, Wentzel-Larsen T, Rødahl E, Thorsen F, Schreiner T, Aanderud S, Lund-Johansen M: Gamma knife stereotactic radiosurgery of Nelson syndrome. Eur J Endocrinol; 2009 Feb;160(2):143-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • OBJECTIVE: Gamma knife radiosurgery (GKR) can be used as primary or adjuvant therapy for the treatment of an ACTH-producing pituitary tumor after bilateral adrenalectomy, called Nelson syndrome (NS).
  • We have examined the effect of GKR on tumor growth and ACTH-hypersecretion, and characterized the adverse events of this treatment in patients with NS.
  • RESULTS: Tumor growth was stopped in all patients.
  • The ACTH levels declined in eight patients, and normalized in one patient.
  • There was a significant drop in ACTH levels, with a half-time of 2.8 years.
  • The substitution therapy of three pituitary axes present at GKR treatment could be stopped during the same period.
  • As the radiation level was below 1Gy to this area, it is unlikely that the GKR treatment itself induced the malignant tumor.

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  • (PMID = 18996962.001).
  • [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] 9002-60-2 / Adrenocorticotropic Hormone
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3. Kuo SF, Chen JY, Chuang WY, Jung SM, Chang YC, Lin JD: Concurrent papillary thyroid cancer with pituitary ACTH-secreting tumor. J Formos Med Assoc; 2007 Apr;106(4):330-5
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  • [Title] Concurrent papillary thyroid cancer with pituitary ACTH-secreting tumor.
  • Concomitant thyroid cancer with pituitary tumor is uncommon.
  • This study reports a case of advanced papillary thyroid carcinoma with pituitary adrenocorticotropic hormone (ACTH)-secreting tumor.
  • A 58-year-old male patient had thyroid cancer in 1991 and presented with headache caused by pituitary tumor with apoplexy in 1993.
  • During follow-up for thyroid cancer, (201)thallium scan proved to be an effective tool for detecting metastatic thyroid cancer in the patient without pituitary TSH reserve.
  • Pituitary ACTH-secreting tumor was confirmed in 2001 based on the high serum ACTH level and positive immunohistochemical stain for ACTH.
  • Moreover, serum ACTH levels were 337 and 232 pg/mL with normal serum cortisol and urine-free cortisol.


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4. Hashiba T, Saitoh Y, Asanuma N, Kouhara H, Maruo T, Fujinaka T, Kasayama S, Yoshimine T: Reduction of a pancreatic tumor after total removal of an ACTH secreting pituitary tumor: differential diagnosis of Cushing's syndrome. Endocr J; 2006 Apr;53(2):203-8
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  • [Title] Reduction of a pancreatic tumor after total removal of an ACTH secreting pituitary tumor: differential diagnosis of Cushing's syndrome.
  • Endocrinologic tests sometimes fail to distinguish adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma from ectopic ACTH-secreting tumor.
  • The authors experienced a case of Cushing's disease associated with a pancreatic tumor.
  • A 54-year-old woman presented with Cushing's syndrome and pancreatic tumor.
  • Magnetic resonance imaging (MRI) failed to reveal a pituitary tumor, but a gadolinium-enhanced tumor with cystic components was seen in the pancreatic tail.
  • Results of conventional endocrinologic tests suggested ectopic ACTH syndrome, but venous sampling including cavernous sinus sampling indicated an ACTH-secreting pituitary adenoma.
  • Transsphenoidal surgery revealed a pituitary microadenoma, and total removal of the tumor was achieved.
  • Postoperative abdominal MRI revealed that the pancreatic tumor diminished gradually without treatment.
  • Selective cavernous sinus sampling was useful for distinguishing ACTH-secreting pituitary adenoma from ectopic ACTH syndrome in this complex case.
  • This was a rare case in which the pancreatic tumor diminished after total removal of the ACTH-secreting pituitary adenoma.
  • [MeSH-major] Adrenocorticotropic Hormone / secretion. Cushing Syndrome / diagnosis. Pancreatic Neoplasms / complications. Pituitary Neoplasms / secretion
  • [MeSH-minor] ACTH Syndrome, Ectopic / diagnosis. Adenoma / secretion. Adenoma / surgery. Diagnosis, Differential. Female. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Middle Aged. Pituitary ACTH Hypersecretion / diagnosis. Positron-Emission Tomography


5. Czepielewski MA, Colli M, Harlos T, Silveiro SP, Maraschin J, Copette F, Leitão CB, Rollin GA: [Octreotide + bilateral adrenalectomy in the management of ACTH-producing carcinoid tumors]. Arq Bras Endocrinol Metabol; 2005 Oct;49(5):791-6
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  • [Title] [Octreotide + bilateral adrenalectomy in the management of ACTH-producing carcinoid tumors].
  • [Transliterated title] Octreotide-LAR + adrenalectomia bilateral no manejo de tumores carcinóides produtores de ACTH.
  • Cushing's syndrome (CS) due to ectopic ACTH secretion has a high morbidity and mortality.
  • Carcinoid tumors associated with ectopic ACTH (CTu-ACTH) syndrome represent a more severe clinical picture, due to the carcinoid symptoms that worsen the hypercortisolism state.
  • Management of patients with CTu-ACTH should include the control of hypercortisolism, as well as the carcinoid disturbance.
  • We report 3 patients (2F, 1M) with CTu-ACTH (2 pancreatic, 1 occult) who presented with clinical manifestations of CS (n= 3) and carcinoid syndrome (2): 2 were initially investigated for CS and 1 carcinoid syndrome.
  • In all hypokalemia, hypertension and diabetes mellitus were associated with severe hypercortisolism and high ACTH levels.
  • Administration of octreotide-LAR reduced ACTH levels from 230,000 to 30,000 pg/ml in patient 1, and controlled symptoms of carcinoid syndrome and neoplasic lesions in patient 2; treatment with subcutaneous octreotide in patient 3 controlled carcinoid syndrome and partially reduced symptoms of hypercortisolism.
  • Our data show that combined anti-neoplastic therapy may contribute to the stabilization and/or definitive control of CTu-ACTH.
  • [MeSH-major] Adrenocorticotropic Hormone / secretion. Antineoplastic Agents, Hormonal / therapeutic use. Carcinoid Tumor / therapy. Neoplasm Proteins / secretion. Octreotide / therapeutic use. Pituitary Neoplasms / therapy

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  • (PMID = 16444362.001).
  • [ISSN] 0004-2730
  • [Journal-full-title] Arquivos brasileiros de endocrinologia e metabologia
  • [ISO-abbreviation] Arq Bras Endocrinol Metabol
  • [Language] por
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Brazil
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Neoplasm Proteins; 9002-60-2 / Adrenocorticotropic Hormone; RWM8CCW8GP / Octreotide
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6. Bush ZM, Lopes MB, Hussaini IM, Jane JA Jr, Laws ER Jr, Vance ML: Immunohistochemistry of COUP-TFI: an adjuvant diagnostic tool for the identification of corticotroph microadenomas. Pituitary; 2010;13(1):1-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Cushing's disease is caused by an ACTH-producing pituitary tumor, and accounts for 10-15% of pituitary tumors.
  • The majority of corticotroph tumors are microadenomas (<10 mm), and accurate histologic identification of these tumors can be challenging because of their small size and the presence of nests of normal corticotroph cells in the anterior pituitary.
  • Retinoic acid has been shown to inhibit ACTH production and induce apoptosis in corticotroph tumor cells.
  • The expression of the orphan nuclear receptor COUP-TFI antagonizes retinoic acid signaling and has been shown to be expressed in normal corticotroph cells, but absent in corticotroph tumor cell lines.
  • We analyzed 34 corticotroph tumor specimens by immunohistochemistry using a goat polyclonal IgG antibody with epitope mapping to the N-terminus of human COUP-TFI.
  • Segments of normal pituitary in each of the 34 specimens demonstrate COUP-TFI immunoreactivity in normal corticotroph cells.
  • Twenty-nine of 34 ACTH producing tumors were immunonegative for COUP-TFI.
  • Immunohistochemistry of COUP-TFI may be a useful adjuvant diagnostic tool in distinguishing corticotroph microadenomas from nests of normal corticotroph cells in the anterior pituitary.
  • Furthermore, this study identifies two unique corticotroph tumor populations which differ in their expression of COUP-TFI, the presence of which occurs more frequently in macroadenomas.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / diagnosis. Adenoma / diagnosis. COUP Transcription Factor I / analysis

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  • (PMID = 19526345.001).
  • [ISSN] 1573-7403
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Grant] United States / NIDDK NIH HHS / DK / 1-T32-DK-07646; United States / NIDDK NIH HHS / DK / T32 DK007646; United States / NCRR NIH HHS / RR / M01RR000847; United States / NIDDK NIH HHS / DK / 1-F32-DK082159-01; United States / NINDS NIH HHS / NS / 5R01NS035122-10
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / COUP Transcription Factor I
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7. Pimentel-Filho FR, Silva ME, Nogueira KC, Berger K, Cukiert A, Liberman B: Pituitary-adrenal dynamics after ACTH-secreting pituitary tumor resection in patients receiving no steroids post-operatively. J Endocrinol Invest; 2005 Jun;28(6):502-8
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  • [Title] Pituitary-adrenal dynamics after ACTH-secreting pituitary tumor resection in patients receiving no steroids post-operatively.
  • We compared the dynamics of ACTH and cortisol from a group of CD patients (cured and not cured), receiving no steroids post-operatively, with a control group of acromegalic patients who presented normal hypothalamic-pituitary-adrenal (HPA) axis.
  • Blood samples for ACTH and cortisol determination were obtained immediately before, at the end of surgery and at 4, 8, 12, 16, 24, 48 and 72 h after surgery, in 8 cured CD patients (Group I), 9 not cured CD patients (Group II) and in 7 subjects with acromegaly (Group III) who presented normal HPA axis (control group).
  • The mean ACTH level in Group I was significantly lower than in Group III from 4 to 12 h and lower than in Group II from 8 to 12 h post-operatively.
  • [MeSH-major] Adrenal Glands / physiopathology. Adrenocorticotropic Hormone / secretion. Glucocorticoids / administration & dosage. Pituitary Gland / physiopathology. Pituitary Neoplasms / secretion. Pituitary Neoplasms / surgery
  • [MeSH-minor] Adenoma / physiopathology. Adenoma / secretion. Adenoma / surgery. Adrenal Insufficiency / drug therapy. Adrenal Insufficiency / etiology. Adult. Female. Humans. Hydrocortisone / blood. Male. Pituitary ACTH Hypersecretion / physiopathology. Pituitary ACTH Hypersecretion / surgery. Postoperative Care. Postoperative Complications. Time Factors

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  • (PMID = 16117190.001).
  • [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 / Glucocorticoids; 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone
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8. Illouz F, Dubois-Ginouves S, Laboureau S, Rohmer V, Rodien P: [Use of cabergoline in persisting Cushing's disease]. Ann Endocrinol (Paris); 2006 Sep;67(4):353-6
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  • [Transliterated title] Utilisation de la cabergoline dans la maladie de Cushing non contrôlée.
  • Cabergoline is a dopaminergic agonist with demonstrated efficiency of for the treatment of prolactin-secreting pituitary tumors.
  • We describe the use of cabergoline in three patients with Cushing's disease, one of them presenting a silent ACTH-secreting pituitary tumor.
  • We describe a decrease or a normalization in hypercortisolism; for one of the subjects, tumor growth seemed to be stopped.
  • While cabergoline can induce a suppression of cortisol secretion or a corticotroph tumor shrinkage, the sites of action remain unclear.
  • [MeSH-major] Adrenocortical Hyperfunction / drug therapy. Ergolines / therapeutic use. Pituitary ACTH Hypersecretion / diagnosis

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  • (PMID = 17072242.001).
  • [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 / Dopamine Agonists; 0 / Ergolines; LL60K9J05T / cabergoline; WI4X0X7BPJ / Hydrocortisone
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9. Liu JK, Fleseriu M, Delashaw JB Jr, Ciric IS, Couldwell WT: Treatment options for Cushing disease after unsuccessful transsphenoidal surgery. Neurosurg Focus; 2007;23(3):E8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Cushing disease is considered an aggressive pituitary endocrinopathy because of the devastating effects from untreated hypercortisolemia.
  • Although they are histologically benign, these adrenocorticotropic hormone (ACTH)-secreting pituitary tumors are associated with significant morbidity and premature death.
  • Currently, transsphenoidal surgery is the primary treatment of Cushing disease associated with an ACTH-secreting pituitary tumor, resulting in remission rates ranging from about 50 to 90%.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / surgery. Adenoma / surgery. Pituitary ACTH Hypersecretion / therapy

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  • (PMID = 17961031.001).
  • [ISSN] 1092-0684
  • [Journal-full-title] Neurosurgical focus
  • [ISO-abbreviation] Neurosurg Focus
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 67
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10. Castillo V, Giacomini D, Páez-Pereda M, Stalla J, Labeur M, Theodoropoulou M, Holsboer F, Grossman AB, Stalla GK, Arzt E: Retinoic acid as a novel medical therapy for Cushing's disease in dogs. Endocrinology; 2006 Sep;147(9):4438-44
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  • Cushing's disease is almost always caused by an ACTH-secreting pituitary tumor, but effective medical therapy is currently limited.
  • Clinical signs, plasma ACTH and alpha-MSH, the cortisol/creatinine urine ratio, and pituitary magnetic resonance imaging were assessed and compared at different time points.
  • We recorded a significant reduction in plasma ACTH and alpha-MSH, and also in the cortisol/creatinine urine ratio, of the dogs treated with retinoic acid.
  • Pituitary adenoma size was also significantly reduced at the end of retinoic acid treatment.
  • Retinoic acid treatment controls ACTH and cortisol hyperactivity and tumor size in dogs with ACTH-secreting tumors, leading to resolution of the clinical phenotype.
  • This study highlights the possibility of using retinoic acid as a novel therapy in the treatment of ACTH-secreting tumors in humans with Cushing's disease.
  • [MeSH-major] Dog Diseases / drug therapy. Pituitary ACTH Hypersecretion / veterinary. Tretinoin / therapeutic use
  • [MeSH-minor] Adenoma / pathology. Adrenocorticotropic Hormone / blood. Animals. Body Weight. Creatinine / urine. Dogs. Female. Hydrocortisone / urine. Ketoconazole / therapeutic use. Magnetic Resonance Imaging / veterinary. Male. Pituitary Gland / pathology. Pituitary Neoplasms / pathology. Survival Rate. alpha-MSH / blood

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  • (PMID = 16740975.001).
  • [ISSN] 0013-7227
  • [Journal-full-title] Endocrinology
  • [ISO-abbreviation] Endocrinology
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 5688UTC01R / Tretinoin; 581-05-5 / alpha-MSH; 9002-60-2 / Adrenocorticotropic Hormone; AYI8EX34EU / Creatinine; R9400W927I / Ketoconazole; WI4X0X7BPJ / Hydrocortisone
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11. Amaral FC, Torres N, Saggioro F, Neder L, Machado HR, Silva WA Jr, Moreira AC, Castro M: MicroRNAs differentially expressed in ACTH-secreting pituitary tumors. J Clin Endocrinol Metab; 2009 Jan;94(1):320-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] MicroRNAs differentially expressed in ACTH-secreting pituitary tumors.
  • OBJECTIVE: The aim of the study was to analyze the differential expression of let-7a, miR-15a, miR-16, miR-21, miR-141, miR-143, miR-145, and miR-150 in corticotropinomas and normal pituitary tissue and verify whether their profile of expression correlates with tumor size or remission after treatment.
  • MATERIAL AND METHODS: ACTH-secreting pituitary tumor samples were obtained during transphenoidal surgery from patients with Cushing disease and normal pituitary tissues from autopsies.
  • RESULTS: We found underexpression of miR-145 (2.0-fold; P = 0.04), miR-21 (2.4-fold; P = 0.004), miR-141 (2.6-fold; P = 0.02), let-7a (3.3-fold; P = 0.003), miR-150 (3.8-fold; P = 0.04), miR-15a (4.5-fold; P = 0.03), miR-16 (5.0-fold; P = 0.004), and miR-143 (6.4-fold; P = 0.004) in ACTH-secreting pituitary tumors when compared to normal pituitary tissues.
  • There were no differences between miRNA expression and tumor size as well as miRNA expression and ratio of remission after surgery, except in patients presenting lower miR-141 expression who showed a better chance of remission.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / genetics. Adenoma / genetics. MicroRNAs / analysis
  • [MeSH-minor] Adolescent. Adult. Female. Humans. Male. Middle Aged. Pituitary ACTH Hypersecretion / genetics. Young Adult

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  • (PMID = 18840638.001).
  • [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 / MicroRNAs
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12. Sakihara S, Kageyama K, Matsumoto A, Ikeda H, Tsushima Y, Naraoka M, Terui K, Nigawara T, Suda T: Exaggerated response of adrenocorticotropic hormone to growth hormone-releasing peptide-2 test in Cushing's disease. Case report. Neurol Med Chir (Tokyo); 2009 Aug;49(8):365-9
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  • A 47-year-old woman presented with a pituitary microadenoma manifesting as typical Cushing's syndrome.
  • Plasma adrenocorticotropic hormone (ACTH) levels were greatly increased from 66 pg/ml to 2490 pg/ml (about 38-fold) in response to the administration of 100 microg human growth hormone-releasing peptide (GHRP)-2.
  • GHRP receptor type 1a messenger ribonucleic acid was detected in the tumor.
  • Therefore, GHRP-2 may stimulate ACTH via the GHRP receptor type 1a in pituitary ACTH-producing tumor.
  • [MeSH-major] Adenoma / metabolism. Adrenocorticotropic Hormone / blood. Oligopeptides. Pituitary ACTH Hypersecretion / diagnosis. Pituitary ACTH Hypersecretion / physiopathology. Pituitary Neoplasms / metabolism
  • [MeSH-minor] Biomarkers / analysis. Biomarkers / blood. Female. Humans. Hypothalamo-Hypophyseal System / metabolism. Hypothalamo-Hypophyseal System / physiopathology. Hypothalamo-Hypophyseal System / secretion. Middle Aged. Pituitary-Adrenal System / metabolism. Pituitary-Adrenal System / physiopathology. Pituitary-Adrenal System / secretion. Predictive Value of Tests. RNA, Messenger / metabolism. Receptors, Neuropeptide / genetics. Receptors, Pituitary Hormone-Regulating Hormone / genetics

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  • (PMID = 19707004.001).
  • [ISSN] 1349-8029
  • [Journal-full-title] Neurologia medico-chirurgica
  • [ISO-abbreviation] Neurol. Med. Chir. (Tokyo)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Biomarkers; 0 / Oligopeptides; 0 / RNA, Messenger; 0 / Receptors, Neuropeptide; 0 / Receptors, Pituitary Hormone-Regulating Hormone; 0 / growth hormone-releasing peptide-2; 0 / somatocrinin receptor; 9002-60-2 / Adrenocorticotropic Hormone
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13. Suri D, Weiss RE: Effect of pioglitazone on adrenocorticotropic hormone and cortisol secretion in Cushing's disease. J Clin Endocrinol Metab; 2005 Mar;90(3):1340-6
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  • Peroxisomal proliferator-activated receptors (PPAR)-gamma are abundantly expressed in ACTH-secreting pituitary tumors.
  • Treatment with PPARgamma agonists inhibits ACTH-secreting pituitary tumor growth, proliferation, and ACTH secretion in vitro in human and murine models and in vivo in murine corticotroph tumors.
  • It was hypothesized that treatment with the PPARgamma agonist pioglitazone would normalize the hypothalamic-pituitary-adrenal axis of patients with CD.
  • We evaluated the hypothalamic pituitary adrenal axis in five patients with CD in whom we measured:.
  • 2) the 24-h profile of serum cortisol and plasma ACTH; and 3) the ACTH and cortisol response to CRH stimulation.
  • At baseline, before low-dose dexamethasone, all five patients had elevated 24-h urine free cortisol, elevated 24-h serum cortisol and plasma ACTH levels, and robust responses to CRH, consistent with their diagnosis of CD.
  • Furthermore, there was no significant difference in the number of cortisol or ACTH spikes or in their diurnal rhythms.
  • In summary, pioglitazone treatment (45 mg daily for 30 d) of patients with CD was not found to be effective at attenuating either ACTH or cortisol levels and does not appear to be an alternative to surgical therapy.
  • [MeSH-major] Adrenocorticotropic Hormone / blood. Hydrocortisone / blood. Hypoglycemic Agents / administration & dosage. Pituitary ACTH Hypersecretion / drug therapy. Pituitary ACTH Hypersecretion / metabolism. Thiazolidinediones / administration & dosage
  • [MeSH-minor] Adult. Circadian Rhythm. Female. Humans. Hypothalamo-Hypophyseal System / drug effects. Male. Middle Aged. PPAR gamma / metabolism. Pituitary-Adrenal System / drug effects. Treatment Failure

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  • (PMID = 15585550.001).
  • [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 / DK 58258; United States / NIDDK NIH HHS / DK / DK07011; United States / NIDDK NIH HHS / DK / DK17050; United States / NIDDK NIH HHS / DK / DK58258; United States / NCRR NIH HHS / RR / RR00055; United States / NCRR NIH HHS / RR / RR18372
  • [Publication-type] Clinical Trial; Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Hypoglycemic Agents; 0 / PPAR gamma; 0 / Thiazolidinediones; 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone; X4OV71U42S / pioglitazone
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14. Stilling G, Sun Z, Zhang S, Jin L, Righi A, Kovācs G, Korbonits M, Scheithauer BW, Kovacs K, Lloyd RV: MicroRNA expression in ACTH-producing pituitary tumors: up-regulation of microRNA-122 and -493 in pituitary carcinomas. Endocrine; 2010 Aug;38(1):67-75
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  • [Title] MicroRNA expression in ACTH-producing pituitary tumors: up-regulation of microRNA-122 and -493 in pituitary carcinomas.
  • MicroRNAs (miRNAs) are involved in cell proliferation, differentiation, and apoptosis, and can function as tumor suppressor genes or oncogenes.
  • The expression of miRNAs in pituitary carcinomas has not been previously examined.
  • We used miRNA profiling with 1,145 probes to study miRNA expression in normal anterior pituitary (6 cases), adrenocorticotropin (ACTH)-producing adenomas (8 cases), and ACTH-producing pituitary carcinomas (two cases).
  • Real-time RT-PCR and in situ hybridization were used to confirm and independently validate miRNAs that were significantly up-regulated or down-regulated between the pituitary tissues.
  • Both real-time RT-PCR and in situ hybridization showed significant up-regulation of miRNA-122 between pituitary carcinomas and adenomas.
  • MiRNA-493 was also up-regulated in carcinomas compared to ACTH adenomas.
  • Analysis of genes that miRNA-493 interacts with included LGALS3 and RUNX2 ( http://microrna.sanger.ac.uk ) both of which have been shown to have roles in pituitary tumor cell growth.
  • These results provide information about marker miRNAs that may lead to further insights into the regulation of pituitary tumor growth and development.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / genetics. Adenoma / genetics. Gene Expression Profiling. Gene Expression Regulation, Neoplastic. MicroRNAs / genetics
  • [MeSH-minor] Adult. Aged. Female. Humans. In Situ Hybridization. Oligonucleotide Array Sequence Analysis. Pituitary Gland, Anterior / pathology. Pituitary Gland, Anterior / physiology. Reverse Transcriptase Polymerase Chain Reaction. Up-Regulation / genetics

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  • (PMID = 20960104.001).
  • [ISSN] 1559-0100
  • [Journal-full-title] Endocrine
  • [ISO-abbreviation] Endocrine
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / MIRN122 microRNA, human; 0 / MIRN493 microRNA, human; 0 / MicroRNAs
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15. Mittelbronn M, Psaras T, Capper D, Meyermann R, Honegger J: ACTH- and prolactin-producing pituitary gland microadenoma with biphasic features of atypia and intermediate filament expression. Neuro Endocrinol Lett; 2006 Feb-Apr;27(1-2):89-92
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  • [Title] ACTH- and prolactin-producing pituitary gland microadenoma with biphasic features of atypia and intermediate filament expression.
  • Neuroradiological examination revealed an intrasellar tumor mass of 7 mm in diameter.
  • Subsequently, transsphenoidal tumor resection was performed.
  • Histological and immunohistochemical investigations revealed a pituitary gland adenoma showing a biphasic tumor growth pattern with two morphologically different tumor areas producing ACTH and prolactin respectively.
  • Co-expression of ACTH and prolactin is exceedingly rare in pituitary adenoma.
  • To our surprise, both tumor areas exhibited features of atypia consisting in elevated MIB-1 proliferation index in the ACTH-producing portion as well as p53 expression selectively in the prolactin-producing tumor parts.
  • To our knowledge, this is the first case of an ACTH- and prolactin-producing pituitary gland adenoma exhibiting biphasic features of atypia.
  • [MeSH-major] Adenoma / metabolism. Adrenocorticotropic Hormone / biosynthesis. Intermediate Filament Proteins / biosynthesis. Pituitary Neoplasms / metabolism. Prolactin / biosynthesis
  • [MeSH-minor] Adult. Cell Proliferation. Female. Humans. Immunohistochemistry. Ki-67 Antigen / metabolism. Pituitary Hormones / chemistry. Pituitary Hormones / metabolism. Tumor Suppressor Protein p53 / biosynthesis

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  • (PMID = 16648816.001).
  • [ISSN] 0172-780X
  • [Journal-full-title] Neuro endocrinology letters
  • [ISO-abbreviation] Neuro Endocrinol. Lett.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Sweden
  • [Chemical-registry-number] 0 / Intermediate Filament Proteins; 0 / Ki-67 Antigen; 0 / Pituitary Hormones; 0 / Tumor Suppressor Protein p53; 9002-60-2 / Adrenocorticotropic Hormone; 9002-62-4 / Prolactin
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16. Salinas-Lara C, Rembao-Bojórquez D, de la Cruz E, Márquez C, Portocarrero L, Tena-Suck ML: Pituitary apoplexy due to mucormycosis infection in a patient with an ACTH producing pulmonary tumor. J Clin Neurosci; 2008 Jan;15(1):67-70
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  • [Title] Pituitary apoplexy due to mucormycosis infection in a patient with an ACTH producing pulmonary tumor.
  • The incidence of pituitary apoplexy ranges from 6% to 17%, presenting as a capsule rupture in up to 1.7-2.0%.
  • Autopsy findings included: plurihormonal pituitary adenoma with extension to the sphenoid bone and sellar erosion; many thick, septated, mucormycosis hyphae; and recent fronto-temporal brain infarction.
  • Also, a solitary adrenal corticotropic hormone (ACTH)-producing neuroendocrine tumor, 3 cm in diameter, was found in the left lung.
  • This patient illustrates the correlation between ACTH-producing ectopic pulmonary tumor, pituitary apoplexy and mucormycosis.
  • [MeSH-major] Adrenocorticotropic Hormone / secretion. Lung Neoplasms / pathology. Lung Neoplasms / secretion. Mucormycosis / etiology. Pituitary Apoplexy / etiology. Pituitary Neoplasms / secondary

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  • (PMID = 17462904.001).
  • [ISSN] 0967-5868
  • [Journal-full-title] Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
  • [ISO-abbreviation] J Clin Neurosci
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Scotland
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone
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17. Wong M, Isa SH, Kamaruddin NA, Khalid BA: ACTH producing pulmonary carcinoid and pituitary macroadenoma: a fortuitous association? Med J Malaysia; 2007 Jun;62(2):168-70
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  • [Title] ACTH producing pulmonary carcinoid and pituitary macroadenoma: a fortuitous association?
  • We report a case of a 45 year-old man who presented initially with a non-functioning pituitary macroadenoma.
  • Four years later, he presented acutely with adrenocorticotrophic hormone (ACTH) dependent Cushing's syndrome which resolved following a right lobectomy.
  • To our knowledge, this is the first reported case of an ectopic ACTH secreting pulmonary carcinoid found in association with a non-functioning pituitary macroadenoma.
  • [MeSH-major] ACTH Syndrome, Ectopic / complications. Carcinoid Tumor / secretion. Lung Neoplasms / secretion. Pituitary Neoplasms / complications

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  • (PMID = 18705457.001).
  • [ISSN] 0300-5283
  • [Journal-full-title] The Medical journal of Malaysia
  • [ISO-abbreviation] Med. J. Malaysia
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Malaysia
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18. Jin L, Riss D, Ruebel K, Kajita S, Scheithauer BW, Horvath E, Kovacs K, Lloyd RV: Galectin-3 Expression in Functioning and Silent ACTH-Producing Adenomas. Endocr Pathol; 2005;16(2):107-14
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  • [Title] Galectin-3 Expression in Functioning and Silent ACTH-Producing Adenomas.
  • Galectin-3 (Gal-3), a beta galactoside-binding protein, has been implicated in a variety of biological functions including cell growth, differentiation, tumor cell adhesion, angiogenesis, tumor progression, and metastasis.
  • We recently reported that Gal-3 was expressed in a subset of normal pituitary cells and tumors including PRL, ACTH, and in folliculo-stellate (FS) cells and tumors and that Gal-3 had an important regulatory role in pituitary cell proliferation.
  • We further investigated the expression of Gal-3 protein in ACTH- and PRL-producing tumors and the expression of various galectin mRNAs by RT-PCR in pituitary adenomas and normal pituitary.
  • Most silent ACTH subtypes 1 and 2 adenomas were negative or only focally positive for Gal-3 expression compared to functioning ACTH tumors from patients with Cushing's disease and Nelson's syndrome.
  • In the normal pituitary, Gal-3 was expressed in less than 1% of the basophil-invading cells (ACTH cells present in the posterior pituitary) and in a subset of the anterior lobe ACTH-positive cells.
  • RT-PCR analyses showed that many members of the galectin family including galectins 1, 2, 3, 4, 5, 6, 7, 8, and 9 were expressed in normal pituitary and in functioning ACTH- and PRL-producing tumors.
  • These results indicate that Gal-3 is associated with functioning ACTH and PRL tumors and is expressed infrequently in silent ACTH adenomas, suggesting that Gal-3 protein and/or gene is altered in non-functioning ACTH tumors.
  • The use of ACTH and Gal-3 immunostaining should help in the diagnosis of silent ACTH adenomas.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / metabolism. Adenoma / metabolism. Adrenocorticotropic Hormone / secretion. Galectin 3 / biosynthesis. Pituitary Gland / metabolism. Pituitary Neoplasms / metabolism

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  • (PMID = 16199895.001).
  • [ISSN] 1046-3976
  • [Journal-full-title] Endocrine pathology
  • [ISO-abbreviation] Endocr. Pathol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA90249
  • [Publication-type] Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Galectin 3; 0 / RNA, Messenger; 9002-60-2 / Adrenocorticotropic Hormone; 9002-62-4 / Prolactin
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19. Pinchot SN, Sippel R, Chen H: ACTH-producing carcinoma of the pituitary with refractory Cushing's Disease and hepatic metastases: a case report and review of the literature. World J Surg Oncol; 2009;7:39
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  • [Title] ACTH-producing carcinoma of the pituitary with refractory Cushing's Disease and hepatic metastases: a case report and review of the literature.
  • BACKGROUND: Pituitary carcinomas are rare neuroendocrine tumors affecting the adenohypophysis.
  • CASE PRESENTATION: Here, we report the case of a fatal pituitary carcinoma evolving within two years from an adrenocorticotrophic hormone (ACTH)-secreting macroadenoma and review the global literature regarding this rare neuroendocrine tumor.
  • CONCLUSION: Pituitary carcinomas are extremely rare neoplasms, representing only 0.1% to 0.2% of all pituitary tumors.
  • The latency period between initial presentation of a pituitary adenoma and the development of distal metastases marking carcinoma is extremely variable, and some patients may live well over 10 years with pituitary carcinoma.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / pathology. Liver Neoplasms / secondary. Pituitary ACTH Hypersecretion / complications

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  • (PMID = 19356251.001).
  • [ISSN] 1477-7819
  • [Journal-full-title] World journal of surgical oncology
  • [ISO-abbreviation] World J Surg Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Parathyroid Hormone
  • [Other-IDs] NLM/ PMC2678126
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20. Giorgi RR, Correa-Giannella ML, Casarini AP, Machado MC, Bronstein MD, Cescato VA, Giannella-Neto D: Metallothionein isoform 3 gene is differentially expressed in corticotropin-producing pituitary adenomas. Neuroendocrinology; 2005;82(3-4):208-14
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  • [Title] Metallothionein isoform 3 gene is differentially expressed in corticotropin-producing pituitary adenomas.
  • In order to search for candidate genes related to pituitary adenoma aggressiveness, the present investigation was intended to compare the mRNA expression profile from a pool of four nonfunctional pituitary adenomas (NFPA) with a spinal cord metastasis of a nonfunctional pituitary carcinoma (MNFPC).
  • A microarray dataset comprising 19,881 probes was employed for comparing expression profiles of a spinal cord metastasis of a nonfunctional pituitary carcinoma with a pool of four nonfunctional pituitary adenomas.
  • RT-qPCR confirmed the microarray findings and was used to investigate MT3 mRNA gene expression in tumor samples of a series of 52 different pituitary adenoma subtypes comprising 10 corticotropin (ACTH)-producing, 18 growth hormone (GH)-producing, 8 prolactin (PRL)-producing, and 16 nonfunctional adenomas.
  • MT3 mRNA expression was statistically significantly higher in ACTH-producing pituitary adenomas and in nonfunctional pituitary adenomas in comparison to the other pituitary adenoma subtypes.
  • The more abundant expression of this gene in ACTH-producing pituitary adenomas suggests that MT3 could be related to distinct pituitary cell lineage regulating the activity of some transcription factor of importance in hormone production and/or secretion.
  • [MeSH-major] Adenoma / metabolism. Adrenocorticotropic Hormone / metabolism. Nerve Tissue Proteins / biosynthesis. Pituitary Neoplasms / metabolism

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  • (PMID = 16601360.001).
  • [ISSN] 0028-3835
  • [Journal-full-title] Neuroendocrinology
  • [ISO-abbreviation] Neuroendocrinology
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Nerve Tissue Proteins; 0 / Protein Isoforms; 0 / RNA, Messenger; 0 / growth inhibitory factor; 12629-01-5 / Human Growth Hormone; 9002-60-2 / Adrenocorticotropic Hormone; 9002-62-4 / Prolactin
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21. Scheithauer BW, Kovacs K, Horvath E, Kim DS, Osamura RY, Ketterling RP, Lloyd RV, Kim OL: Pituitary blastoma. Acta Neuropathol; 2008 Dec;116(6):657-66
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  • [Title] Pituitary blastoma.
  • Aside from blood adrenocorticotropin (ACTH) and cortisol elevation, other pituitary hormone blood levels were normal or markedly reduced.
  • The subtotally resected lesion consisted of synaptophysin-immunoreactive lobules of (a) large, polygonal, amphophilic, PAS-positive cells immunoreactive for ACTH, beta-endorphin, alpha melanocyte stimulating hormone (MSH), and keratin (CAM5.2) in some cells showing Crooke hyaline change, (b) less frequent acidophilic, growth hormone (GH) immunoreactive cells, and (c) rare luteinizing hormone (LH) and/or alpha subunit immunopositive cells.
  • Transcription factors, including Neuro-D1 and Pit-1, were present in ACTH- and GH-producing cells, respectively, but only in occasional Rathke-type cells.
  • Ultrastructurally, the tissue resembled fetal pituitary of 10-12 weeks gestation and contained fully differentiated corticotrophs and somatotrophs, scant cells of glycoprotein-hormone producing type with small secretory granules, and glandular epithelial cells consistent with committed, but largely undifferentiated Rathke-type epithelium.
  • We consider the tumor as a pituitary blastoma, a lesion composed of multiple cell types common to the development of the affected organ based upon (a) prominence of primitive Rathke-type epithelium, (b) disposition of secretory cells in lobules rather than acini, (c) the limited range of secretory cells represented, (d) the presence of their corresponding transcription factors, and (e) ultrastructural features indicating orderly development of the 10- to 12-week embryonic stage.
  • [MeSH-major] Neoplasms, Complex and Mixed / diagnosis. Pituitary Neoplasms / diagnosis
  • [MeSH-minor] Adrenocorticotropic Hormone / blood. Adrenocorticotropic Hormone / metabolism. Corticosterone / blood. Corticosterone / metabolism. Diabetes Insipidus / etiology. Diabetes Insipidus / pathology. Diagnosis, Differential. Female. Humans. Immunohistochemistry. Infant. Pituitary ACTH Hypersecretion / etiology. Pituitary ACTH Hypersecretion / pathology

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  • (PMID = 18551299.001).
  • [ISSN] 1432-0533
  • [Journal-full-title] Acta neuropathologica
  • [ISO-abbreviation] Acta Neuropathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone; W980KJ009P / Corticosterone
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22. Iino K, Oki Y, Yamashita M, Matsushita F, Hayashi C, Yogo K, Nishizawa S, Yamada S, Maekawa M, Sasano H, Nakamura H: Possible relevance between prohormone convertase 2 expression and tumor growth in human adrenocorticotropin-producing pituitary adenoma. J Clin Endocrinol Metab; 2010 Aug;95(8):4003-11
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  • [Title] Possible relevance between prohormone convertase 2 expression and tumor growth in human adrenocorticotropin-producing pituitary adenoma.
  • CONTEXT: Methods for preoperative diagnosis of prohormone convertase 2 (PC2)-positive ACTH-producing pituitary adenomas (APPAs) have not been established.
  • CONCLUSIONS: Our study suggests that PC2 expression and Akt phosphorylation are related at the molecular level, resulting in a change in cell cycle and an increase in pituitary adenoma size.
  • An elevation of plasma alphaMSH could conjecture the activation of the phosphatidylinositol 3/Akt cascade in PC2-positive APPAs and may become a valuable clinical marker of tumor growth in Cushing's disease.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / metabolism. Adenoma / metabolism. Proprotein Convertase 2 / metabolism. alpha-MSH / blood

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  • (PMID = 20501680.001).
  • [ISSN] 1945-7197
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / RNA, Messenger; 581-05-5 / alpha-MSH; EC 2.7.11.24 / Mitogen-Activated Protein Kinase 3; EC 3.4.21.94 / Proprotein Convertase 2
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23. Takagi J, Otake K, Morishita M, Kato H, Nakao N, Yoshikawa K, Ikeda H, Hirooka Y, Hattori Y, Larsson C, Nogimori T: Multiple endocrine neoplasia type I and Cushing's syndrome due to an aggressive ACTH producing thymic carcinoid. Intern Med; 2006;45(2):81-6
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  • [Title] Multiple endocrine neoplasia type I and Cushing's syndrome due to an aggressive ACTH producing thymic carcinoid.
  • Thymic carcinoid in multiple endocrine neoplasia type 1 (MEN 1) is previously reported as a non-ACTH producing tumor.
  • The present case is a 39-year-old man with mortal outcome from thymic carcinoid and Cushing's syndrome with high plasma ACTH.
  • The symptom was first observed at age 29 and was relieved after extended thymectomy, with reduction of ACTH level.
  • The tumor was positive for ACTH, Grimelius silver staining and Chromogranin A.
  • The finding of primary hyperparathyroidism, pituitary adenoma, and a novel germline nonsense mutation (W423X) established the diagnosis of MEN 1.
  • Cushing's syndrome due to ACTH producing thymic carcinoid should be also considered as one phenotype of the MEN 1 spectrum.
  • [MeSH-major] ACTH Syndrome, Ectopic / etiology. Carcinoid Tumor / complications. Cushing Syndrome / etiology. Multiple Endocrine Neoplasia Type 1 / diagnosis. Thymus Neoplasms / complications


24. Mauermann WJ, Sheehan JP, Chernavvsky DR, Laws ER, Steiner L, Vance ML: Gamma Knife surgery for adrenocorticotropic hormone-producing pituitary adenomas after bilateral adrenalectomy. J Neurosurg; 2007 Jun;106(6):988-93
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  • [Title] Gamma Knife surgery for adrenocorticotropic hormone-producing pituitary adenomas after bilateral adrenalectomy.
  • OBJECT: Patients with adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas may require a bilateral adrenalectomy to treat their Cushing's disease.
  • Approximately one third of these patients, however, will experience progressive enlargement of the residual pituitary adenoma, develop hyperpigmentation, and have an elevated level of serum ACTH.
  • METHODS: The prospectively collected University of Virginia Gamma Knife database of patients with pituitary adenomas was reviewed to identify all individuals with Nelson's syndrome who were treated with GKS.
  • These patients were assessed for tumor control (that is, lack of tumor growth over time) with neuroimaging studies (median follow-up duration 22 months) and for biochemical normalization of their ACTH levels (median follow-up duration 50 months).
  • Neuroimaging follow-up studies were available for 22 patients, and endocrine follow up was available for 15 patients in whom elevation of ACTH levels was documented prior to GKS.
  • In the 22 patients in whom neuroimaging follow-up studies were available, 12 had a decrease in tumor size, eight had no tumor growth, and two had an increase in tumor volume.
  • Ten of 15 patients with elevated ACTH levels prior to GKS showed a decrease in their ACTH levels at last follow up; three of these 10 patients achieved normal ACTH levels (< 50 pg/ml) and the other five patients with initially elevated values had an increase in ACTH levels.
  • Ten patients were thoroughly evaluated for post-GKS pituitary function; four were found to have new pituitary hormone deficiency and six did not have hypopituitarism after GKS.
  • CONCLUSIONS: Gamma Knife surgery may control the residual pituitary adenoma and decrease ACTH levels in patients with Nelson's syndrome.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / surgery. Adenoma / surgery. Adrenalectomy. Nelson Syndrome / surgery. Radiosurgery

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  • (PMID = 17564169.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone
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25. 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.
  • The mean tumor diameter was 19.2 mm and volume was 5.4 cm3.
  • The tumor resolution rate was 2%, the response rate 68.3%, and the control rate 100%.
  • [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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26. Min HS, Lee SJ, Kim SK, Park SH: Pituitary adenoma with rich folliculo-stellate cells and mucin-producing epithelia arising in a 2-year-old girl. Pathol Int; 2007 Sep;57(9):600-5
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  • [Title] Pituitary adenoma with rich folliculo-stellate cells and mucin-producing epithelia arising in a 2-year-old girl.
  • Pituitary adenoma is a rare neoplasm in childhood, with prolactin and adrenocorticotropic hormone (ACTH)-secreting adenomas predominating in this age group.
  • Herein is reported a case of an ACTH-producing macroadenoma with an unusual histology that occurred in a 2-year-old girl.
  • Because of the patient's age and the macroadenoma's suprasellar location and large size (up to 4 cm in diameter), radical surgery was performed under the suspicion of craniopharyngioma or germ-cell tumor.
  • Pathologically, it was a unique pituitary adenoma composed of monotonous ACTH-producing cells, smaller folliculo-stellate cells (FSC), and mucin-producing cells.
  • The FSC, non-hormone-secreting pituitary cells of uncertain function, were confirmed by their S-100 protein, glial fibrillary acidic protein and cytokeratin expression immunoprofiles.
  • The abrupt transition between the prominent gland-forming mucin-producing epithelia and the FSC component suggested that the mucin-producing epithelia might be derived from the FSC.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / pathology. Mucins / secretion. Pituitary Neoplasms / pathology
  • [MeSH-minor] Biomarkers, Tumor / metabolism. Child, Preschool. Cytoplasm / ultrastructure. Disease Progression. Female. Glial Fibrillary Acidic Protein / metabolism. Humans. Keratins / metabolism. Magnetic Resonance Imaging. S100 Proteins / metabolism. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 17685932.001).
  • [ISSN] 1320-5463
  • [Journal-full-title] Pathology international
  • [ISO-abbreviation] Pathol. Int.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Australia
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Glial Fibrillary Acidic Protein; 0 / Mucins; 0 / S100 Proteins; 68238-35-7 / Keratins
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27. Ogo A, Eto T, Hiramatsu S, Watanabe A, Sakai Y, Yoshizumi H, Uesugi N, Nakajima O: Autopsy of a patient with Cushing's Syndrome who was revealed to have pulmonary tumorlets producing ectopic ACTH. Endocr J; 2007 Dec;54(6):863-70
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  • [Title] Autopsy of a patient with Cushing's Syndrome who was revealed to have pulmonary tumorlets producing ectopic ACTH.
  • Biochemical investigations revealed hypokalemia and elevated serum cortisol and plasma ACTH levels, with a loss of diurnal rhythm and failure of suppression at high doses (8 mg) of dexamethasone.
  • No pituitary tumor or parasellar tumor was detected by contrast-enhanced computed tomography (CT) or magnetic resonance image scan of the pituitary.
  • Abdominal and pelvic CT indicated bilateral, slightly diffuse, adrenal gland hyperplasia only.
  • These findings led to a diagnosis of ACTH-dependent hypercortisolism from an undefined source.
  • Immunohistochemical staining of the tumorlets revealed scattered cells containing ACTH and many cells containing chromogranin A that were positive for Grimelius staining.
  • [MeSH-major] ACTH Syndrome, Ectopic / diagnosis. Cushing Syndrome / complications. Lung Neoplasms / secretion

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  • (PMID = 18000346.001).
  • [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] 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone
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28. Oyama K, Yamada S, Hukuhara N, Hiramatsu R, Taguchi M, Yazawa M, Matsuda A, Ohmura E, Imai Y: FSH-producing macroadenoma associated in a patient with Cushing's disease. Neuro Endocrinol Lett; 2006 Dec;27(6):733-6
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  • [Title] FSH-producing macroadenoma associated in a patient with Cushing's disease.
  • OBJECTIVE AND IMPORTANCE: We encountered a Cushing's disease patient whose surgically removed pituitary macroadenoma was not an ACTH-producing, but rather a gonadotroph adenoma.
  • Cure was obtained only after a tiny microadenoma, overlooked on preoperative studies, was removed by a 2nd operation from a compressed thin normal anterior pituitary gland.
  • INTERVENTION: Despite total removal of the invasive macroadenoma by transsphenoidal surgery, her elevated serum cortisol- and ACTH levels failed to decrease.
  • Histologic study of the surgical specimen disclosed that the tumor was a silent FSH-producing, rather than an ACTH-producing adenoma.
  • Detailed re-evaluation of pre- and postoperative MRI suggested the presence of a 3-mm microadenoma on the left side of a thin compressed normal gland.
  • In a 2nd operation an ACTH-producing microadenoma was removed from inside the thin remaining compressed normal pituitary gland and endocrinological cure of Cushing's disease was achieved.
  • CONCLUSION: Although double adenomas, being a non-ACTH producing macroadenoma associated with an ACTH producing tiny microadenoma, are extremely rare in patients with Cushing's disease, detailed preoperative MRI evaluation is necessary to avoid missing tiny adenomas hidden in a compressed normal pituitary gland which is the cause of Cushing's disease, especially when a macroadenoma is found in patient with Cushing's disease.
  • [MeSH-major] Follicle Stimulating Hormone / secretion. Gonadotrophs / secretion. Neoplasms, Multiple Primary / pathology. Pituitary ACTH Hypersecretion / blood. Pituitary Neoplasms / pathology. Pituitary Neoplasms / secretion

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  • (PMID = 17187002.001).
  • [ISSN] 0172-780X
  • [Journal-full-title] Neuro endocrinology letters
  • [ISO-abbreviation] Neuro Endocrinol. Lett.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Sweden
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone; 9002-68-0 / Follicle Stimulating Hormone; WI4X0X7BPJ / Hydrocortisone
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29. Mezosi E, Nemes O: [Treatment of pituitary adenomas]. Orv Hetil; 2009 Sep 27;150(39):1803-10
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  • [Title] [Treatment of pituitary adenomas].
  • According to epidemiological studies, the prevalence of pituitary adenomas is 16.5% and the majority of them are "incidentalomas".
  • The symptoms of pituitary disorders are often non-specific; disturbances of pituitary function, compression symptoms, hypophysis apoplexy or accidental findings may help the diagnosis.
  • The hormonal evaluation of pituitary adenomas is different from the algorithm used in the disorders of peripheral endocrine organs.
  • The first-line therapy of prolactinomas are the dopamine agonists, and the aims of the treatment are to normalize the prolactin level, restore fertility in child-bearing age, decrease tumor mass, save or improve the residual pituitary function and inhibit the relapse of the disease.
  • Neurosurgery is the primary therapy of GH-, ACTH-, TSH-producing and inactive adenomas.
  • The rare TSH-producing tumor can respond to both dopamine agonist and somatostatin analog therapy.
  • Further studies are needed to elucidate the exact role of radiosurgery and fractionated stereotaxic irradiation in the treatment of pituitary tumors.
  • [MeSH-major] Adenoma / therapy. Pituitary Hormones / blood. Pituitary Neoplasms / therapy
  • [MeSH-minor] ACTH-Secreting Pituitary Adenoma / therapy. Acromegaly / drug therapy. Acromegaly / etiology. Adrenocorticotropic Hormone / blood. Aminoquinolines / therapeutic use. Bromocriptine / therapeutic use. Cushing Syndrome / drug therapy. Cushing Syndrome / etiology. Dopamine Agonists / therapeutic use. Female. Growth Hormone-Secreting Pituitary Adenoma / therapy. Human Growth Hormone / analogs & derivatives. Human Growth Hormone / blood. Human Growth Hormone / therapeutic use. Humans. Hypophysectomy. Incidental Findings. Male. Pregnancy. Pregnancy Complications, Neoplastic / therapy. Prolactinoma / therapy. Radiosurgery. Receptors, Somatotropin / antagonists & inhibitors. Somatostatin / analogs & derivatives. Somatostatin / therapeutic use. Thyrotropin / blood

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  • (PMID = 19758960.001).
  • [ISSN] 0030-6002
  • [Journal-full-title] Orvosi hetilap
  • [ISO-abbreviation] Orv Hetil
  • [Language] hun
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Hungary
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Dopamine Agonists; 0 / Pituitary Hormones; 0 / Receptors, Somatotropin; 0 / pegvisomant; 12629-01-5 / Human Growth Hormone; 3A64E3G5ZO / Bromocriptine; 51110-01-1 / Somatostatin; 80Q9QWN15M / quinagolide; 9002-60-2 / Adrenocorticotropic Hormone; 9002-71-5 / Thyrotropin; 98H1T17066 / pasireotide
  • [Number-of-references] 28
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30. Lau Q, Scheithauer B, Kovacs K, Horvath E, Syro LV, Lloyd R: MGMT immunoexpression in aggressive pituitary adenoma and carcinoma. Pituitary; 2010 Dec;13(4):367-79
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  • [Title] MGMT immunoexpression in aggressive pituitary adenoma and carcinoma.
  • Recent case reports have documented the efficacy of temozolomide therapy in some aggressive pituitary adenomas and pituitary carcinomas resistant to multimodality therapy.
  • Herein, we aimed to study MGMT immunoexpression in a spectrum of pituitary tumors, indolent, aggressive and malignant.
  • A literature review of the use of temozolomide in pituitary tumors was also performed.
  • Immunohistochemistry for MGMT was performed on 60 pituitary tumors identified in the Mayo Clinic Tissue Registry and the consultation files of one of us (BWS).
  • The group included 30 pituitary carcinomas (15 ACTH, 10 PRL, 1 FSH/LH, 1 TSH, 1 silent subtype 3 and 2 null cell).
  • In addition, 30 functionally different pituitary adenomas were studied, including 15 invasive and 15 non-invasive adenomas.
  • Overall, 32 cases of pituitary tumors (54%) demonstrated low MGMT immunoexpression.
  • This included 17 of 30 (57%) carcinomas, 9 of 15 (60%) invasive adenomas, and 6 of 15 cases (40%) of non-invasive pituitary adenomas.
  • Prolactin-producing carcinomas had the highest proportion of tumors (80%) with low expression.
  • A significant proportion of pituitary adenomas and carcinomas demonstrate low MGMT immunoexpression.
  • In an effort to anticipate the likelihood of a temozolomide response, all cases of aggressive pituitary tumors should be assessed for MGMT expression.
  • [MeSH-major] DNA Modification Methylases / metabolism. DNA Repair Enzymes / metabolism. Pituitary Neoplasms / immunology. Tumor Suppressor Proteins / metabolism

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  • (PMID = 20740317.001).
  • [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] 0 / Antineoplastic Agents, Alkylating; 0 / Tumor Suppressor Proteins; 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide; 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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31. Singer J, Werner F, Koch CA, Bartels M, Aigner T, Lincke T, Fasshauer M, Paschke R: Ectopic Cushing's syndrome caused by a well differentiated ACTH-secreting neuroendocrine carcinoma of the ileum. Exp Clin Endocrinol Diabetes; 2010 Aug;118(8):524-9
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  • [Title] Ectopic Cushing's syndrome caused by a well differentiated ACTH-secreting neuroendocrine carcinoma of the ileum.
  • Cushing's syndrome can be caused by adrenocorticotropic hormone-secreting solid tumors.
  • We report a rare case of an ileal endocrine carcinoma that produced ACTH and induced hypercortisolism.
  • The search for the primary tumor was difficult.
  • The patient underwent subtotal thyroidectomy and surgical removal of a pituitary lesion.
  • After resection of an ACTH-producing metastasis of the mesentery, temporary remission of Cushing's syndrome ensued.
  • At the age 45 the primary tumor was detected in the ileum by Ga-68 DOTATOC-PET scan and explorative laparotomy.
  • Ectopic ACTH secretion within the small bowel is very rare.
  • This case underscores the difficulty in locating the source of ectopic ACTH secretion and suggests using small bowel barium study, tubus endoscopy or video endoscopy for preoperative localization if the small bowel is suspected as tumor source.
  • [MeSH-major] ACTH Syndrome, Ectopic / diagnosis. Adrenocorticotropic Hormone / secretion. Carcinoma / diagnosis. Cushing Syndrome / diagnosis. Ileal Neoplasms / diagnosis. Neuroendocrine Tumors / diagnosis
  • [MeSH-minor] Blood Pressure. Diabetes Mellitus / etiology. Humans. Male. Mesentery / surgery. Middle Aged. Muscle Strength. Pituitary Gland / surgery

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  • [Copyright] © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.
  • (PMID = 20162505.001).
  • [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] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone
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32. Kovacs K, Horvath E: Effects of medical therapy on pituitary tumors. Ultrastruct Pathol; 2005 May-Aug;29(3-4):163-7
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  • [Title] Effects of medical therapy on pituitary tumors.
  • Previously surgery and irradiation were the only available procedures to treat patients with pituitary tumors.
  • This paper summarizes the effect of medical therapy on the morphologic features of pituitary tumors and illustrates the ultrastructural alterations on electron micrographs.
  • Currently drugs can be used in the management of pituitary tumors secreting GH, PRL, and/or TSH in excess.
  • No medical therapy is available so far for ACTH-, FSH-, LH-, or alpha-subunit-secreting tumors as well as non-hormone-secreting pituitary tumors.
  • Dopamine agonists are effective in the management of PRL-secreting tumors; they cause marked reversible tumor shrinkage in the substantial majority of patients.
  • Long-acting somatostatin analogs are useful in the management of GH- and TSH-secreting pituitary tumors; they lead to mild to moderate tumor shrinkage in approximately 50% of cases.
  • Recently GH receptor blockers (pegvisomant) were introduced in the treatment of GH-producing pituitary adenomas.
  • To the authors' knowledge the effect of these drugs on the morphology of pituitary tumors has not been revealed so far.
  • [MeSH-major] Dopamine Agonists / therapeutic use. Human Growth Hormone / analogs & derivatives. Octreotide / therapeutic use. Pituitary Neoplasms / drug therapy

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  • (PMID = 16036872.001).
  • [ISSN] 0191-3123
  • [Journal-full-title] Ultrastructural pathology
  • [ISO-abbreviation] Ultrastruct Pathol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Dopamine Agonists; 0 / pegvisomant; 12629-01-5 / Human Growth Hormone; 9002-62-4 / Prolactin; 9002-71-5 / Thyrotropin; RWM8CCW8GP / Octreotide
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33. Salgado LR, Machado MC, Cukiert A, Liberman B, Kanamura CT, Alves VA: Cushing's disease arising from a clinically nonfunctioning pituitary adenoma. Endocr Pathol; 2006;17(2):191-9
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  • [Title] Cushing's disease arising from a clinically nonfunctioning pituitary adenoma.
  • A 49-yr-old woman with a large pituitary tumor leading to visual loss and galactorrhea- amenorrhea was submitted to transcranial pituitary surgery, when a clinically nonfunctioning pituitary adenoma was partially removed.
  • Histopathology and immunohistochemistry confirmed the diagnosis of "non-secreting atypical adenoma."
  • Two years later, she presented high free urinary cortisol levels and a positive ACTH response to desmopressin testing on dexametasone 2 mg overnight.
  • A pituitary biopsy confirmed aggressive growth as well as positive immunoreactivity for ACTH, p53, Ki-67, and c-erb-B2.
  • The overall clinical, laboratory, and pathological data suggest a transition from a clinically nonfunctioning to a hypersecreting ACTH-producing tumor.
  • Putative mechanisms of tumor transformation and the possibility of a silent corticotropinoma evolving into clinical Cushing s syndrome are discussed.
  • [MeSH-major] Adenoma / complications. Adenoma / pathology. Pituitary ACTH Hypersecretion / etiology. Pituitary Neoplasms / complications. Pituitary Neoplasms / pathology

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  • (PMID = 17159252.001).
  • [ISSN] 1046-3976
  • [Journal-full-title] Endocrine pathology
  • [ISO-abbreviation] Endocr. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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34. Yamauchi S, Yamada Y, Tsushima T, Kitagawa R, Suto T, Kimura D, Fukuda I: [Thymic carcinoid tumor with Cushing syndrome]. Kyobu Geka; 2008 Feb;61(2):143-6
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  • [Title] [Thymic carcinoid tumor with Cushing syndrome].
  • A case of a 71-year-old male with ectopic adrenocorticotropic polypeptide (ACTH)-producing thymic carcinoid tumor presenting Cushing's syndrome was reported.
  • This patient had symptoms of fatigue and a polyposia for 2 years before a mediastinal tumor was detected.
  • Chest computed tomography (CT) scan demonstrated an anterior mediastinal mass, and serum ACTH and cortisol level revealed very high.
  • We diagnosed ectopic ACTH-producing tumor, and performed complete excision of the thymus including thymic tumor.
  • Histologically, the tumor demonstrated typical carcinoid with the positivity of ACTH immunostaining.
  • After the operation, ACTH and cortisol levels were reduced and the clinical symptoms were improved rapidly.
  • [MeSH-major] ACTH Syndrome, Ectopic / surgery. Carcinoid Tumor / surgery. Pituitary ACTH Hypersecretion / etiology. Thymus Neoplasms / surgery


35. Haap M, Gallwitz B, Meyermann R, Mittelbronn M: Cushing's disease associated with both pituitary microadenoma and corticotroph hyperplasia. Exp Clin Endocrinol Diabetes; 2009 Jun;117(6):289-93
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  • [Title] Cushing's disease associated with both pituitary microadenoma and corticotroph hyperplasia.
  • Laboratory analysis demonstrated elevated plasma levels of ACTH and cortisol.
  • MRI imaging revealed a possible pituitary microadenoma.
  • To confirm the diagnosis a bilateral inferior petrosal sinus sampling was performed presenting higher ACTH levels on the right side.
  • Histological examination of the tumor revealed a microadenoma.
  • Neuropathological autopsy revealed nodular proliferations of corticotropic cells in the pituitary gland that are assumed to be morphological entities between diffuse hyperplasias and adenomas, termed as tumorlets.
  • In single reports, multiple pituitary lesions in patients with Cushing's disease have been demonstrated, but to our knowledge none of these cases presented the combination of an ACTH-producing microadenoma and corticotroph cell hyperplasia in the same patient.
  • Therefore, even after resection of a pituitary microadenoma one should be aware of the possibility of continuously elevated ACTH level being due to multifocal nodular corticotroph hyperplasia which is invisible by neuroradiological examination.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / pathology. Pituitary ACTH Hypersecretion / pathology. Pituitary Neoplasms / pathology

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  • [CommentIn] Exp Clin Endocrinol Diabetes. 2010 Jan;118(1):68 [20127571.001]
  • (PMID = 19085700.001).
  • [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] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone
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36. Moraes AB, Taboada GF, Carneiro MP, Neto LV, Wildemberg LE, Madi K, Domingues RC, Gadelha MR: Utility of [(18)F] fluoro-2-deoxy-D: -glucose positron emission tomography in the localization of ectopic ACTH-secreting tumors. Pituitary; 2009;12(4):380-3

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Utility of [(18)F] fluoro-2-deoxy-D: -glucose positron emission tomography in the localization of ectopic ACTH-secreting tumors.
  • Ectopically ACTH producing tumors may be difficult to localize by conventional radiology and functional imaging may be helpful.
  • Case 1: 31-year-old man was diagnosed with ectopic ACTH-dependent Cushing's syndrome (ECS).
  • Pathological examination confirmed an ACTH-positive carcinoid tumor.
  • Pituitary MRI was normal.
  • [(18)F] FDG PET scan revealed intense uptake in uterus, especially cervix, suggesting this to be the primary tumor site.
  • These cases illustrate the role of [(18)F] FDG PET in the investigation of an ECS where conventional imaging studies were not elucidative in the search for a responsible tumor.
  • [MeSH-minor] Adult. Carcinoid Tumor / diagnosis. Carcinoid Tumor / secretion. Carcinoma, Small Cell / diagnosis. Carcinoma, Small Cell / secretion. Female. Humans. Immunohistochemistry. Magnetic Resonance Imaging. Male. Middle Aged

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  • (PMID = 18459046.001).
  • [ISSN] 1573-7403
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0Z5B2CJX4D / Fluorodeoxyglucose F18
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37. Kobayashi T: Long-term results of stereotactic gamma knife radiosurgery for pituitary adenomas. Specific strategies for different types of adenoma. Prog Neurol Surg; 2009;22:77-95
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  • [Title] Long-term results of stereotactic gamma knife radiosurgery for pituitary adenomas. Specific strategies for different types of adenoma.
  • Long-term results of gamma knife radiosurgery for pituitary adenomas are presented and treatment strategies for different adenoma types are discussed.
  • Two hundred and sixty-seven patients with pituitary adenoma have been treated by gamma knife radiosurgery during the past 12 years.
  • There were 131 cases of nonfunctioning and 136 cases of functioning adenomas, in which 71 GH-producing, 33 PRL-producing and 32 ACTH-producing adenomas were included.
  • Surgical or chemical debulking was necessary before radiosurgery for a large tumor with extrasellar extension.
  • Cushing disease showed the best response because of the smallest tumor size with the highest dose treatment.
  • High-dose treatment was necessary for functioning adenomas to control tumor growth and oversecretion of hormones.
  • In conclusion, gamma knife radiosurgery was effective and safe for the treatment of pituitary adenomas.
  • However, the treatment strategies should be specific to each adenoma type according to the radiosensitivity, chemosensitivity and biological nature of the tumor.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / surgery. Acromegaly / surgery. Adenoma / surgery. Radiosurgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Child. Female. Follow-Up Studies. Growth Hormone-Secreting Pituitary Adenoma / pathology. Growth Hormone-Secreting Pituitary Adenoma / surgery. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Patient Satisfaction. Pituitary ACTH Hypersecretion / pathology. Pituitary ACTH Hypersecretion / surgery. Prolactinoma / pathology. Prolactinoma / surgery. Treatment Outcome. Young Adult

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  • (PMID = 18948721.001).
  • [ISSN] 0079-6492
  • [Journal-full-title] Progress in neurological surgery
  • [ISO-abbreviation] Prog Neurol Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
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38. Bangaru ML, Woodliff J, Raff H, Kansra S: Growth suppression of mouse pituitary corticotroph tumor AtT20 cells by curcumin: a model for treating Cushing's disease. PLoS One; 2010;5(4):e9893
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  • [Title] Growth suppression of mouse pituitary corticotroph tumor AtT20 cells by curcumin: a model for treating Cushing's disease.
  • BACKGROUND: Pituitary corticotroph tumors secrete excess adrenocorticotrophic hormone (ACTH) resulting in Cushing's disease (CD).
  • Standard treatment includes surgery and, if not successful, radiotherapy, both of which have undesirable side effects and frequent recurrence of the tumor.
  • Our laboratory recently demonstrated that curcumin inhibited growth and induced apoptosis in prolactin- and growth hormone-producing tumor cells.
  • Subsequently, Schaaf et.al. confirmed our findings and also showed the in vivo effectiveness of curcumin to suppress pituitary tumorigenesis.
  • PRINCIPAL FINDINGS: Using the mouse corticotroph tumor cells, AtT20 cells, we report that curcumin had a robust, irreversible inhibitory effect on cell proliferation and clonogenic property.
  • Finally, curcumin had a concentration-dependent suppressive effect on ACTH secretion from AtT20 cells.
  • CONCLUSION: The ability of curcumin to inhibit NFkappaB and induce apoptosis in pituitary corticotroph tumor cells leads us to propose developing it as a novel therapeutic agent for the treatment of CD.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / drug therapy. Cell Proliferation / drug effects. Curcumin / pharmacology. Pituitary ACTH Hypersecretion / drug therapy
  • [MeSH-minor] Adrenocorticotropic Hormone / secretion. Animals. Antineoplastic Agents. Apoptosis / drug effects. Cell Line, Tumor. Dose-Response Relationship, Drug. Mice. NF-kappa B / antagonists & inhibitors

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  • [ErratumIn] PLoS One. 2010;5(4). doi:10.1371/annotation/38a101d6-a1f2-4a74-ab63-bc5c61e5f62b
  • (PMID = 20405005.001).
  • [ISSN] 1932-6203
  • [Journal-full-title] PloS one
  • [ISO-abbreviation] PLoS ONE
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / NF-kappa B; 9002-60-2 / Adrenocorticotropic Hormone; IT942ZTH98 / Curcumin
  • [Other-IDs] NLM/ PMC2854133
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39. Suzuki S, Uchida D, Koide H, Suyama K, Shibata T, Yoshida T, Tanaka T, Noguchi Y, Saito Y, Tatsuno I: A possible association between aldosterone response to vasopressin and circadian change of aldosterone in the patients with aldosterone-producing adenoma. Peptides; 2008 Dec;29(12):2225-31
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  • [Title] A possible association between aldosterone response to vasopressin and circadian change of aldosterone in the patients with aldosterone-producing adenoma.
  • Vasopressin was reported to stimulate secretion of both cortisol and aldosterone through eutopic V1a receptors in adrenal gland.
  • Recently, adrenal hyper-responsiveness of plasma cortisol to vasopressin with eutopic overexpession of V1a receptors has been reported in Cushing's syndrome, such as a majority of cases of ACTH-independent macronodular adrenal hyperplasia and some cases of Cushing's adenomas.
  • There were a few reports regarding the aldosterone response to vasopressin in aldosterone-producing adenoma.
  • The aim of our study was to investigate the aldosterone response to vasopressin and its pathophysiological roles in the patients with aldosterone-producing adenoma.
  • Vasopressin-loading test was performed in 10 patients with aldosterone-producing adenoma, and in 16 patients with non-functioning adrenal tumors.
  • The roles of the aldosterone response to vasopressin were analyzed in terms of hormonal secretion and the expression of V1a receptor mRNA on the operated adrenal gland in aldosterone-producing adenoma.
  • We found that (1) a varying aldosterone response to vasopressin was observed, (2) absolute response of plasma aldosterone in aldosterone-producing adenoma was significantly higher than that in non-functioning tumor, (3) aldosterone response rate to vasopressin was significantly and negatively correlated with the decline rate (%) in plasma aldosterone from morning to evening in aldosterone-producing adenoma, (4) V1a receptor mRNA was expressed at various values in aldosterone-producing adenoma, and (5) surgical removal of aldosterone-producing adenoma eliminated the aldosterone response to vasopressin observed in patients with aldosterone-producing adenoma.
  • These findings indicated that vasopressin might be involved in the coordination of aldosterone secretion through eutopic expression of V1a receptor in aldosterone-producing adenoma.
  • [MeSH-major] Adenoma / metabolism. Aldosterone / blood. Circadian Rhythm. Pituitary Neoplasms / metabolism. Vasopressins / pharmacology

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  • (PMID = 18838094.001).
  • [ISSN] 0196-9781
  • [Journal-full-title] Peptides
  • [ISO-abbreviation] Peptides
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / RNA, Messenger; 0 / Receptors, Vasopressin; 11000-17-2 / Vasopressins; 4964P6T9RB / Aldosterone
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40. Kajiwara K, Saito K, Yoshikawa K, Kato S, Akimura T, Nomura S, Ishihara H, Suzuki M: Image-guided stereotactic radiosurgery with the CyberKnife for pituitary adenomas. Minim Invasive Neurosurg; 2005 Apr;48(2):91-6
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  • [Title] Image-guided stereotactic radiosurgery with the CyberKnife for pituitary adenomas.
  • Twenty-one patients with pituitary adenomas received image-guided stereotactic radiosurgery with the CyberKnife, and were followed up for more than 18 months.
  • The patients consisted of 14 with non-functioning adenomas, 3 with prolactinomas, 2 with acromegaly, and 2 with ACTH-producing tumors.
  • The change in the tumor volume, visual acuity, hormonal function, and complications by this therapy were analyzed in each case.
  • The tumor control rate was 95.2 %.
  • In 1 case, visual acuity worsened due to cystic enlargement of the tumor.
  • The hormone level normalized in 1 prolactinoma, and decreased to less than normal in 1 ACTH-producing adenoma.
  • Image-guided stereotactic radiosurgery with the CyberKnife is effective and safe against relatively large pituitary adenomas.
  • Careful long-term follow-up of the patients is necessary because of delayed cystic enlargement of the tumor in rare cases.
  • [MeSH-major] Adenoma / surgery. Pituitary Neoplasms / surgery. Radiosurgery / instrumentation. Surgery, Computer-Assisted / instrumentation

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  • (PMID = 15906203.001).
  • [ISSN] 0946-7211
  • [Journal-full-title] Minimally invasive neurosurgery : MIN
  • [ISO-abbreviation] Minim Invasive Neurosurg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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41. Liu RX, Wang WQ, Ye L, Bi YF, Fang H, Cui B, Zhou WW, Dai M, Zhang J, Li XY, Ning G: p21-activated kinase 3 is overexpressed in thymic neuroendocrine tumors (carcinoids) with ectopic ACTH syndrome and participates in cell migration. Endocrine; 2010 Aug;38(1):38-47
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  • [Title] p21-activated kinase 3 is overexpressed in thymic neuroendocrine tumors (carcinoids) with ectopic ACTH syndrome and participates in cell migration.
  • Thymic carcinoid is an important component of the tumor spectrum causing Ectopic ACTH Syndrome (EAS) and usually carries a poor prognosis.
  • Efforts have been focused on exploring the mechanism of the excessive ACTH production in non-pituitary tumors, whereas few studies have reported the molecular events underlying the tumor progression.
  • In this study, seven patients with ACTH producing thymic carcinoids were enrolled.
  • Our findings suggested a potential role of PAK3 in the progression of ACTH-producing thymic carcinoid.
  • [MeSH-major] ACTH Syndrome, Ectopic / genetics. Carcinoid Tumor / genetics. Carcinoma, Neuroendocrine / genetics. Thymus Neoplasms / genetics. p21-Activated Kinases / genetics

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  • (PMID = 20960100.001).
  • [ISSN] 1559-0100
  • [Journal-full-title] Endocrine
  • [ISO-abbreviation] Endocrine
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Neuropeptides; 0 / Rac1 protein, mouse; 9002-60-2 / Adrenocorticotropic Hormone; EC 2.7.11.1 / PAK3 protein, human; EC 2.7.11.1 / Pak3 protein, mouse; EC 2.7.11.1 / p21-Activated Kinases; EC 3.6.5.2 / rac GTP-Binding Proteins; EC 3.6.5.2 / rac1 GTP-Binding Protein
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42. Ceyhan K, Yagmurlu B, Dogan BE, Erdogan N, Bulut S, Erekul S: Cytopathologic features of pituitary carcinoma with cervical vertebral bone metastasis: a case report. Acta Cytol; 2006 Mar-Apr;50(2):225-30
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  • [Title] Cytopathologic features of pituitary carcinoma with cervical vertebral bone metastasis: a case report.
  • BACKGROUND: Pituitary carcinomas are extremely rare tumors of the adenohypophysis.
  • The presence of craniospinal and/or systemic extracranial metastases is the only reliable criterion for the diagnosis of pituitary carcinoma.
  • We present an additional case of pituitary carcinoma with FNAB features.
  • CASE: A 60-year-old woman presented with clinical features of Cushing's disease and a pituitary tumor.
  • She underwent transsphenoidal resection of the tumor.
  • The initial diagnosis was an adrenocorticotrophic hormone (ACTH)-producing invasive pituitary adenoma.
  • Magnetic resonance imaging revealed metastatic tumor masses at the level of C5-C6 of the cervical vertebrae.
  • Cytologically, tumor cells were composed of a combination of loose groups and single cells.
  • Neoplastic cells had a relatively monotonous appearance and displayed characteristic neuroendocrine tumor features.
  • Immunocytochemistry from cell block sections revealed AE1/ AE3, synaptophysin chromogranin A and ACTH positivity in the tumor cells.
  • CONCLUSION: Pituitary carcinoma with extracranial systemic metastases demonstrates typical neuroendocrine features on fine needle aspiration.
  • [MeSH-major] Bone Neoplasms / secondary. Carcinoma / pathology. Cervical Vertebrae / pathology. Pituitary Neoplasms / pathology
  • [MeSH-minor] Biopsy, Fine-Needle / methods. Carcinoma, Neuroendocrine / diagnosis. Female. Humans. Magnetic Resonance Imaging. Middle Aged. Neoplasm, Residual. Pituitary ACTH Hypersecretion / etiology. Sensitivity and Specificity


43. Shah NA, Urusova IA, D'Agnolo A, Colquhoun SD, Rosenbloom BE, Vener SL, Geller SA, Younes M, Lechago J, Heaney AP: Primary hepatic carcinoid tumor presenting as Cushing's syndrome. J Endocrinol Invest; 2007 Apr;30(4):327-33
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  • [Title] Primary hepatic carcinoid tumor presenting as Cushing's syndrome.
  • ACTH-producing carcinoid tumors most commonly originate in the lung or thymus and present insidiously with bronchospasm and/or chest mass.
  • Occasionally, ectopic ACTH syndromes have been reported in association with pancreatic islet cell tumors, medullary thyroid cancer, pheochromocytoma, small-cell lung carcinoma, and rarely, ovarian and prostate tumors.
  • We report here a patient with an ectopic ACTH-secreting primary hepatic carcinoid tumor who presented with cushingoid appearance, profound proximal muscle weakness, severe lower extremity edema, and markedly elevated urinary free cortisol.
  • ACTH levels were in the low normal range.
  • Following surgical resection of the hepatic tumor, histopathology confirmed an ACTH-secreting neuroendocrine tumor (NET), the patient had complete resolution of hypercortisolemic symptoms and remains in remission, now 4 yr after hepatic tumor resection.
  • This case reports the first ACTH-secreting primary hepatic NET presenting as ectopic Cushing's syndrome.
  • Interesting aspects of this case include the presence of a pituitary incidentaloma, the low normal ACTH, and photopenia on 18FDG-PET imaging.
  • [MeSH-major] ACTH Syndrome, Ectopic / diagnosis. Carcinoid Tumor / diagnosis. Cushing Syndrome / diagnosis. Liver Neoplasms / diagnosis


44. Yoshida D, Kim K, Yamazaki M, Teramoto A: Expression of hypoxia-inducible factor 1alpha and cathepsin D in pituitary adenomas. Endocr Pathol; 2005;16(2):123-31
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  • [Title] Expression of hypoxia-inducible factor 1alpha and cathepsin D in pituitary adenomas.
  • In order to determine the involvement of angiogenesis in pituitary adenomas, we studied the expression of both HIF-1alpha and cathepsin D in tissues from 58 patients (39 women, 19 men, ranging in age from 20 to 78 yr), sorted by histological group, and assayed by double immunohistochemistry.
  • HIF-1alpha immunoreactivity, confined to the nucleoplasm, was present in both tumor and vascular endothelial cells.
  • ACTH-producing adenomas showed the lowest level of HIF-1alpha, whereas prolactin (PRL)-producing adenomas and HIF-1alpha-positive microvessels showed the highest (p < 0.001).
  • In contrast, the lowest expression of cathepsin D was observed in PRL-producing adenomas, whereas the highest expression was detected in ACTH-producing adenomas (p < 0.0001).
  • Imaging analysis with fluorescence double immunohistochemistry showed that HIF-1alpha-negative tumor cells did not express significantly higher levels of cathepsin D.
  • The mechanisms of tumor angiogenesis and cell invasion in pituitary adenomas may differ from those in other tumor cells.
  • [MeSH-major] Adenoma / metabolism. Cathepsin D / biosynthesis. Hypoxia-Inducible Factor 1, alpha Subunit / biosynthesis. Pituitary Neoplasms / metabolism

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  • (PMID = 16199897.001).
  • [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 / Hypoxia-Inducible Factor 1, alpha Subunit; EC 3.4.23.5 / Cathepsin D
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45. Kageyama K, Ikeda H, Nigawara T, Sakihara S, Suda T: Expression of adrenocorticotropic hormone, prolactin and transcriptional factors in clinically nonfunctioning pituitary adenoma. Endocr J; 2007 Dec;54(6):961-8
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  • [Title] Expression of adrenocorticotropic hormone, prolactin and transcriptional factors in clinically nonfunctioning pituitary adenoma.
  • We describe here a case of a clinically nonfunctioning pituitary adenoma, but with expression of ACTH and PRL.
  • A 42-year-old woman was referred to our department for further evaluation of pituitary tumor.
  • GH, IGF-I, LH, FSH, TSH, ACTH and cortisol levels in blood were all within the normal ranges, while PRL levels were mildly elevated.
  • Both ACTH and cortisol levels were adequately increased in response to CRH, and both were suppressed by a small dose of dexamethasone.
  • Plasma ACTH and cortisol levels were decreased at night, suggesting the circadian rhythms for plasma ACTH levels were undisturbed.
  • Based on these findings we did not clinically suspect ACTH-producing tumor, however immunohistochemistry revealed ACTH immunoreactivity in the pituitary adenoma.
  • Therefore, the tumor was considered a silent corticotroph adenoma.
  • PRL was co-expressed in a significant subpopulation of ACTH-immunoreactive tumor cells.
  • It is therefore possible that a tumor originating in an immature or uncommited adenohypophysial stem cell may later differentiate into different cell types due to a combination of certain specific transcriptional factors.
  • [MeSH-major] Adenoma, Chromophobe / metabolism. Adrenocorticotropic Hormone / biosynthesis. Pituitary Neoplasms / metabolism. Prolactin / biosynthesis. Transcription Factors / biosynthesis

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  • (PMID = 18079591.001).
  • [ISSN] 1348-4540
  • [Journal-full-title] Endocrine journal
  • [ISO-abbreviation] Endocr. J.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Basic Helix-Loop-Helix Transcription Factors; 0 / ERGIC2 protein, human; 0 / Homeodomain Proteins; 0 / NEUROD1 protein, human; 0 / T-Box Domain Proteins; 0 / TBX19 protein, human; 0 / Transcription Factor Pit-1; 0 / Transcription Factors; 0 / Vesicular Transport Proteins; 12629-01-5 / Human Growth Hormone; 9002-60-2 / Adrenocorticotropic Hormone; 9002-62-4 / Prolactin; 9002-71-5 / Thyrotropin
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46. Kim K, Yoshida D, Teramoto A: Expression of hypoxia-inducible factor 1alpha and vascular endothelial growth factor in pituitary adenomas. Endocr Pathol; 2005;16(2):115-21
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  • [Title] Expression of hypoxia-inducible factor 1alpha and vascular endothelial growth factor in pituitary adenomas.
  • In malignant tumors, HIF-1alpha upregulates vascular endothelial growth factor (VEGF) expression to induce tumor angiogenesis.
  • Although VEGF and HIF-1alpha are expressed in pituitary adenomas, the relationships of these factors remain unclear.
  • Therefore, we examined the expression of HIF-1alpha and VEGF using real-time RT-PCR and immunohistochemistry to clarify the relationship of these factors in pituitary adenomas.
  • HIF-1alpha mRNA and VEGF mRNA levels in pituitary adenoma tissues from 25 operated patients were quantified using real-time RT-PCR.
  • HIF-1alpha mRNA and protein were expressed in all pituitary adenomas examined.
  • Their expression tended to be higher in GH-producing and lower in ACTH-producing tumors.
  • VEGF mRNA and protein were also expressed in all pituitary adenomas.
  • Our results suggest that in pituitary adenomas VEGF expression may not depend strongly on HIF-1alpha expression.
  • [MeSH-major] Adenoma / metabolism. Hypoxia-Inducible Factor 1, alpha Subunit / biosynthesis. Pituitary Neoplasms / metabolism. Vascular Endothelial Growth Factor A / biosynthesis

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  • (PMID = 16199896.001).
  • [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 / Hypoxia-Inducible Factor 1, alpha Subunit; 0 / RNA, Messenger; 0 / Vascular Endothelial Growth Factor A
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47. Kunishio K, Okada M, Matsumoto Y, Nagao S, Nishiyama Y: Technetium-99m sestamibi single photon emission computed tomography findings correlated with P-glycoprotein expression in pituitary adenoma. J Med Invest; 2006 Aug;53(3-4):285-91
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  • [Title] Technetium-99m sestamibi single photon emission computed tomography findings correlated with P-glycoprotein expression in pituitary adenoma.
  • The aim of this study is to evaluate whether the technetium-99m sestamibi ((99m)Tc-MIBI) single photon emission computed tomography (SPECT) characteristics of pituitary adenomas might be correlated with cavernous sinus invasion, proliferative potential or the multidrug-resistance (MDR-1) gene product P-glycoprotein (Pgp) expression in pituitary adenomas.
  • Fifteen patients with pituitary adenomas, including 10 nonfunctioning adenomas, two prolactinomas, two GH producing adenomas, and one ACTH producing adenomas was investigated for this study.
  • The tumor-to-normal brain ratio was calculated both early (ER) and delayed (DR) images.
  • The pituitary adenomas specimens were examined by immunohistochemistry using anti-Pgp and MIB-1 monoclonal antibodies.(99m)Tc-MIBI SPECT findings were not related to MIB-1 labeling index or cavernous sinus invasion. (99m)Tc-MIBI SPECT RI (-38.55+/-20.77) of the Pgp-positive group was significantly lower than that (-15.78+/-19.40) of Pgp-negative group (p=0.0494).
  • Our study suggests that although (99m)Tc-MIBI SPECT is not useful to evaluate the proliferative potential or cavernous sinus invasion of pituitary adenomas. (99m)Tc-MIBI SPECT could predict anti-cancer drug resistance related to the expression of Pgp in pituitary adenomas.
  • [MeSH-major] P-Glycoprotein / metabolism. Pituitary Neoplasms / metabolism. Pituitary Neoplasms / radionuclide imaging
  • [MeSH-minor] Adult. Aged. Cavernous Sinus / pathology. Cell Proliferation. Female. Gene Expression Regulation, Neoplastic. Genes, MDR. Humans. Immunohistochemistry. Male. Middle Aged. Neoplasm Invasiveness. RNA, Messenger / genetics. RNA, Messenger / metabolism. Technetium Tc 99m Sestamibi. Tomography, Emission-Computed, Single-Photon

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  • (PMID = 16953066.001).
  • [ISSN] 1343-1420
  • [Journal-full-title] The journal of medical investigation : JMI
  • [ISO-abbreviation] J. Med. Invest.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / P-Glycoprotein; 0 / RNA, Messenger; 971Z4W1S09 / Technetium Tc 99m Sestamibi
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48. Gaffey TA Jr, Scheithauer BW, Leech RW, Blick K, Kovacs K, Horvath E, Weaver AL, Lloyd RV, Ebersold M, Laws ER Jr, DeBault LE: Pituitary adenoma: a DNA flow cytometric study of 192 clinicopathologically characterized tumors. Clin Neuropathol; 2005 Mar-Apr;24(2):56-63
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pituitary adenoma: a DNA flow cytometric study of 192 clinicopathologically characterized tumors.
  • A clinically, immunohistochemically and ultrastructurally characterized series of 192 pituitary adenomas was analyzed for DNA content by flow cytometry.
  • Results were assessed not only relative to tumor immunotype, size, and invasiveness, but also with frequency of recurrence.
  • Female patients were slightly younger and, in all adenoma categories, less often had invasive tumors: PRL (15%/30%), ACTH (17%/44%), LH/FSH (8%/27%) and null cell adenomas (0%/27%).
  • With the exception of prolactin cell adenomas, similar proportions of macroadenomas and invasive tumors in all tumor subtypes were diploid and non-diploid.
  • ACTH adenomas were mainly microadenomas (81%), their rate invasion (29%) and of non-diploidy being low (14%).
  • Among "non-functioning" (LH/FSH, null cell adenomas), LH/FSH-producing tumors were all macroadenomas, but with low rates of invasion (23%) and non-diploidy (9%).
  • When compared to long-term follow-up, neither this parameter nor ploidy correlated with tumor size or invasiveness.
  • Lastly, long-term follow-up showed ploidy to be an unreliable predictor of tumor persistence or recurrence.
  • [MeSH-major] Adenoma / genetics. Adenoma / metabolism. DNA / metabolism. Pituitary Neoplasms / genetics. Pituitary Neoplasms / metabolism. Ploidies
  • [MeSH-minor] Adrenocorticotropic Hormone / metabolism. Female. Flow Cytometry. Gonadotropins, Pituitary / metabolism. Human Growth Hormone / metabolism. Humans. Male. Neoplasm Invasiveness. Neoplasm Recurrence, Local / genetics. Neoplasm Recurrence, Local / metabolism. Neoplasm Recurrence, Local / pathology. S Phase. Sex Factors

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  • (PMID = 15803804.001).
  • [ISSN] 0722-5091
  • [Journal-full-title] Clinical neuropathology
  • [ISO-abbreviation] Clin. Neuropathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Gonadotropins, Pituitary; 12629-01-5 / Human Growth Hormone; 9002-60-2 / Adrenocorticotropic Hormone; 9007-49-2 / DNA
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49. Borrero CG, McCook B, Mountz JM: Indium-111 pentetreotide imaging of carcinoid tumor of the thymus. Clin Nucl Med; 2005 Apr;30(4):218-21
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  • [Title] Indium-111 pentetreotide imaging of carcinoid tumor of the thymus.
  • In this report, we present imaging findings and discussion pertaining to a 43-year-old man who presented with Cushing's syndrome resulting from a thymic carcinoid tumor.
  • The imaging is of interest because there is not only marked uptake of In-111 pentetreotide in the thymic carcinoid tumor, but also within the adrenal glands attributable to elevated tumor-derived ACTH.
  • RESULTS: Initial clinical workup for Cushing's syndrome included a contrast-enhanced brain magnetic resonance image that showed a small pituitary lesion thought to represent a microadenoma.
  • Normal inferior petrosal venous sinus sampling for ACTH suggested there was an ectopic ACTH source.
  • Avid uptake within the mass on In-111 pentetreotide images suggested that the underlying cause of Cushing's syndrome was ACTH production from a thymic carcinoid.
  • Surgical resection and histologic evaluation established the diagnosis of a moderately differentiated thymic carcinoid tumor.
  • CONCLUSION: This case illustrates the complementary ability of In-111 pentetreotide planar and SPECT imaging and CT to diagnose an ACTH-producing thymic carcinoid tumor leading to adrenal hyperplasia and Cushing's syndrome.
  • [MeSH-major] Carcinoid Tumor / radiography. Carcinoid Tumor / radionuclide imaging. Cushing Syndrome / diagnosis. Somatostatin / analogs & derivatives. Thymus Neoplasms / radiography. Thymus Neoplasms / radionuclide imaging

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  • (PMID = 15764874.001).
  • [ISSN] 0363-9762
  • [Journal-full-title] Clinical nuclear medicine
  • [ISO-abbreviation] Clin Nucl Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 51110-01-1 / Somatostatin; G083B71P98 / pentetreotide
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50. Tateno T, Kato M, Tani Y, Yoshimoto T, Oki Y, Hirata Y: Processing of high-molecular-weight form adrenocorticotropin in human adrenocorticotropin-secreting tumor cell line (DMS-79) after transfection of prohormone convertase 1/3 gene. J Endocrinol Invest; 2010 Feb;33(2):113-7
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  • [Title] Processing of high-molecular-weight form adrenocorticotropin in human adrenocorticotropin-secreting tumor cell line (DMS-79) after transfection of prohormone convertase 1/3 gene.
  • Ectopic ACTH-producing tumors preferentially secrete biologically inactive ACTH precursors and ACTH-related fragments.
  • DMS-79 is known to secrete unprocessed high-molecular-weight (HMW) form ACTH.
  • Molecular weights of ACTH-related peptides were determined by chromatographical analyses coupled with ACTH and beta-endorphin (beta-END) radioimmunoassays.
  • The steady-state mRNA levels of PC1/3 and 2 in DMS-79 were lower than those in ACTH-secreting and nonfunctioning pituitary tumors.
  • DMS-79 predominantly secreted HMW form with both ACTH and beta-END immunoreactivities by size-exclusion chromatography.
  • After purification by immunoaffinity chromatography with anti-ACTH antibody, the apparent molecular weight of HMW form ACTH was estimated to be 16 kDa by sodium dodecyl sulfate-polyacrylamide gel electrophoresis with silver staining.
  • After retroviral transfection of PC1/3 cDNA into DMS-79 and puromycin selection, PC1/3 stably-expressing cell line (DMS-79T) secreted two immunoreactive ACTH components, a major one coeluting with ACTH(1-39) and a minor one as a HMW form as well as two beta- END immunoreactive components coeluting with beta-lipotropic hormone and beta-END, respectively.
  • Thus, we have established PC1/3 stably-expressing cell line (DMS-79T) capable of proteolytically processing ACTH precursor molecule(s) into mature ACTH and beta-END.
  • [MeSH-minor] Adenoma / secretion. Cell Line, Tumor. Electrophoresis, Polyacrylamide Gel. Humans. Lung Neoplasms. Molecular Weight. Pituitary Neoplasms / secretion. Proprotein Convertase 2 / genetics. Proprotein Convertase 2 / metabolism. RNA, Messenger / analysis. Retroviridae / genetics. Small Cell Lung Carcinoma. Transfection. beta-Endorphin / metabolism

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  • (PMID = 19786827.001).
  • [ISSN] 1720-8386
  • [Journal-full-title] Journal of endocrinological investigation
  • [ISO-abbreviation] J. Endocrinol. Invest.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / RNA, Messenger; 60617-12-1 / beta-Endorphin; 66796-54-1 / Pro-Opiomelanocortin; 9002-60-2 / Adrenocorticotropic Hormone; EC 3.4.21.93 / Proprotein Convertase 1; EC 3.4.21.94 / Proprotein Convertase 2
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51. Miyoshi T, Otsuka F, Suzuki J, Inagaki K, Takeda M, Kano Y, Yamashita T, Ogura T, Date I, Tanaka Y, Hashimoto K, Makino H: Periodic secretion of adrenocorticotropin in a patient with Cushing's disease manifested during pregnancy. Endocr J; 2005 Jun;52(3):287-92
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  • [Title] Periodic secretion of adrenocorticotropin in a patient with Cushing's disease manifested during pregnancy.
  • We report the case of 19-year-old woman with cyclical Cushing's disease, in whom plasma adrenocorticotropin (ACTH) was secreted periodically after her first pregnancy.
  • Her ACTH secretion lacked normal daily fluctuation but exhibited periodic change during 1-year observation, showing 119 pg/ml, 34.6 pg/ml and 115 pg/ml at the 4th, 7th and 13th months after delivery.
  • Plasma ACTH levels were increased by corticotropin releasing hormone and metyrapone, while low-dose dexamethasone suppressed cortisol secretion.
  • Gel filtration analysis of the patient's plasma detected big ACTH molecules being eluted with a peak of authentic 1-39 ACTH.
  • Cranial magnetic resonance imaging revealed a 1-cm pituitary mass in right cavernous sinus.
  • The pituitary tumor was removed by transsphenoidal surgery at 13th month after delivery and was pathologically compatible with ACTH-producing pituitary adenoma by immunohistochemistry.
  • This case includes clinically rare subsets of Cushing's syndrome showing periodic ACTH secretion and aberrant ACTH molecules.
  • [MeSH-major] Adenoma / secretion. Adrenocorticotropic Hormone / secretion. Pituitary ACTH Hypersecretion / blood. Pituitary Neoplasms / secretion. Pregnancy Complications, Neoplastic / blood
  • [MeSH-minor] Adult. Corticotropin-Releasing Hormone / pharmacology. Female. Humans. Hydrocortisone / blood. Hydrocortisone / secretion. Metyrapone. Pregnancy

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  • (PMID = 16006722.001).
  • [ISSN] 0918-8959
  • [Journal-full-title] Endocrine journal
  • [ISO-abbreviation] Endocr. J.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone; 9015-71-8 / Corticotropin-Releasing Hormone; WI4X0X7BPJ / Hydrocortisone; ZS9KD92H6V / Metyrapone
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52. Tsuchiya K, Ohta K, Yoshimoto T, Doi M, Izumiyama H, Hirata Y: A Case of acromegaly associated with subclinical Cushing's disease. Endocr J; 2006 Oct;53(5):679-85
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Magnetic resonance imaging of the brain revealed the presence of a pituitary macroadenoma.
  • Endocrine examination of the hypothalamo-pituitary-adrenal (HPA) axis showed a lack of circadian rhythm of ACTH and cortisol, non-suppressibility to low-dose (1 mg), but suppressibility to high-dose (8 mg) dexamethasone, and normal response to CRH stimulation.
  • The tumor resected by transsphenoidal surgery was histopathologically consistent with the diagnosis of eosinophilic adenoma: positive immunoreactivities of GH, PRL and ACTH were demonstrated, but negative immunoreactivities of prohormone convertase (PC) 1/3 by immunohistochemical method.
  • Metabolic co-morbidities such as diabetes and hypertension disappeared after removal of the pituitary tumor.
  • This is a very rare case of GH-producing pituitary adenoma causing typical acromegaly with concomitant production of ACTH causing subclinical Cushing's disease.
  • [MeSH-major] Acromegaly / complications. Pituitary ACTH Hypersecretion / complications
  • [MeSH-minor] Adenoma / diagnosis. Adenoma / radiography. Adenoma / surgery. Adrenocorticotropic Hormone / blood. Diabetes Mellitus, Type 2 / blood. Diabetes Mellitus, Type 2 / complications. Growth Hormone-Secreting Pituitary Adenoma / diagnosis. Growth Hormone-Secreting Pituitary Adenoma / radiography. Growth Hormone-Secreting Pituitary Adenoma / surgery. Human Growth Hormone / blood. Humans. Hydrocortisone / blood. Male. Middle Aged. Pituitary Function Tests

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  • (PMID = 16926523.001).
  • [ISSN] 0918-8959
  • [Journal-full-title] Endocrine journal
  • [ISO-abbreviation] Endocr. J.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone
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53. Dehdashti AR, Gentili F: Current state of the art in the diagnosis and surgical treatment of Cushing disease: early experience with a purely endoscopic endonasal technique. Neurosurg Focus; 2007;23(3):E9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • OBJECT: Transsphenoidal pituitary surgery is the primary therapy for Cushing disease because of its potential to produce lasting remission without the need for long-term drug or hormone replacement therapy.
  • The authors evaluated the current role of pure endoscopic endonasal pituitary surgery in the treatment of Cushing disease.
  • Final histological results were consistent with adrenocorticotropin hormone (ACTH)-secreting adenoma in 20 patients.
  • Three patients presented with new anterior pituitary deficiency, but no one had permanent diabetes insipidus.
  • Treatment failure was attributable to involvement of the cavernous sinus in two patients, incomplete tumor removal in one, negative exploration in one, and nodular corticotroph hyperplasia of the pituitary gland in one.
  • CONCLUSIONS: Early results indicated that endoscopic endonasal surgery is a safe and effective treatment for ACTH-producing adenomas.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / surgery. Adenoma / surgery. Endoscopy. Paranasal Sinuses / surgery. Pituitary ACTH Hypersecretion / diagnosis. Pituitary ACTH Hypersecretion / surgery

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  • (PMID = 17961027.001).
  • [ISSN] 1092-0684
  • [Journal-full-title] Neurosurgical focus
  • [ISO-abbreviation] Neurosurg Focus
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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54. Jang BG, Kim SY, Park SH: Multiple pulmonary atypical carcinoids presenting with long-standing Cushing syndrome masked by pulmonary tuberculosis. Pathol Int; 2009 Jun;59(6):399-404
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Sometimes these adrenocorticotropic hormone (ACTH)-producing tumors are too small to localize, and it may take a long time to identify them.
  • This CS was due to the ectopic ACTH produced by the pulmonary atypical carcinoids, which were recognized at the disseminated stage 5 years after the initial presentation of CS.
  • Microscopically, multiple whitish nodules (up to 1.0 cm in diameter) of the wedge-resected lung were composed of small round cells appearing to be typical neuroendocrine but were diagnosed as atypical carcinoid, based on the findings of focal necrosis, high mitotic rates and multiple endolymphatic tumor emboli.
  • Immunohistochemically, tumor cells robustly stained for ACTH.
  • In addition, this patient had a Crooke's cell hyperplasia of the pituitary gland, which represents the reactive change of corticotrophs exposed to the excess cortisol rather than neoplastic change leading to CS.
  • [MeSH-major] Carcinoid Tumor / complications. Cushing Syndrome / etiology. Lung Neoplasms / complications. Tuberculosis, Pulmonary / complications
  • [MeSH-minor] Adrenocorticotropic Hormone / blood. Adult. Antitubercular Agents / therapeutic use. Humans. Immunohistochemistry. Male. Pituitary Diseases / etiology


55. Oki K, Yamane K, Oda Y, Kamei N, Watanabe H, Tominaga A, Amatya VJ, Oki Y, Kohno N: Combined acromegaly and subclinical Cushing disease related to high-molecular-weight adrenocorticotropic hormone. J Neurosurg; 2009 Feb;110(2):369-73
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The clinical diagnosis of growth hormone (GH)-producing pituitary adenoma was confirmed by MR imaging findings, nonsuppression of serum GH levels during a 75-g oral glucose tolerance test (trough GH 6.33 ng/ml), and elevated serum insulin-like growth factor-I levels (1361.3 ng/ml).
  • Moreover, autonomic adrenocorticotropic hormone (ACTH) secretion was suspected, based on inadequate suppression of ACTH or cortisol levels by an 0.5-mg overnight dexamethasone suppression test.
  • Analysis of the patient's plasma by using the gel filtration method revealed the presence of a high-molecular-weight (HMW) form of ACTH known to exhibit low biological activity.
  • Transsphenoidal adenomectomy was performed for the pituitary tumor.
  • Immunohistochemical investigation of the resected specimen showed strong and diffuse immunoreactivity to GH and focal immunoreactivity to ACTH.
  • Although there have been a few cases of pituitary adenoma that produced GH and ACTH concomitantly, this is the first report of the detection of HMW ACTH in patients with GH- and ACTH-producing adenomas.
  • It is suggested that the secretion of ACTH in patients with concurrent GH- and ACTH-secreting adenomas might consist of the HMW form and that the HMW ACTH is consequently associated with a subclinical Cushing state.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / diagnosis. Adrenocorticotropic Hormone / blood. Growth Hormone-Secreting Pituitary Adenoma / diagnosis. Neoplasms, Multiple Primary / diagnosis. Pituitary ACTH Hypersecretion / diagnosis. Pituitary Neoplasms / diagnosis
  • [MeSH-minor] Adult. Craniotomy. Humans. Male. Molecular Weight. Pituitary Function Tests. Radioimmunoassay. Sphenoid Bone / surgery

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  • (PMID = 18991502.001).
  • [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] 9002-60-2 / Adrenocorticotropic Hormone
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56. Petrossians P, Thonnard AS, Beckers A: Medical treatment in Cushing's syndrome: dopamine agonists and cabergoline. Neuroendocrinology; 2010;92 Suppl 1:116-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Dopamine (DA) is a catecholamine with a wide range of functions and whose five subtype receptors are found in different organs where they exert a mainly inhibitory action.
  • Since this action may also appear in a number of secretory tumors in various locations, DA agonists have elicited some interest as a medical treatment for hypercorticism.
  • Non-iatrogenic Cushing's syndromes are due in 70% of the cases to a pituitary adrenocorticotropic hormone (ACTH)-producing adenoma, and, less frequently, to an adrenal adenoma or an ectopic ACTH secretion by a neuroendocrine tumor.
  • First-line treatment in Cushing's syndrome consists of the surgical removal of the secreting tumor.
  • Clinical trials of DA agonists in Cushing's disease have shown an inhibitory effect of these drugs with an inhibition of ACTH secretion and/or a decrease of tumor size.
  • There are only a few cases of documented use of DA agonists in ectopic ACTH secretion, but when the tumor expresses DA receptors, DA agonists may represent a useful complementary treatment.
  • DA receptors are also expressed in normal and tumoral adrenals, suggesting a potential use of DA agonists in Cushing's syndrome secondary to adrenal tumors.
  • In conclusion, DA agonists represent a potential preparatory or complementary treatment for endogenous Cushing's syndrome, especially in Cushing's disease.

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  • [Copyright] Copyright © 2010 S. Karger AG, Basel.
  • (PMID = 20829631.001).
  • [ISSN] 1423-0194
  • [Journal-full-title] Neuroendocrinology
  • [ISO-abbreviation] Neuroendocrinology
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Dopamine Agonists; 0 / Ergolines; LL60K9J05T / cabergoline
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57. Tanaka H, Kobayashi A, Bando M, Hosono T, Tsujita A, Yamasawa H, Ohno S, Hironaka M, Sugiyama Y: [Case of small cell lung cancer complicated with diabetes insipidus and Cushing syndrome due to ectopic adrenocorticotropic hormone secretion]. Nihon Kokyuki Gakkai Zasshi; 2007 Oct;45(10):793-8
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  • Small-cell lung cancer (metastases in the pituitary, subcutaneous tissue, and lungs) was diagnosed by transbronchial lung biopsy and subcutaneous nodule biopsy of the abdomen.
  • Chemotherapy was done with CDDP and VP-16, which resulted in reduction of the tumor and improvement in endocrinological findings.
  • We concluded that this case was Cushing syndrome caused by ectopic adrenocorticotropic hormone-producing small cell lung cancer, and that it presented with diabetes insipidus because of pituitary metastasis.
  • [MeSH-major] ACTH Syndrome, Ectopic / etiology. Carcinoma, Small Cell / complications. Cushing Syndrome / etiology. Diabetes Insipidus, Neurogenic / etiology. Lung Neoplasms / complications
  • [MeSH-minor] Fatal Outcome. Female. Humans. Middle Aged. Pituitary Neoplasms / secondary


58. Fasshauer M, Lincke T, Witzigmann H, Kluge R, Tannapfel A, Moche M, Buchfelder M, Petersenn S, Kratzsch J, Paschke R, Koch CA: Ectopic Cushing' syndrome caused by a neuroendocrine carcinoma of the mesentery. BMC Cancer; 2006;6:108
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  • BACKGROUND: ACTH overproduction within the pituitary gland or ectopically leads to hypercortisolism.
  • Here, we report the first case of Cushing' syndrome caused by an ectopic ACTH-secreting neuroendocrine carcinoma of the mesentery.
  • Moreover, diagnostic procedures and pitfalls associated with ectopic ACTH-secreting tumors are demonstrated and discussed.
  • First, subtotal thyroidectomy was performed without remission of hypercortisolism, because an octreotide scan showed increased activity in the left thyroid gland and an ultrasound revealed nodules in both thyroid lobes one of which was autonomous.
  • In addition, the patient had a 3 mm hypoenhancing lesion of the neurohypophysis and a 1 cm large adrenal tumor.
  • Surgical removal of the pituitary lesion within the posterior lobe did not improve hypercortisolism and we continued to treat the patient with metyrapone to block cortisol production.
  • At 18-months follow-up from initial presentation, we detected an ACTH-producing neuroendocrine carcinoma of the mesentery by using a combination of octreotide scan, computed tomography scan, and positron emission tomography.
  • Intraoperatively, use of a gamma probe after administration of radiolabeled (111)In-pentetreotide helped identify the mesenteric neuroendocrine tumor.
  • CONCLUSION: This case underscores the diagnostic challenge in identifying an ectopic ACTH-producing tumor and the pluripotency of cells, in this case of mesenteric cells that can start producing and secreting ACTH.

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  • (PMID = 16643652.001).
  • [ISSN] 1471-2407
  • [Journal-full-title] BMC cancer
  • [ISO-abbreviation] BMC Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone
  • [Other-IDs] NLM/ PMC1464147
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59. Nieman LK, Ilias I: Evaluation and treatment of Cushing's syndrome. Am J Med; 2005 Dec;118(12):1340-6
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  • Cushing's syndrome results from sustained pathologic hypercortisolism caused by excessive corticotropin (ACTH) secretion by tumors in the pituitary gland (Cushing's disease, 70%) or elsewhere (15%), or by ACTH-independent cortisol secretion from adrenal tumors (15%).
  • The diagnosis of Cushing's syndrome should be followed by the measurement of plasma ACTH concentration to determine whether the hypercortisolism is ACTH-independent.
  • In ACTH-dependent patients, bilateral inferior petrosal sinus sampling with measurement of ACTH before and after administration of ACTH-releasing hormone most accurately distinguishes pituitary from ectopic ACTH secretion.
  • Surgical resection of tumor is the optimal treatment for all forms of Cushing's syndrome; bilateral adrenalectomy, medical treatment, or radiotherapy are sought in inoperable or recurrent cases.
  • The prognosis is better for Cushing's disease and benign adrenal causes of Cushing's syndrome than adrenocortical cancer and malignant ACTH-producing tumors.

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  • (PMID = 16378774.001).
  • [ISSN] 1555-7162
  • [Journal-full-title] The American journal of medicine
  • [ISO-abbreviation] Am. J. Med.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antifungal Agents; 9002-60-2 / Adrenocorticotropic Hormone; R9400W927I / Ketoconazole
  • [Number-of-references] 100
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60. Nishikawa T, Saito J, Omura M: [Medical treatment for Cushing's syndrome]. Nihon Rinsho; 2008 Jan;66(1):186-91
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Adrenalectomy is essential for treatment for Cushing's syndrome even in the patients with pituitary or ectopic ACTH-producing tumor.
  • We commonly treat the patients with Cushing's syndrome due to adrenal tumor and pituitary or ectopic ACTH producing tumor by using metyrapone which mainly inhibits 11-hydroxylase.
  • Metyrapone is also recommended to treat the patients who are not well differentiated Cushing's disease from ectopic ACTH syndrome.

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  • (PMID = 18186263.001).
  • [ISSN] 0047-1852
  • [Journal-full-title] Nihon rinsho. Japanese journal of clinical medicine
  • [ISO-abbreviation] Nippon Rinsho
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Aromatase Inhibitors; 0O54ZQ14I9 / Aminoglutethimide; EC 1.14.15.4 / Steroid 11-beta-Hydroxylase; R9400W927I / Ketoconazole; ZS9KD92H6V / Metyrapone
  • [Number-of-references] 6
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61. Nakagawa H, Yamamoto K: [A case of small cell lung cancer complicated by Cushing syndrome]. Nihon Kokyuki Gakkai Zasshi; 2008 Mar;46(3):210-5
MedlinePlus Health Information. consumer health - Lung Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Marked increases in ACTH levels were observed, but no abnormality was found in the pituitary MRI findings, and therefore ACTH-producing small cell lung cancer was suspected.
  • The tumor temporarily began to decrease in size, but hypercortisolemia remained, and thus adrenal hormone synthesis-inhibiting therapy was concurrently administered.

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  • (PMID = 18409568.001).
  • [ISSN] 1343-3490
  • [Journal-full-title] Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society
  • [ISO-abbreviation] Nihon Kokyuki Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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62. Porterfield JR, Thompson GB, Young WF Jr, Chow JT, Fryrear RS, van Heerden JA, Farley DR, Atkinson JL, Meyer FB, Abboud CF, Nippoldt TB, Natt N, Erickson D, Vella A, Carpenter PC, Richards M, Carney JA, Larson D, Schleck C, Churchward M, Grant CS: Surgery for Cushing's syndrome: an historical review and recent ten-year experience. World J Surg; 2008 May;32(5):659-77
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  • RESULTS: Two-hundred thirty-one patients (78%) had ACTH-dependent CS and 67 patients (22%) had ACTH-independent CS.
  • One-hundred ninety-six patients (66%) had pituitary-dependent CS and 35 patients (12%) had ectopic ACTH syndrome.
  • Fifty-four patients (18%) had cortisol-secreting adenomas, 10 patients (3%) had cortisol-producing adrenocortical carcinomas, and 1% had other causes.
  • Cure rates for first time pituitary operations (transsphenoidal, sublabial, and endonasal) were 80% and 55% for reoperations.
  • Five-year survival rates (all causes) were 90%, 51%, and 23% for adrenocortical adenomas, ectopic ACTH syndrome, and adrenocortical carcinomas, respectively.
  • CONCLUSIONS: Surgery for CS is highly successful for pituitary-dependent CS and most ACTH-independent adrenal causes.
  • Bilateral total adrenalectomy can also provide effective palliation from the ravages of hypercortisolism in patients with ectopic ACTH syndrome and for those who have failed transsphenoidal surgery.
  • Future successes with this disease will likely depend on a better understanding of tumor biology, more effective adjuvant therapies and earlier detection.

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  • (PMID = 18196319.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 139
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