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1. Jane JA Jr: Management of pediatric sellar tumors. Pediatr Endocrinol Rev; 2008 Feb;5 Suppl 2:720-6
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  • Craniopharyngiomas and pituitary adenomas are the most common forms of sellar tumors in children.
  • First-line treatment usually consists of surgical resection of the tumor, although dopamine agonist therapy may be considered as first-line therapy in most patients with prolactin-secreting adenomas.
  • Transsphenoidal resection has become increasingly widespread and represents the mainstay of surgical therapy for pituitary adenomas and selected craniopharyngiomas.
  • [MeSH-major] Pituitary Neoplasms / therapy
  • [MeSH-minor] Adenoma / diagnosis. Adenoma / epidemiology. Adenoma / therapy. Adolescent. Adult. Child. Craniopharyngioma / diagnosis. Craniopharyngioma / epidemiology. Craniopharyngioma / therapy. Female. Human Growth Hormone / secretion. Humans. Male. Pituitary ACTH Hypersecretion / therapy. Prolactinoma / therapy. Radiosurgery. Radiotherapy. Surgical Procedures, Operative / methods

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  • (PMID = 18317443.001).
  • [ISSN] 1565-4753
  • [Journal-full-title] Pediatric endocrinology reviews : PER
  • [ISO-abbreviation] Pediatr Endocrinol Rev
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Israel
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone
  • [Number-of-references] 57
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2. Groussin L, Cazabat L, René-Corail F, Jullian E, Bertherat J: Adrenal pathophysiology: lessons from the Carney complex. Horm Res; 2005;64(3):132-9
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  • PRKAR1A is a key component of the cyclic AMP signaling pathway that has been implicated in endocrine tumorigenesis and could, at least partly, function as a tumor suppressor gene.
  • Interestingly, patients with isolated PPNAD and no familial history of CNC can also present a germline de novo mutation of PRKAR1A.
  • Somatic mutations of PRKAR1A have been found in PPNAD as a mechanism of inactivation of the wild-type allele, in a patient already presenting a germline mutation, and in a subset of sporadic secreting adrenocortical adenomas with clinical, hormonal, and pathological features quite similar to PPNAD.
  • [MeSH-minor] Adult. Child, Preschool. Cyclic AMP / physiology. Cyclic AMP-Dependent Protein Kinase RIalpha Subunit. Cyclic AMP-Dependent Protein Kinases. Humans. Pituitary ACTH Hypersecretion / etiology. Pituitary ACTH Hypersecretion / physiopathology. Proteins / genetics. Signal Transduction

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  • [Copyright] Copyright (c) 2005 S. Karger AG, Basel.
  • (PMID = 16192737.001).
  • [ISSN] 0301-0163
  • [Journal-full-title] Hormone research
  • [ISO-abbreviation] Horm. Res.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Cyclic AMP-Dependent Protein Kinase RIalpha Subunit; 0 / PRKAR1A protein, human; 0 / Proteins; E0399OZS9N / Cyclic AMP; EC 2.7.11.11 / Cyclic AMP-Dependent Protein Kinases
  • [Number-of-references] 31
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3. Guignat L, Assie G, Bertagna X, Bertherat J: [Corticotroph adenoma]. Presse Med; 2009 Jan;38(1):125-32
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  • Corticotroph adenomas cause ACTH oversecretion responsible for Cushing's disease.
  • Corticotroph macroadenomas are rare, but can be responsible for an aggressive tumor.
  • Cushing's disease diagnosis requires careful hormonal and imaging investigations, aiming first at the diagnosis of Cushing's syndrome and in a second step at the diagnosis of its pituitary origin.
  • The treatment of corticotroph adenoma is mainly based on pituitary surgery.
  • In case of failure of pituitary surgery, or in patients in whom surgery is not appropriate as a first line treatment, medical therapy (mainly anticortisolic drugs), pituitary radiotherapy or surgical bilateral adrenalectomy can be discussed.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / complications. Pituitary ACTH Hypersecretion / etiology. Pituitary Neoplasms / complications
  • [MeSH-minor] Adrenalectomy. Adrenocorticotropic Hormone / analysis. Chemotherapy, Adjuvant. Corticotropin-Releasing Hormone / analysis. Cushing Syndrome / diagnosis. Cushing Syndrome / etiology. Cushing Syndrome / therapy. Diagnosis, Differential. Humans. Hydrocortisone / analysis. Hydrocortisone / antagonists & inhibitors. Magnetic Resonance Imaging. Neoadjuvant Therapy. Radiotherapy, Adjuvant

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  • (PMID = 19041214.001).
  • [ISSN] 2213-0276
  • [Journal-full-title] Presse medicale (Paris, France : 1983)
  • [ISO-abbreviation] Presse Med
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone; 9015-71-8 / Corticotropin-Releasing Hormone; WI4X0X7BPJ / Hydrocortisone
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4. Kreutzer J, Jeske I, Hofmann B, Blumcke I, Fahlbusch R, Buchfelder M, Buslei R: No effect of the PPAR-gamma agonist rosiglitazone on ACTH or cortisol secretion in Nelson's syndrome and Cushing's disease in vitro and in vivo. Clin Neuropathol; 2009 Nov-Dec;28(6):430-9
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  • [Title] No effect of the PPAR-gamma agonist rosiglitazone on ACTH or cortisol secretion in Nelson's syndrome and Cushing's disease in vitro and in vivo.
  • OBJECTIVE: Surgical tumor resection remains the primary treatment strategy in ACTH-secreting pituitary adenomas, i.e.
  • However, an effective long-term pharmacological regime is not available in patients with persistent ACTH-hypersecretion.
  • The nuclear receptor peroxisome proliferator-activated receptor gamma (PPAR-gamma) is abundantly expressed in most pituitary adenomas.
  • First encouraging data reported that the PPAR-gamma ligand rosiglitazone antagonizes ACTH hypersecretion and exerts also antiproliferative effects in pituitary cell lines.
  • Herein, we studied the potential therapeutical effects of rosiglitazone in patients with ACTH-secreting pituitary adenomas in vitro and in vivo.
  • MATERIALS AND METHODS: Seven patients with persistent ACTH-hypersecretion (3 with NS, 4 with persistent CD) were treated 5 months with rosiglitazone (4 - 16 mg/day).
  • In vitro assays were performed in primary cell cultures obtained from eight additional patients with ACTH-secreting pituitary adenomas applying 80 microM rosiglitazone repeatedly over a time period of 14 days.
  • RESULTS: Our long-term clinical trial with the PPAR-gamma activator rosiglitazone showed no amelioration of clinical symptoms nor an inhibiting effect on ACTH-secretion in vivo.
  • In vitro, rosiglitazone treatment led to a statistically significant decrease of ACTH levels in 2 out of 8 primary cell cultures after 14 days compared to untreated controls.
  • CONCLUSION: In contrast to the initially promising laboratory data gathered in pituitary cell line experiments and nude mice models, our experimental data obtained in primary human ACTH-expressing pituitary adenoma cell cultures as well as our clinical experience with a long-term rosiglitazone trial in approved antidiabetic doses support the recently reported disappointing reports on acute or short-term medical treatment of ACTH-hypersecretion with PPAR-gamma activators.
  • [MeSH-major] Adrenocorticotropic Hormone / secretion. Hydrocortisone / secretion. Nelson Syndrome / blood. PPAR gamma / agonists. Pituitary ACTH Hypersecretion / blood. Thiazolidinediones / pharmacology
  • [MeSH-minor] Adenoma / pathology. Adenoma / secretion. Adult. Female. Humans. In Vitro Techniques. Magnetic Resonance Imaging. Male. Middle Aged. Pituitary Neoplasms / pathology. Pituitary Neoplasms / secretion. Treatment Outcome. Tumor Cells, Cultured

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  • (PMID = 19919817.001).
  • [ISSN] 0722-5091
  • [Journal-full-title] Clinical neuropathology
  • [ISO-abbreviation] Clin. Neuropathol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / PPAR gamma; 0 / Thiazolidinediones; 05V02F2KDG / rosiglitazone; 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone
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5. Labeur M, Refojo D, Wölfel B, Stalla J, Vargas V, Theodoropoulou M, Buchfelder M, Paez-Pereda M, Arzt E, Stalla GK: Interferon-gamma inhibits cellular proliferation and ACTH production in corticotroph tumor cells through a novel janus kinases-signal transducer and activator of transcription 1/nuclear factor-kappa B inhibitory signaling pathway. J Endocrinol; 2008 Nov;199(2):177-89
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  • [Title] Interferon-gamma inhibits cellular proliferation and ACTH production in corticotroph tumor cells through a novel janus kinases-signal transducer and activator of transcription 1/nuclear factor-kappa B inhibitory signaling pathway.
  • Moreover, IFNG modulates normal pituitary hormone secretion, and was shown to inhibit the expression of the ACTH precursor POMC in murine ACTH-secreting AtT-2010/21/2008 tumor cells.
  • We have studied the functional role of IFNG on pituitary tumor cells, focusing on the involvement of IFNG in the molecular events leading to the control of POMC transcriptional repression.
  • Herein, it is shown that IFNG inhibits AtT-20 tumor cell proliferation without inducing apoptosis.
  • Interestingly, IFNG inhibits ACTH production from these cells in primary cell culture, without affecting basal ACTH biosynthesis in normal non-tumoral pituitary cells.
  • [MeSH-major] Adrenocorticotropic Hormone / biosynthesis. Cell Proliferation / drug effects. Interferon-gamma / pharmacology. Janus Kinases / metabolism. NF-kappa B / metabolism. Pituitary Neoplasms / metabolism. STAT1 Transcription Factor / metabolism

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  • (PMID = 18715881.001).
  • [ISSN] 1479-6805
  • [Journal-full-title] The Journal of endocrinology
  • [ISO-abbreviation] J. Endocrinol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / NF-kappa B; 0 / STAT1 Transcription Factor; 66796-54-1 / Pro-Opiomelanocortin; 82115-62-6 / Interferon-gamma; 9002-60-2 / Adrenocorticotropic Hormone; EC 2.7.10.2 / Janus Kinases
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6. Wasko R, Jaskula M, Kotwicka M, Andrusiewicz M, Jankowska A, Liebert W, Sowinski J: The expression of ghrelin in somatotroph and other types of pituitary adenomas. Neuro Endocrinol Lett; 2008 Dec;29(6):929-38
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The expression of ghrelin in somatotroph and other types of pituitary adenomas.
  • OBJECTIVES: It has been suggested that ghrelin synthesized locally in pituitary regulates the function and growth of pituitary cells in autocrine/paracrine way and might be an important factor of pituitary tumorogenesis.
  • The expression of ghrelin receptor in neoplastic cells of pituitary adenomas has also been demonstrated.
  • This study showed the presence of ghrelin mRNA and its protein in different types of pituitary adenomas.
  • DESIGN: The samples of 37 pituitary adenomas were obtained during standard neurosurgical tumor removal.
  • The study tissues included 20 somatotroph tumors (15 patients treated and 5 patients untreated with octreotide LAR before the surgery), 12 nonfunctioning adenomas, 4 prolactinomas and 1 ACTH-secreting tumor.
  • Expression of ghrelin mRNA was studied in 28 pituitary adenomas by RT-PCR.
  • RESULTS: The presence of ghrelin gene transcripts was demonstrated in 10 out of 15 examined somatotroph tumors (obtained from patients treated with octreotide LAR before the surgery) and also in 2 out of 4 samples of prolactinomas, 7 out of 8 of nonfunctioning tumors and in 2 samples of normal pituitary.
  • The peptide was detected also in 10 out of 12 examined nonfunctioning tumors and in 2 examined PRL-secreting tumors.
  • CONCLUSIONS: The study demonstrated that ghrelin gene is expressed in somatotroph adenomas, both treated and untreated with octreotide LAR before the surgery, and also in other types of pituitary adenomas (prolactinomas and nonfunctioning adenomas).
  • [MeSH-major] Adenoma / metabolism. Ghrelin / metabolism. Pituitary Neoplasms / metabolism. Somatotrophs / metabolism

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  • (PMID = 19112387.001).
  • [ISSN] 0172-780X
  • [Journal-full-title] Neuro endocrinology letters
  • [ISO-abbreviation] Neuro Endocrinol. Lett.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Sweden
  • [Chemical-registry-number] 0 / Ghrelin; 0 / RNA, Messenger
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7. 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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  • 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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8. 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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  • 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.


9. 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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10. Salgado LR, Fragoso MC, Knoepfelmacher M, Machado MC, Domenice S, Pereira MA, de Mendonça BB: Ectopic ACTH syndrome: our experience with 25 cases. Eur J Endocrinol; 2006 Nov;155(5):725-33
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  • [Title] Ectopic ACTH syndrome: our experience with 25 cases.
  • OBJECTIVE: Ectopic ACTH syndrome (EAS) occurs in about 5-10% of all patients with ACTH-dependent hypercortisolism with most of them caused by intrathoracic neoplasms.
  • DESIGN AND SUBJECTS: Tumor markers, imaging, and outcome data from 25 patients (13F/12M) aged 18-72 years.
  • High dexamethasone suppression test (HDDST), desmopressin test, GHRP-6 test, corticotropin-releasing hormone (CRH) test, IPSS, computed tomography (CT), magnetic resonance imaging (MRI), and (111)In-pentetreotide scintigraphy were revised.
  • In 13 patients who underwent desmopressin test, ACTH- and cortisol-positive responses were seen in six and five patients respectively.
  • In the seven patients submitted to IPSS using desmopressin in six of them, none had ACTH gradients.
  • Fourteen patients had intrathoracic tumors, five had pheochromocytomas, three had pancreatic tumors, one had a glomic tumor, and had three occult tumors.

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  • (PMID = 17062889.001).
  • [ISSN] 0804-4643
  • [Journal-full-title] European journal of endocrinology
  • [ISO-abbreviation] Eur. J. Endocrinol.
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Oligopeptides; 7S5I7G3JQL / Dexamethasone; 87616-84-0 / growth hormone releasing hexapeptide; 9015-71-8 / Corticotropin-Releasing Hormone; ENR1LLB0FP / Deamino Arginine Vasopressin
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11. Ren SG, Melmed S: Pyridoxal phosphate inhibits pituitary cell proliferation and hormone secretion. Endocrinology; 2006 Aug;147(8):3936-42
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  • [Title] Pyridoxal phosphate inhibits pituitary cell proliferation and hormone secretion.
  • Pyridoxal phosphate (PLP), a bioactive form of pyridoxine, dose-dependently (10-1000 microm) inhibited cell proliferation in rat pituitary MMQ and GH3 cells and in mouse AtT-20 cells.
  • PLP (400-1000 microm) reduced GH3 cell GH and prolactin secretion and AtT-20 cell ACTH secretion (adjusted for cell number) by approximately 70% after 2 d.
  • The 100 microm PLP also inhibited prolactin secretion (65%, P < 0.05) in primary rat pituitary cells treated for 2 d.
  • These results indicate that pharmacological doses of PLP inhibit pituitary cell proliferation and hormone secretion, in part mediated through PLP-induced cell-cycle arrest and apoptosis.
  • Pyridoxine may therefore be appropriate for testing as a relatively safe drug for adjuvant treatment of hormone-secreting pituitary adenomas.

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  • (PMID = 16690808.001).
  • [ISSN] 0013-7227
  • [Journal-full-title] Endocrinology
  • [ISO-abbreviation] Endocrinology
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / R01 CA075979; United States / NCI NIH HHS / CA / CA 75979
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Proto-Oncogene Proteins c-bcl-2; 12001-76-2 / Vitamin B Complex; 5V5IOJ8338 / Pyridoxal Phosphate; 9002-62-4 / Prolactin; 9002-72-6 / Growth Hormone
  • [Other-IDs] NLM/ NIHMS10630; NLM/ PMC1513048
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12. Mayberg M, Vermeulen S: Advances in stereotactic radiosurgery in the treatment of pituitary adenomas. Curr Opin Endocrinol Diabetes Obes; 2007 Aug;14(4):296-300
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  • [Title] Advances in stereotactic radiosurgery in the treatment of pituitary adenomas.
  • PURPOSE OF REVIEW: Stereotactic radiosurgery has become the preferred radiation treatment modality for secreting and nonsecreting pituitary adenomas, although randomized studies comparing delivery systems, fractionation and dose have not been performed.
  • With a reduction in acute and chronic side effects, the total dose to abnormal tissue can be increased allowing for greater tumor control.
  • SUMMARY: The radiobiology, control rates and normal tissue tolerances of stereotactic radiosurgery in the treatment of pituitary adenomas is reviewed.
  • [MeSH-major] Adenoma / surgery. Pituitary Neoplasms / surgery. Radiosurgery
  • [MeSH-minor] Acromegaly / radiotherapy. Acromegaly / surgery. Humans. Pituitary ACTH Hypersecretion / radiotherapy. Pituitary ACTH Hypersecretion / surgery. Prolactinoma / surgery. Prolactinoma / therapy

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  • (PMID = 17940455.001).
  • [ISSN] 1752-2978
  • [Journal-full-title] Current opinion in endocrinology, diabetes, and obesity
  • [ISO-abbreviation] Curr Opin Endocrinol Diabetes Obes
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 18
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13. Josephs L, Jones L, Marenette L, McKeever P: Cushing's Syndrome: An Unusual Presentation of Olfactory Neuroblastoma. Skull Base; 2008 Jan;18(1):73-6
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  • Subsequent laboratory studies revealed markedly elevated adrenocorticotropic (ACTH) and cortisol levels, as well as a hypoklemic metabolic alkalosis.
  • A pituitary MRI was performed, which revealed a normal pituitary; however, a large mass was seen centered in the ethmoid and paranasal sinuses with a significant amount of extension into surrounding structures.
  • Immunohistochemical staining further defined the tumor as an ACTH-secreting esthesioneuroblastoma.
  • After total resection of the mass and further treatment with adjuvant radiation therapy, the patient's symtoms completely resolved and the ACTH and cortisol levels were also greatly reduced.
  • This case demonstrates the successful diagnosis and treatment of a rare neoplasm.
  • Ectopic ACTH syndrome due to esthesioneuroblastoma is extremely uncommon with only five other cases being discussed in the literature.

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  • (PMID = 18592016.001).
  • [ISSN] 1531-5010
  • [Journal-full-title] Skull base : official journal of North American Skull Base Society ... [et al.]
  • [ISO-abbreviation] Skull Base
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC2435464
  • [Keywords] NOTNLM ; Cushing's syndrome / Ectopic ACTH syndrome / esthesioneuroblastoma / olfactory Neuroblastoma
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14. Weil RJ, Vortmeyer AO, Nieman LK, Devroom HL, Wanebo J, Oldfield EH: Surgical remission of pituitary adenomas confined to the neurohypophysis in Cushing's disease. J Clin Endocrinol Metab; 2006 Jul;91(7):2656-64
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  • [Title] Surgical remission of pituitary adenomas confined to the neurohypophysis in Cushing's disease.
  • CONTEXT: Partial or total removal of the pituitary cures 60-80% of patients with Cushing's disease (CD) in whom an adenoma cannot be identified at surgery.
  • Tumor was visible at surgery in 11 patients; all 12 tumors were positive for ACTH by immunohistochemistry.
  • CONCLUSION: We report a new subset of patients with CD, ACTH-secreting adenomas that arise wholly within the posterior lobe of the pituitary gland.
  • In cases of CD in which an adenoma is not identified in the adenohypophysis and in patients with persistent hypercortisolism after complete or partial excision of the anterior lobe, tumor within the neurohypophysis should be considered; selective adenomectomy of a neurohypophyseal, ACTH-secreting tumor can produce long-term remission.
  • [MeSH-major] Adenoma / surgery. Pituitary ACTH Hypersecretion / surgery. Pituitary Gland, Posterior / surgery. Pituitary Neoplasms / surgery

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  • (PMID = 16636117.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone
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15. Tateno T, Kato M, Tani Y, Oyama K, Yamada S, Hirata Y: Differential expression of somatostatin and dopamine receptor subtype genes in adrenocorticotropin (ACTH)-secreting pituitary tumors and silent corticotroph adenomas. Endocr J; 2009;56(4):579-84
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  • [Title] Differential expression of somatostatin and dopamine receptor subtype genes in adrenocorticotropin (ACTH)-secreting pituitary tumors and silent corticotroph adenomas.
  • Somatostatin analogs and dopamine agonists are clinically used for medical therapy of functioning pituitary tumors, such as growth hormone- and prolactin-secreting tumors, however, their effects on ACTH-secreting tumors are controversial.
  • This study was aimed to determine whether somatostatin receptor (SSTR) subtype (1-5) and dopamine receptor type 2 (D2R) are differentially expressed in pituitary tumors causing Cushing's disease (CD), silent corticotroph adenoma (SCA), and non-functioning pituitary tumor (NFT).
  • Tissue specimens were obtained from 35 pituitary tumors during transsphenoidal surgery.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / genetics. Adenoma / genetics. Pituitary ACTH Hypersecretion / metabolism. Pituitary Neoplasms / genetics. Receptors, Dopamine D2 / genetics. Receptors, Somatostatin / physiology

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  • (PMID = 19318729.001).
  • [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 / Receptors, Dopamine D2; 0 / Receptors, Somatostatin; 0 / somatostatin receptor 2; 0 / somatostatin receptor 5; 0 / somatostatin receptor type 1; 9002-60-2 / Adrenocorticotropic Hormone
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16. Bezerra MG, Latronico AC, Fragoso MC: [Endocrine tumors associated to protein Gsalpha/Gi2alpha mutations]. Arq Bras Endocrinol Metabol; 2005 Oct;49(5):784-90
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  • Many oncogenic mutations promote tumor growth by inducing autonomous activity of proteins that normally transmit proliferative signal initiated by extracellular factors.
  • The G proteins couple an array of seven transmembrane receptors at the cell surface with a variety of intracellular effectors, which produce second messenger molecules.
  • A subset of endocrine tumors, such as GH- or ACTH-secreting pituitary adenomas, functioning thyroid adenomas, adrenocortical and gonadal tumors were associated with somatic activating mutations in the highly conserved codons of the Gs (Arg201 and Gln227) and Gi (Arg179 and Gln205) proteins.
  • [MeSH-major] Endocrine Gland Neoplasms / genetics. GTP-Binding Protein alpha Subunits, Gi-Go / genetics. GTP-Binding Protein alpha Subunits, Gs / genetics. Mutation / genetics. Oncogenes / genetics

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  • (PMID = 16444361.001).
  • [ISSN] 0004-2730
  • [Journal-full-title] Arquivos brasileiros de endocrinologia e metabologia
  • [ISO-abbreviation] Arq Bras Endocrinol Metabol
  • [Language] por
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Brazil
  • [Chemical-registry-number] EC 3.6.5.1 / GTP-Binding Protein alpha Subunits, Gi-Go; EC 3.6.5.1 / GTP-Binding Protein alpha Subunits, Gs
  • [Number-of-references] 64
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17. Bode H, Seiz M, Lammert A, Brockmann MA, Back W, Hammes HP, Thomé C: SOM230 (pasireotide) and temozolomide achieve sustained control of tumour progression and ACTH secretion in pituitary carcinoma with widespread metastases. Exp Clin Endocrinol Diabetes; 2010 Nov;118(10):760-3
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  • [Title] SOM230 (pasireotide) and temozolomide achieve sustained control of tumour progression and ACTH secretion in pituitary carcinoma with widespread metastases.
  • Pituitary carcinomas are rare and neurosurgically challenging lesions, as they commonly relapse after surgical removal.
  • We report a patient with an ACTH-secreting pituitary carcinoma and widespread intracranial, spinal and systemic metastases despite repeated surgical treatment, bilateral adrenalectomy, medical treatment and radiotherapy.
  • Additionally to chemotherapy with temozolomide, the patient received SOM230 as salvage therapy with an improvement of the patient's clinical status, and a reduction of ACTH levels.
  • After 12 months of combination therapy a sustained tumor control was achieved and persisted upon monotherapy with SOM230 for more than 9 months thereafter.
  • Thus, temozolomide in combination with SOM230 seems to be promising in patients with ACTH-secreting metastasized pituitary carcinoma.
  • [MeSH-major] Adrenocorticotropic Hormone / secretion. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma / drug therapy. Carcinoma / secondary. Dacarbazine / analogs & derivatives. Pituitary Neoplasms / drug therapy. Somatostatin / analogs & derivatives

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  • [Copyright] © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.
  • (PMID = 20496311.001).
  • [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] 0 / Antineoplastic Agents, Alkylating; 0 / Antineoplastic Agents, Hormonal; 51110-01-1 / Somatostatin; 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide; 9002-60-2 / Adrenocorticotropic Hormone; 98H1T17066 / pasireotide
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18. 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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  • (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
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  • [Other-IDs] NLM/ PMC2854133
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19. Ruebel KH, Leontovich AA, Jin L, Stilling GA, Zhang H, Qian X, Nakamura N, Scheithauer BW, Kovacs K, Lloyd RV: Patterns of gene expression in pituitary carcinomas and adenomas analyzed by high-density oligonucleotide arrays, reverse transcriptase-quantitative PCR, and protein expression. Endocrine; 2006 Jun;29(3):435-44
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  • [Title] Patterns of gene expression in pituitary carcinomas and adenomas analyzed by high-density oligonucleotide arrays, reverse transcriptase-quantitative PCR, and protein expression.
  • Very few of the genes that are important in pituitary tumor initiation, progression, and metastasis have been identified to date.
  • To identify potential genes that may be important in pituitary tumor progression and carcinoma development, we used Affymetrix GeneChip HGU-133A-oligonucleotide arrays, which contain more than 15,000 characterized genes from the human genome to study gene expression in an ACTH pituitary carcinoma metastatic to the liver and four pituitary adenomas.
  • Reverse-transcriptase real-time quantitative- PCR (RT-qPCR) was then used to analyze 4 nonneoplastic pituitaries, 19 adenomas, and the ACTH carcinoma.
  • A larger series of pituitary adenomas and carcinomas were also analyzed for protein expression using tissue microarrays (TMA) (n = 233) and by Western blotting (n = 18).
  • Prolactin (PRL) and ACTH tumors had the highest levels of expression of galectin-3.
  • Prolactin and ACTH tumors had the highest levels of expression of hASH-1.
  • Transducin-like enhancer of split four/ Groucho (TLE-4) was over-expressed in adenomas compared to the ACTH carcinoma.
  • These results indicate that the LGALS3, hASH1, ID2, and TLE-4 genes may have important roles in the development of pituitary carcinomas.
  • [MeSH-major] Adenoma / genetics. Carcinoma / genetics. Gene Expression Profiling / methods. Oligonucleotide Array Sequence Analysis / methods. Pituitary Neoplasms / genetics. Reverse Transcriptase Polymerase Chain Reaction / methods
  • [MeSH-minor] ACTH-Secreting Pituitary Adenoma / metabolism. Blotting, Western. DNA-Binding Proteins / metabolism. Follicle Stimulating Hormone / secretion. GRB2 Adaptor Protein / metabolism. Growth Hormone-Secreting Pituitary Adenoma / metabolism. Humans. Immunohistochemistry. Inhibitor of Differentiation Protein 2 / metabolism. Luteinizing Hormone / secretion. Nuclear Proteins / metabolism. Prolactinoma / metabolism. Repressor Proteins / metabolism

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  • (PMID = 16943582.001).
  • [ISSN] 1355-008X
  • [Journal-full-title] Endocrine
  • [ISO-abbreviation] Endocrine
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 90249
  • [Publication-type] Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Validation Studies
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA-Binding Proteins; 0 / GRB2 Adaptor Protein; 0 / GRB2 protein, human; 0 / ID2 protein, human; 0 / Inhibitor of Differentiation Protein 2; 0 / Nuclear Proteins; 0 / Repressor Proteins; 0 / TLE4 protein, human; 9002-67-9 / Luteinizing Hormone; 9002-68-0 / Follicle Stimulating Hormone
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20. Lupi I, Manetti L, Caturegli P, Menicagli M, Cosottini M, Iannelli A, Acerbi G, Bevilacqua G, Bogazzi F, Martino E: Tumor infiltrating lymphocytes but not serum pituitary antibodies are associated with poor clinical outcome after surgery in patients with pituitary adenoma. J Clin Endocrinol Metab; 2010 Jan;95(1):289-96
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  • [Title] Tumor infiltrating lymphocytes but not serum pituitary antibodies are associated with poor clinical outcome after surgery in patients with pituitary adenoma.
  • CONTEXT: Serum pituitary antibodies (Pit Abs) and tumor-infiltrating lymphocytes (TILs) have been described in pituitary adenomas, but their clinical significance remains unknown.
  • OBJECTIVE: The objective of the study was to assess Pit Abs and TILs prevalence in pituitary adenomas and their influence on clinical outcome.
  • PATIENTS AND SETTING: Two hundred ninety-one pituitary adenoma cases (110 non-secreting, 30 ACTH-69 GH-71 prolactin- and 13 TSH-secreting adenoma; 177 operated and 114 untreated), 409 healthy controls, and 14 autoimmune hypophysitis were enrolled in a tertiary referral center.
  • MAIN OUTCOME MEASURE: Clinical response of pituitary adenoma after surgery was evaluated.
  • Similarly, TILs prevalence was higher in adenomas than normal pituitary (P = 0.01) and lower than in autoimmune hypophysitis (P < 0.0001).
  • Multivariate regression analysis identified the presence of TILs as independent prognostic factor for persistence/recurrence of pituitary adenoma.
  • CONCLUSIONS: TILs and Pit Abs are present in a significant number of pituitary adenoma patients.

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  • (PMID = 19875479.001).
  • [ISSN] 1945-7197
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] ENG
  • [Grant] United States / NIDDK NIH HHS / DK / R21 DK080351; United States / NIDDK NIH HHS / DK / DK080351
  • [Publication-type] Evaluation Studies; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Autoantibodies; 0 / Biomarkers
  • [Other-IDs] NLM/ PMC2805498
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21. Pouratian N, Prevedello DM, Jagannathan J, Lopes MB, Vance ML, Laws ER Jr: Outcomes and management of patients with Cushing's disease without pathological confirmation of tumor resection after transsphenoidal surgery. J Clin Endocrinol Metab; 2007 Sep;92(9):3383-8
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  • [Title] Outcomes and management of patients with Cushing's disease without pathological confirmation of tumor resection after transsphenoidal surgery.
  • CONTEXT: Despite the success of transsphenoidal surgery (TSS) for the treatment of Cushing's disease, in a number of cases, an ACTH-staining pituitary adenoma is not identified histologically.
  • RESULTS: Overall, 50% of these patients achieved remission, a figure lower than for our entire series (79%) and for patients with histological confirmation of an ACTH-staining adenoma (88%) (P < 0.001).
  • The incidence of early recurrence may be a unique feature of this patient population; patients without histological confirmation of tumor resection therefore require close and consistent monitoring postoperatively.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / surgery. Pituitary ACTH Hypersecretion / diagnosis. Pituitary ACTH Hypersecretion / surgery
  • [MeSH-minor] Adenoma / diagnosis. Adenoma / pathology. Adenoma / surgery. Adolescent. Adult. Aged. Child. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / diagnosis. Neoplasm Recurrence, Local / pathology. Neoplasm, Residual. Prognosis. Remission Induction. Retrospective Studies. Treatment Failure. Treatment Outcome

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  • [CommentIn] Nat Clin Pract Endocrinol Metab. 2008 Jan;4(1):14-5 [17940518.001]
  • (PMID = 17595252.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
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22. 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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23. Bogazzi F, Russo D, Locci MT, Chifenti B, Ultimieri F, Raggi F, Viacava P, Cecchetti D, Cosci C, Sardella C, Acerbi G, Gasperi M, Martino E: Peroxisome proliferator-activated receptor (PPAR)gamma is highly expressed in normal human pituitary gland. J Endocrinol Invest; 2005 Nov;28(10):899-904
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  • [Title] Peroxisome proliferator-activated receptor (PPAR)gamma is highly expressed in normal human pituitary gland.
  • OBJECTIVE: Expression of peroxisome proliferator-activated receptor (PPAR)gamma in normal pituitary seems to be restricted to ACTH-secreting cells.
  • The aim of the study was to evaluate the expression of PPARgamma in normal human pituitary tissue and to study its localization in the pituitary secreting cells.
  • MATERIALS AND METHODS: Normal pituitary tissue samples were obtained form 11 patients with non-secreting adenoma who underwent surgical excision of the tumor.
  • Expression of PPARgamma was evaluated by immunostaining and western blotting; localization of PPARgamma in each pituitary secreting cell lineage was evaluated by double immunofluorescence using confocal microscopy.
  • Pituitary non-functioning adenomas served as Controls.
  • RESULTS: PPARgamma was highly expressed in all pituitary samples with a (mean +/- SD) 81 +/- 6.5% of stained cells; expression of PPARgamma was confirmed by western blotting.
  • Non-functioning pituitary adenomas had 74 +/- 11% PPARgamma positive cells.
  • Double immunostaining revealed that every pituitary secreting cell (GH, TSH, LH, FSH, PRL and ACTH) had PPARgamma expressed.
  • DISCUSSION: The present study demonstrated that PPARgamma is highly expressed in every normal pituitary secreting cell lineage.
  • It can translocate into the nucleus by ligand binding; however, its role in pituitary hormone regulation remains to be elucidated.
  • [MeSH-major] PPAR gamma / analysis. Pituitary Gland / chemistry
  • [MeSH-minor] Adrenocorticotropic Hormone / metabolism. Adult. Aged. Animals. Blotting, Western. Cell Line, Tumor. Female. Follicle Stimulating Hormone / metabolism. Growth Hormone / metabolism. Humans. Immunohistochemistry. Luteinizing Hormone / metabolism. Male. Microscopy, Confocal. Middle Aged. Peptide Fragments / metabolism. Pituitary Hormones / metabolism. Pituitary Neoplasms / chemistry. Pituitary Neoplasms / metabolism. Pituitary Neoplasms / pathology. Prolactin / metabolism. Thyrotropin / metabolism

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  • (PMID = 16419492.001).
  • [ISSN] 0391-4097
  • [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 / PPAR gamma; 0 / Peptide Fragments; 0 / Pituitary Hormones; 0 / somatotropin (134-154); 9002-60-2 / Adrenocorticotropic Hormone; 9002-62-4 / Prolactin; 9002-67-9 / Luteinizing Hormone; 9002-68-0 / Follicle Stimulating Hormone; 9002-71-5 / Thyrotropin; 9002-72-6 / Growth Hormone
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24. da Rocha AA, Giorgi RR, de Sa SV, Correa-Giannella ML, Fortes MA, Cavaleiro AM, Machado MC, Cescato VA, Bronstein MD, Giannella-Neto D: Hepatocyte growth factor-regulated tyrosine kinase substrate (HGS) and guanylate kinase 1 (GUK1) are differentially expressed in GH-secreting adenomas. Pituitary; 2006;9(2):83-92
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  • [Title] Hepatocyte growth factor-regulated tyrosine kinase substrate (HGS) and guanylate kinase 1 (GUK1) are differentially expressed in GH-secreting adenomas.
  • Pituitary tumors, adenomas in their vast majority, represent around 10-15% of the intracranial neoplasms.
  • Pituitary carcinomas are exceedingly rare.
  • Pituitary tumorigenesis is still poorly understood.
  • In order to investigate the expression of cancer-related genes in pituitary tumors, we employed a human cancer cDNA macroarray membrane with 1176 well-characterized human genes related to cancer and tumor biology.
  • We were able to identify several differentially expressed genes, among them hepatocyte growth factor-regulated tyrosine kinase substrate (HGS) and guanylate kinase 1 (GUK1) which were over expressed in a pool of clinically nonfunctioning pituitary adenomas, compared with a spinal cord metastasis of a nonfunctioning pituitary carcinoma.
  • HGS and GUK1 mRNA expression were chosen to be validated by quantitative RT-qPCR, however, only GUK1 had the differential expression confirmed between the adenomas and the metastasis of a pituitary carcinoma.
  • We have also investigated HGS and GUK1 mRNA expressions in a series of 46 pituitary adenomas (18 nonfunctioning, 12 GH-secreting, nine PRL-secreting, and seven ACTH-secreting adenomas).
  • HGS and GUK1 were significantly over expressed in GH-secreting adenomas, compared with ACTH-secreting adenomas and nonfunctioning tumors, and with PRL-secreting adenomas, respectively.
  • We have shown that these genes, involved in tumorigenesis in other tissues, are as well over expressed in the pituitary tumors, however, their role in the oncogenesis of these tumors need to be further investigated.
  • [MeSH-major] Adenoma / metabolism. Growth Hormone-Secreting Pituitary Adenoma / metabolism. Guanylate Kinases / metabolism. Phosphoproteins / metabolism
  • [MeSH-minor] ACTH-Secreting Pituitary Adenoma / genetics. ACTH-Secreting Pituitary Adenoma / metabolism. Adolescent. Adult. Aged. DNA, Neoplasm / genetics. Endosomal Sorting Complexes Required for Transport. Female. Gene Expression Regulation, Neoplastic. Humans. Male. Middle Aged. Oligonucleotide Array Sequence Analysis. Prolactinoma / genetics. Prolactinoma / metabolism. RNA, Messenger / genetics

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  • (PMID = 16832584.001).
  • [ISSN] 1386-341X
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA, Neoplasm; 0 / Endosomal Sorting Complexes Required for Transport; 0 / Phosphoproteins; 0 / RNA, Messenger; 0 / hepatocyte growth factor-regulated tyrosine kinase substrate; EC 2.7.4.8 / Guanylate Kinases
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25. Gondim JA, Schops M, de Almeida JP, de Albuquerque LA, Gomes E, Ferraz T, Barroso FA: Endoscopic endonasal transsphenoidal surgery: surgical results of 228 pituitary adenomas treated in a pituitary center. Pituitary; 2010;13(1):68-77
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  • [Title] Endoscopic endonasal transsphenoidal surgery: surgical results of 228 pituitary adenomas treated in a pituitary center.
  • Pituitary tumors are challenging tumors in the sellar region.
  • Surgical approaches to the pituitary have undergone numerous refinements over the last 100 years.
  • The introduction of the endoscope have revolutionized pituitary surgery.
  • The aim of this study is to report the results of a consecutive series of patients undergoing pituitary surgery using a pure endoscopic endonasal approach and to evaluate the efficacy and safety of this procedure.
  • Tumor removal rate, endocrinological outcomes, and complications were retrospectively assessed in 228 patients with pituitary adenomas who underwent 251 procedures between December 1998 and December 2007.
  • There were 93 nonfunctioning adenomas, 58 growth hormone-secreting, 41 prolactin-secreting, 28 adrenocorticotropin hormone secreting, 7 FSH-LH secreting and 1 thyroid-stimulating hormone-secreting adenomas.
  • The remission results for patients with nonfunctioning adenomas was 83% and for functioning adenomas were 76.3% (70.6% for GH hormone-secreting, 85.3% for prolactin hormone-secreting, 71.4% for ACTH hormone-secreting, 85.7% for FSH-LH hormone-secreting and 100% for TSH hormone-secreting), with no recurrence at the time of the last follow-up.
  • The endoscopic endonasal approach for resection of pituitary adenomas, provides acceptable results representing a safe alternative procedure to the microscopic approach.
  • This less invasive method, associated with a small number of complications, provides excellent tumor removal rates and represents an important tool for the achievement of good results in the pituitary surgery, mainly for the complete removal of large adenomas.
  • [MeSH-major] Adenoma / surgery. Endoscopy / methods. Pituitary Neoplasms / surgery
  • [MeSH-minor] Humans. Pituitary Hormones / blood. Postoperative Complications. Retrospective Studies

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  • (PMID = 19697135.001).
  • [ISSN] 1573-7403
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Pituitary Hormones
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26. Kim JP, Park BJ, Kim SB, Lim YJ: Pituitary Apoplexy due to Pituitary Adenoma Infarction. J Korean Neurosurg Soc; 2008 May;43(5):246-9
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  • [Title] Pituitary Apoplexy due to Pituitary Adenoma Infarction.
  • Cause of pituitary apoplexy has been known as hemorrhage, hemorrhagic infarction or infarction of pituitary adenoma or adjacent tissues of pituitary gland.
  • However, pituitary apoplexy caused by pure infarction of pituitary adenoma has been rarely reported.
  • Here, we present the two cases pituitary apoplexies caused by pituitary adenoma infarction that were confirmed by transsphenoidal approach (TSA) and pathologic reports.
  • Pathologic report of first case revealed total tumor infarction of a nonfunctioning pituitary macroadenoma and second case partial tumor infarction of ACTH secreting pituitary macroadenoma.
  • Patients with pituitary apoplexy which was caused by pituitary adenoma infarction unrelated to hemorrhage or hemorrhagic infarction showed good response to TSA treatment.
  • Further study on the predisposing factors of pituitary apoplexy and the mechanism of infarction in pituitary adenoma is necessary.

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  • (PMID = 19096606.001).
  • [ISSN] 2005-3711
  • [Journal-full-title] Journal of Korean Neurosurgical Society
  • [ISO-abbreviation] J Korean Neurosurg Soc
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2588219
  • [Keywords] NOTNLM ; Pituitary adenoma infarction / Pituitary apoplexy
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27. Colao A, Pivonello R, Di Somma C, Savastano S, Grasso LF, Lombardi G: Medical therapy of pituitary adenomas: effects on tumor shrinkage. Rev Endocr Metab Disord; 2009 Jun;10(2):111-23
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  • [Title] Medical therapy of pituitary adenomas: effects on tumor shrinkage.
  • The efficacy of dopamine-agonists (DA) in patients with prolactinomas and that of somatostatin analogues (SSA) in those with GH- and TSH-secreting adenomas is well established.
  • More recently, data are accumulating suggesting a potential therapeutic role of DA also in patients with ACTH-secreting and clinically non-functioning (NFA) pituitary adenomas.
  • This review aims at summarizing published results of DA and SSA on tumor shrinkage in patients with different histotypes of pituitary adenomas.
  • Results of tumor shrinkage are of clinical relevance as tumor size is the one of the most important determinant of surgical outcome.
  • While reduction of tumor size more than 50% of baseline size in macroprolactinomas treated with DA is a frequent finding in patients with GH-secreting adenomas treated with SSA tumor shrinkage only recently is becoming frequent thanks to the availability of depot formulations.
  • Data on tumor shrinkage in patients with TSH-secreting adenomas treated with SSA are limited because of the rarity of these tumors.
  • Very recently, DA have been reported of some efficacy also in patients with ACTH-secreting adenomas but data are still very limited.
  • NFA respond very scantly to both DA and SSA even if receptors targeting these drugs are present.
  • [MeSH-major] Hormones / therapeutic use. Pituitary Neoplasms / drug therapy. Somatostatin / analogs & derivatives. Somatostatin / therapeutic use

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  • (PMID = 18791829.001).
  • [ISSN] 1573-2606
  • [Journal-full-title] Reviews in endocrine & metabolic disorders
  • [ISO-abbreviation] Rev Endocr Metab Disord
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Dopamine Agonists; 0 / Hormones; 51110-01-1 / Somatostatin; 9002-60-2 / Adrenocorticotropic Hormone; 9002-71-5 / Thyrotropin; 9002-72-6 / Growth Hormone
  • [Number-of-references] 103
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28. 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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  • 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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29. Tauchmanovà L, Pivonello R, De Martino MC, Rusciano A, De Leo M, Ruosi C, Mainolfi C, Lombardi G, Salvatore M, Colao A: Effects of sex steroids on bone in women with subclinical or overt endogenous hypercortisolism. Eur J Endocrinol; 2007 Sep;157(3):359-66
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  • PATIENTS: Seventy-one consecutive women were enrolled: 36 with overt hypercortisolism (26 with ACTH-secreting pituitary adenoma and 10 with cortisol-secreting adrenal tumor) and 35 with subclinical hypercortisolism due to adrenal incidentalomas.

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  • (PMID = 17766720.001).
  • [ISSN] 0804-4643
  • [Journal-full-title] European journal of endocrinology
  • [ISO-abbreviation] Eur. J. Endocrinol.
  • [Language] ENG
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Gonadal Steroid Hormones; 3XMK78S47O / Testosterone; 409J2J96VR / Androstenedione; 4TI98Z838E / Estradiol; 57B09Q7FJR / Dehydroepiandrosterone Sulfate; 9002-68-0 / Follicle Stimulating Hormone; WI4X0X7BPJ / Hydrocortisone
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30. Barahona MJ, Sojo L, Wägner AM, Bartumeus F, Oliver B, Cano P, Webb SM: Determinants of neurosurgical outcome in pituitary tumors. J Endocrinol Invest; 2005 Oct;28(9):787-94
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  • [Title] Determinants of neurosurgical outcome in pituitary tumors.
  • OBJECTIVE: Neurosurgery is one of the main therapies for pituitary tumors; optimising outcome is highly desirable for the patient and the health system.
  • We have analysed predictors of outcome in surgically treated pituitary adenomas operated in this centre.
  • DESIGN AND PATIENTS: A total of 289 patients underwent neurosurgery for a pituitary tumor, by the same two neurosurgeons, between 1982 and 2001.
  • Most tumors (70.2%) were macroadenomas; 28.4% were non-functioning, 27.3% secreted PRL, 26.3% GH of which 14 (4.8%) also secreted PRL, 17.3% ACTH, 0.3% FSH and 0.3% TSH.
  • RESULTS: A stepwise, forward logistic regression analysis revealed tumor size as the only significant predictor of radiological cure [odds ratio (OR) for macroadenoma 0.16 vs microadenoma, p=0.0005].
  • Hormonally, PRL-secretion by the tumor was a predictor of poor prognosis (OR 3.29 for cure of non-PRL-secreting tumors, p=0.005), as was tumor size (OR 0.45 for cure of macroadenomas, p=0.005).
  • Considering simultaneous radiological and hormonal remission, tumor size (OR 0.35 for macroadenoma, p=0.0002), and operation date (OR 0.40 for up to 1991, p=0.0002) were the only significant predictors.
  • CONCLUSIONS: PRL secretion, tumor size and operation date are the main predictors of neurosurgical outcome in pituitary tumors, the latter suggesting that neurosurgical experience plays an important role.
  • [MeSH-major] Adenoma / surgery. Neurosurgical Procedures / methods. Pituitary Neoplasms / surgery

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  • (PMID = 16370556.001).
  • [ISSN] 0391-4097
  • [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] 12629-01-5 / Human Growth Hormone; 9002-60-2 / Adrenocorticotropic Hormone
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31. Xu H, Zhang M, Zhai G, Zhang M, Ning G, Li B: The role of integrated (18)F-FDG PET/CT in identification of ectopic ACTH secretion tumors. Endocrine; 2009 Dec;36(3):385-91
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  • [Title] The role of integrated (18)F-FDG PET/CT in identification of ectopic ACTH secretion tumors.
  • The role of (18)F-Flurodeoxyglucose positron emission tomography ((18)F-FDG PET) scan in localization of ectopic Cushing's syndrome (EAS) tumor is still controversial.
  • Five patients, three men and two women, were reported, whose endocrine investigations and negative pituitary imaging were suggestive of ectopic ACTH secretion. (18)F-FDG PET/CT was performed to identify the source of ACTH secretion.
  • Four of them underwent lesion resection, whose plasma ACTH and serum cortisol levels returned to normal after the surgery.
  • Unfortunately, one patient died due to severe infection and electrolyte disorders. (18)F-FDG PET/CT technology integrates PET and CT imaging in one device so as to increase the accuracy of tumor localization and further improve the prognosis of the patients by curative resection.
  • [MeSH-major] ACTH Syndrome, Ectopic / diagnostic imaging. ACTH-Secreting Pituitary Adenoma / diagnostic imaging. Adenoma / diagnostic imaging. Carcinoid Tumor / diagnostic imaging. Fluorodeoxyglucose F18. Positron-Emission Tomography / methods. Tomography, Emission-Computed / methods

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  • (PMID = 19806477.001).
  • [ISSN] 1559-0100
  • [Journal-full-title] Endocrine
  • [ISO-abbreviation] Endocrine
  • [Language] eng
  • [Publication-type] Case Reports; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0Z5B2CJX4D / Fluorodeoxyglucose F18; WI4X0X7BPJ / Hydrocortisone
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32. Candrina R, Sleiman I, Zorzi F: ACTH-secreting pituitary adenoma within an ovarian teratoma. Eur J Intern Med; 2005 Sep;16(5):359-60
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  • [Title] ACTH-secreting pituitary adenoma within an ovarian teratoma.
  • The differential diagnosis of Cushing's syndrome is one of the most difficult tasks in medicine, and it is especially problematic in cases with "occult" ectopic ACTH syndrome.
  • We describe the case of a 26-year-old woman who was found to suffer from ectopic ACTH syndrome due to pituitary microadenoma, localized within a mature ovarian teratoma.
  • Only rarely has ectopic ACTH syndrome in association with an ovarian tumor been described.

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  • (PMID = 16137552.001).
  • [ISSN] 0953-6205
  • [Journal-full-title] European journal of internal medicine
  • [ISO-abbreviation] Eur. J. Intern. Med.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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33. Curtò L, Torre ML, Ferraù F, Pitini V, Altavilla G, Granata F, Longo M, Hofland LJ, Trimarchi F, Cannavò S: Temozolomide-induced shrinkage of a pituitary carcinoma causing Cushing's disease--report of a case and literature review. ScientificWorldJournal; 2010;10:2132-8
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  • [Title] Temozolomide-induced shrinkage of a pituitary carcinoma causing Cushing's disease--report of a case and literature review.
  • Temozolomide (TMZ) is an alkylating chemotherapeutic agent that has recently been used in some cases as a new therapeutic tool for pituitary carcinomas and aggressive pituitary adenomas.
  • In this report, we present the case of effective TMZ treatment in a 42-year-old man with ACTH-secreting carcinoma.
  • The tumor grew progressively over 4 years, from 2.2 to 31.1 cm³, despite three surgical approaches and γ-knife treatment.
  • Thereafter, four cycles of 5-day TMZ administration (200 mg/m²/day during the first, and 150 mg/m²/day during the following cycles) induced dramatic tumor size reduction (>90%).
  • [MeSH-major] Adenoma / drug therapy. Dacarbazine / analogs & derivatives. Pituitary ACTH Hypersecretion / drug therapy. Pituitary Neoplasms / drug therapy

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  • [CommentIn] Turk Neurosurg. 2015;25(4):679-80 [26242353.001]
  • (PMID = 21057727.001).
  • [ISSN] 1537-744X
  • [Journal-full-title] TheScientificWorldJournal
  • [ISO-abbreviation] ScientificWorldJournal
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide; 9002-60-2 / Adrenocorticotropic Hormone
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34. Gilliot O, Khalil T, Irthum B, Zasadny X, Verrelle P, Tauveron I, Pontvert D: Radiotherapy of pituitary adenomas: state of the art. Ann Endocrinol (Paris); 2007 Oct;68(5):337-48
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  • [Title] Radiotherapy of pituitary adenomas: state of the art.
  • Pituitary adenomas represent approximately 12% of intracranial tumors.
  • Prolactin-secreting adenomas are first treated with dopamine agonists, and GH-secreting adenomas are first treated by surgery if excising the complete tumor is possible; otherwise medical treatment is started.
  • The first-line treatment of ACTH-secreting adenomas is surgery; however, in many cases, insufficient control of either secretion or tumoral volume leads to consideration of irradiation.
  • Because the indications of radiotherapy are still debated, irradiation of pituitary adenomas must be decided by the complete team of endocrinologists, neurosurgeons, radiologists and radiotherapists.
  • [MeSH-major] Adenoma / radiotherapy. Pituitary Neoplasms / radiotherapy

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  • (PMID = 17512895.001).
  • [ISSN] 0003-4266
  • [Journal-full-title] Annales d'endocrinologie
  • [ISO-abbreviation] Ann. Endocrinol. (Paris)
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 9002-62-4 / Prolactin
  • [Number-of-references] 94
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35. 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


36. Castinetti F, Brue T: [Radiotherapy and radiosurgery of pituitary adenomas]. Presse Med; 2009 Jan;38(1):133-9
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  • [Title] [Radiotherapy and radiosurgery of pituitary adenomas].
  • There are two principal types of treatment for pituitary adenomas: fractionated conventional radiation therapy, based on biological selectivity, and radiosurgery, which is delivered in a single dose, based on anatomic selectivity and indicated preferentially for small tumors sufficiently distant from the optic chiasm.
  • Radiation therapy and radiosurgery make it possible to stabilize or diminish tumor volume in 70-100% of cases.
  • This is especially useful in the case of an active residue after surgery for non-secreting adenoma, but the long-term side effects of radiation must be borne in mind.
  • The principal side effect is the onset of a pituitary deficiency (in more than 50% of cases after radiation therapy, 20% after radiosurgery).
  • [MeSH-major] Adenoma / radiotherapy. Pituitary Neoplasms / radiotherapy. Radiosurgery
  • [MeSH-minor] Acromegaly / therapy. Antineoplastic Agents / therapeutic use. Decision Trees. Dose Fractionation. Humans. Hypopituitarism / etiology. Pituitary ACTH Hypersecretion / therapy. Pituitary Gland / radiation effects. Pituitary Gland / secretion. Postoperative Complications. Prolactinoma / radiotherapy. Prolactinoma / secretion. Prolactinoma / surgery. Radiation Injuries / etiology. Risk Factors. Time Factors. Treatment Outcome

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  • (PMID = 18954960.001).
  • [ISSN] 2213-0276
  • [Journal-full-title] Presse medicale (Paris, France : 1983)
  • [ISO-abbreviation] Presse Med
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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37. Waugh MS, Soler AP, Robboy SJ: Silent corticotroph cell pituitary adenoma in a struma ovarii. Int J Gynecol Pathol; 2007 Jan;26(1):26-9
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  • [Title] Silent corticotroph cell pituitary adenoma in a struma ovarii.
  • This is the first report of a silent corticotroph cell pituitary adenoma arising in a struma ovarii.
  • The patient, a 79-year-old woman, was found to have an asymptomatic left-sided adnexal mass confirmed by vaginal sonography to be a complex cystic and solid tumor.
  • The pituitary cells were predominantly immunoreactive for adrenocorticotropic hormone, in addition to synaptophysin.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / pathology. Corticotrophs / pathology. Struma Ovarii / pathology

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  • (PMID = 17197893.001).
  • [ISSN] 0277-1691
  • [Journal-full-title] International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists
  • [ISO-abbreviation] Int. J. Gynecol. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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38. McDermott JH, Thabit H, Hickey N, Thompson C, Gaffney E, Young V, Sreenan S: ACTH-secreting bronchial carcinoid: a diagnostic and therapeutic challenge. Ir J Med Sci; 2008 Sep;177(3):269-72
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  • [Title] ACTH-secreting bronchial carcinoid: a diagnostic and therapeutic challenge.
  • OBJECTIVE: We describe a case of Cushing's syndrome due to ectopic ACTH secretion, where the only potential source on conventional imaging was a tiny benign-appearing lung nodule, which failed to take up radiolabelled octreotide.
  • RESULTS: Compared to ACTH and cortisol levels on a control day, the levels following the test dose of octreotide were lower.
  • Histological examination of the resected specimen confirmed bronchial carcinoid staining positive for ACTH.
  • CONCLUSIONS: This is one of the few cases described where ectopic ACTH secretion secondary to bronchial carcinoid responded to somatostatin analogue therapy.
  • The case was also unusual in that the tumour responded despite not taking up radiolabelled octreotide.
  • [MeSH-major] ACTH Syndrome, Ectopic / etiology. Bronchial Neoplasms / diagnosis. Carcinoid Tumor / diagnosis. Pituitary ACTH Hypersecretion / etiology

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39. 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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40. de Herder WW, Kwekkeboom DJ, Valkema R, Feelders RA, van Aken MO, Lamberts SW, van der Lely AJ, Krenning EP: Neuroendocrine tumors and somatostatin: imaging techniques. J Endocrinol Invest; 2005;28(11 Suppl International):132-6
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  • The sensitivity of 111In-pentetreotide scintigraphy for the detection of gastrinomas, vasoactive intestinal polypeptide-secreting tumors, and glucagonomas as well as clinically non-functioning lesions is 75-100%.
  • Most GH- and TSH-secreting pituitary adenomas can be visualized using 111In-pentetreotide.
  • 111In-pentetreotide scintigraphy is negative in microprolactinomas and ACTH-secreting pituitary microadenomas.
  • 111In-pentetreotide scintigraphy has been successful for the localization of extra-pituitary ACTH-secreting tumors and their metastases, and especially for occult tumors.
  • A large variety of lesions in and around the pituitary region express somatostatin receptors and, therefore, can be visualized by 111In-pentetreotide scintigraphy.
  • [MeSH-minor] Carcinoid Tumor / radionuclide imaging. Gastrointestinal Neoplasms / radionuclide imaging. Humans. Indium Radioisotopes. Paraganglioma / radionuclide imaging. Pheochromocytoma / radionuclide imaging. Pituitary Neoplasms / radionuclide imaging. Receptors, Somatostatin / analysis

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  • (PMID = 16625862.001).
  • [ISSN] 0391-4097
  • [Journal-full-title] Journal of endocrinological investigation
  • [ISO-abbreviation] J. Endocrinol. Invest.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Indium Radioisotopes; 0 / Receptors, Somatostatin; 0 / somatostatin receptor 2; 0 / somatostatin receptor 5; 51110-01-1 / Somatostatin; G083B71P98 / pentetreotide
  • [Number-of-references] 49
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41. Goh KP, Lee HY, Rajasoorya RC: Triple jeopardy in the pituitary. Pituitary; 2008;11(3):331-6
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  • [Title] Triple jeopardy in the pituitary.
  • Aggressive pituitary tumors are rare the pathogenesis is not well established.
  • The development of pituitary tumor after apoplexy has also been rarely reported.
  • We describe the sequential development of Cushing's disease, apoplexy and aggressive pituitary tumor in the same patient.
  • A 31-year old male presented with eutopic ACTH dependent Cushing's syndrome which failed initial pituitary surgery.
  • An episode of pituitary apoplexy then occurred which was followed by the development of a null-cell pituitary tumor.
  • This second tumor exhibited an aggressive behavior with invasion into the surrounding structures and systemic spread clinically.
  • This case provides important evidence for the hypotheses of the pathogenesis of aggressive pituitary tumors which could have arisen from surviving adenoma cells following apoplexy or as a de novo development of pituitary carcinoma from cells which were not part of the original adenoma.
  • This is the first report of a transformation of Cushing's disease to an aggressive and invasive null cell tumor after pituitary irradiation, apoplexy and surgery.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / complications. Adenoma / complications. Carcinoma / etiology. Neoplasms, Second Primary. Pituitary ACTH Hypersecretion / complications. Pituitary Apoplexy / complications. Pituitary Gland / pathology. Pituitary Neoplasms / etiology
  • [MeSH-minor] Adrenalectomy. Adult. Fatal Outcome. Humans. Magnetic Resonance Imaging. Male. Neoplasm Invasiveness. Radiotherapy, Adjuvant

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  • (PMID = 18058238.001).
  • [ISSN] 1386-341X
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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42. Ysrraelit MC, Gaitán MI, Lopez AS, Correale J: Impaired hypothalamic-pituitary-adrenal axis activity in patients with multiple sclerosis. Neurology; 2008 Dec 9;71(24):1948-54
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  • [Title] Impaired hypothalamic-pituitary-adrenal axis activity in patients with multiple sclerosis.
  • OBJECTIVE: To investigate hypothalamic-pituitary-adrenal axis activity in well-defined multiple sclerosis (MS) patient subgroups.
  • Plasma cortisol, adrenocorticotropic hormone (ACTH), and dehydroepiandrosterone sulfate (DHEAS), as well as urine cortisol levels, were measured using commercial radioimmunoassays.
  • PBMC production of the proinflammatory peptide corticotrophin-releasing hormone (CRH), interleukin (IL)-1beta, IL-6, interferon (IFN)-gamma, and tumor necrosis factor (TNF)-alpha was evaluated using enzyme-linked immunosorbent spot assay.
  • RESULTS: All four groups of patients displayed significantly higher cortisol, ACTH, and DHEAS plasma concentrations and urine cortisol values than controls.
  • The numbers of IL-1beta-, IL-6-, and TNF-alpha-secreting cells increased significantly in relapsing-remitting MS patients only during exacerbations; in contrast, IFN-gamma-secreting cells increased during both exacerbations and remission.
  • Finally, PBMC CRH-secreting cell numbers were considerably greater in all forms of MS.
  • CONCLUSIONS: Patients with multiple sclerosis show hypothalamic-pituitary-adrenal axis hyperactivity, with lymphocytes expressing similar glucocorticoid receptor numbers to controls; however, binding affinity and glucocorticoid sensitivity of these lymphocytes seem to be reduced.
  • [MeSH-major] Endocrine System Diseases / immunology. Hypothalamo-Hypophyseal System / immunology. Multiple Sclerosis / complications. Pituitary-Adrenal System / immunology
  • [MeSH-minor] Adult. Biomarkers / blood. Cytokines / blood. Enzyme-Linked Immunosorbent Assay. Female. Glucocorticoids / blood. Glucocorticoids / urine. Humans. Lymphocytes / drug effects. Lymphocytes / immunology. Lymphocytes / secretion. Male. Middle Aged. Monocytes / drug effects. Monocytes / immunology. Monocytes / secretion. Neuroimmunomodulation / immunology. Pituitary Hormones / blood. Pituitary Hormones / urine. Radioimmunoassay. Receptors, Glucocorticoid / drug effects. Receptors, Glucocorticoid / immunology. Receptors, Glucocorticoid / metabolism. Up-Regulation / immunology


43. Erickson D, Erickson B, Watson R, Patton A, Atkinson J, Meyer F, Nippoldt T, Carpenter P, Natt N, Vella A, Thapa P: 3 Tesla magnetic resonance imaging with and without corticotropin releasing hormone stimulation for the detection of microadenomas in Cushing's syndrome. Clin Endocrinol (Oxf); 2010 Jun;72(6):793-9
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  • [Title] 3 Tesla magnetic resonance imaging with and without corticotropin releasing hormone stimulation for the detection of microadenomas in Cushing's syndrome.
  • OBJECTIVE: We sought to determine if higher resolution 3 Tesla (T) magnetic resonance imaging (MRI) with or without ovine corticotropin releasing hormone (o-CRH) stimulation would increase the sensitivity for detection of pituitary microadenomas in ACTH-dependent Cushing's syndrome (CS).
  • DESIGN AND PATIENTS: We prospectively identified 23 patients over a 2-year period with clinical and biochemical evidence of ACTH-dependent CS with no lesion (n = 11) or equivocal lesion (n = 10) on 1.5T MRI.
  • MEASUREMENTS AND RESULTS: Both 3T MRI without (P < 0.016) and with o-CRH stimulation (P < 0.013) was significantly more sensitive for detection of pituitary microadenomas than 1.5T MRI for Group 1 (definitive proof of Cushing's disease, n = 10).
  • Group 2 (those in group 1, plus three patients where dynamic/invasive testing suggested pituitary source) also showed a significant (P < 0.012) advantage for 3T.
  • CONCLUSIONS: The results of our prospective blinded studies suggest that 3T MRI of pituitary gland should be considered in evaluation of patients with ACTH-dependent CD when 1.5T imaging is negative or equivocal.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / radiography. Adenoma / radiography. Corticotropin-Releasing Hormone / therapeutic use. Cushing Syndrome / radiography. Magnetic Resonance Imaging / methods
  • [MeSH-minor] Adult. Aged. Diagnostic Techniques, Endocrine. Female. Humans. Male. Middle Aged. Sensitivity and Specificity. Single-Blind Method. Stimulation, Chemical. Tumor Burden / drug effects. Tumor Burden / physiology. Young Adult

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  • (PMID = 19811509.001).
  • [ISSN] 1365-2265
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Journal Article; Randomized Controlled Trial
  • [Publication-country] England
  • [Chemical-registry-number] 9015-71-8 / Corticotropin-Releasing Hormone
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44. Katavetin P, Cheunsuchon P, Swearingen B, Hedley-Whyte ET, Misra M, Levitsky LL: Review: Pituitary adenomas in children and adolescents. J Pediatr Endocrinol Metab; 2010 May;23(5):427-31
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  • [Title] Review: Pituitary adenomas in children and adolescents.
  • Clinical manifestations and outcomes of pituitary adenomas in children are not clearly defined.
  • We retrospectively reviewed cases of pituitary adenomas in children 0-18 years treated at MassGeneral Hospital for Children over 15 years.
  • Patients with or without recurrence did not differ for age, tumor-size and hormone levels.
  • [MeSH-major] Adenoma / pathology. Pituitary Neoplasms / pathology
  • [MeSH-minor] Adolescent. Child. Combined Modality Therapy. Female. Growth Hormone-Secreting Pituitary Adenoma / pathology. Humans. Male. Pituitary ACTH Hypersecretion / pathology. Prolactinoma / pathology. Retrospective Studies

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  • (PMID = 20662340.001).
  • [ISSN] 0334-018X
  • [Journal-full-title] Journal of pediatric endocrinology & metabolism : JPEM
  • [ISO-abbreviation] J. Pediatr. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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45. Wan H, Chihiro O, Yuan S: MASEP gamma knife radiosurgery for secretory pituitary adenomas: experience in 347 consecutive cases. J Exp Clin Cancer Res; 2009;28:36
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  • [Title] MASEP gamma knife radiosurgery for secretory pituitary adenomas: experience in 347 consecutive cases.
  • BACKGROUND: Secretory pituitary adenomas are very common brain tumors.
  • Historically, the treatment armamentarium for secretory pituitary adenomas included neurosurgery, medical management, and fractionated radiotherapy.
  • In recent years, MASEP gamma knife radiosurgery (MASEP GKRS) has emerged as an important treatment modality in the management of secretory pituitary adenomas.
  • The goal of this research is to define accurately the efficacy, safety, complications, and role of MASEP GKRS for treatment of secretory pituitary adenomas.
  • METHODS: Between 1997 and 2007 a total of 347 patients with secretory pituitary adenomas treated with MASEP GKRS and with at least 60 months of follow-up data were identified.
  • Of the 68 patients with adrenocorticotropic hormone-secreting(ACTH) adenomas, 89.7% showed tumor volume decrease or remain unchanged and 27.9% experienced normalization of hormone level.
  • Of the 176 patients with prolactinomas, 23.3% had normalization of hormone level and 90.3% showed tumor volume decrease or remain unchanged.
  • Of the 103 patients with growth hormone-secreting(GH) adenomas, 95.1% experienced tumor volume decrease or remain unchanged and 36.9% showed normalization of hormone level.
  • CONCLUSION: MASEP GKRS is safe and effective in treating secretory pituitary adenomas.
  • However, treatment must be tailored to meet the patient's symptoms, tumor location, tumor morphometry, and overall health.
  • [MeSH-major] Adenoma / surgery. Pituitary Neoplasms / surgery. Radiosurgery / methods

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  • (PMID = 19284583.001).
  • [ISSN] 1756-9966
  • [Journal-full-title] Journal of experimental & clinical cancer research : CR
  • [ISO-abbreviation] J. Exp. Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
  • [Other-IDs] NLM/ PMC2660297
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46. Santoro A, Minniti G, Ruggeri A, Esposito V, Jaffrain-Rea ML, Delfini R: Biochemical remission and recurrence rate of secreting pituitary adenomas after transsphenoidal adenomectomy: long-term endocrinologic follow-up results. Surg Neurol; 2007 Nov;68(5):513-8; discussion 518
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  • [Title] Biochemical remission and recurrence rate of secreting pituitary adenomas after transsphenoidal adenomectomy: long-term endocrinologic follow-up results.
  • BACKGROUND: Transsphenoidal surgery is safe and effective in patients with secreting pituitary adenomas; however, variable outcomes have been reported according to the different criteria used to define the biochemical remission of hormone hypersecretion.
  • We report the long-term endocrinologic follow-up results of a large cohort of patients who underwent TSS for secreting pituitary adenomas according to the most recent stringent criteria of cure.
  • METHODS: Two hundred ten consecutive patients were operated on by TSS between 1995 and 2004 for a secreting pituitary adenoma (65 PRL-, 109 GH-, and 36 ACTH-secreting adenomas) and were considered for the study.
  • RESULTS: The overall remission rate was 65% for the whole series, being 64%, 61%, and 75% for PRL-, GH-, and ACTH-secreting adenomas, respectively.
  • Remission rates were significantly higher in GH- and ACTH-secreting pituitary macroadenomas than in macroprolactinomas.
  • At a median follow-up of 56 months, tumor recurrence was 0%, 11%, and 14% for GH-, ACTH-, and PRL-secreting tumors.
  • Tumor size, cavernous sinus invasion, and high hormone levels were negatively correlated to the outcome.
  • CONCLUSION: Transsphenoidal surgery remains an effective treatment for secreting pituitary tumors according to the most recent criteria of cure.
  • Patients with PRL- or ACTH-secreting adenomas may recur after apparently successful surgery, thereby justifying long-term careful endocrinologic follow-up.
  • [MeSH-major] Adenoma / surgery. Hyperpituitarism / prevention & control. Pituitary Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Aged. Female. Follow-Up Studies. Humans. Male. Middle Aged. Pituitary Hormones, Anterior / blood. Pituitary Hormones, Anterior / secretion. Recurrence. Remission Induction. Retrospective Studies. Time Factors. Treatment Outcome

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  • (PMID = 17961741.001).
  • [ISSN] 0090-3019
  • [Journal-full-title] Surgical neurology
  • [ISO-abbreviation] Surg Neurol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Pituitary Hormones, Anterior
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47. 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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48. 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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49. 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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50. 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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51. Karavitaki N, Scheithauer BW, Watt J, Ansorge O, Moschopoulos M, Llaguno AV, Wass JA: Collision lesions of the sella: co-existence of craniopharyngioma with gonadotroph adenoma and of Rathke's cleft cyst with corticotroph adenoma. Pituitary; 2008;11(3):317-23
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  • Most contributions include a pituitary adenoma or a cyst/cystic tumor, particularly a Rathke cleft cyst.
  • Among reported cases, some have included secondary prolactin cell hyperplasia due to pituitary stalk section effect.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / complications. Adenoma / complications. Central Nervous System Cysts / complications. Corticotrophs / pathology. Craniopharyngioma / complications. Gonadotrophs / pathology. Pituitary Neoplasms / complications. Sella Turcica / pathology

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  • (PMID = 17917812.001).
  • [ISSN] 1386-341X
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 65
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52. Morris DG, Musat M, Czirják S, Hanzély Z, Lillington DM, Korbonits M, Grossman AB: Differential gene expression in pituitary adenomas by oligonucleotide array analysis. Eur J Endocrinol; 2005 Jul;153(1):143-51
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  • [Title] Differential gene expression in pituitary adenomas by oligonucleotide array analysis.
  • OBJECTIVES: Microarray technology allows for the expression profile of many thousands of genes to be quantified at the same time, and has resulted in novel discoveries about the tumour biology of a number of cancers.
  • We sought to do this in pituitary adenomas, the most common intracranial neoplasm.
  • METHODS: Affymetrix GeneChip HG-U133A oligonucleotide arrays covering 14 500 well-characterised genes from the human genome were used to study pooled RNA for each of the four major pituitary adenoma subtypes.
  • Individual gene-expression levels in the tumours were compared relative to the expression profile in normal pooled pituitary RNA.
  • RESULTS: Bioinformatic analysis showed that 3906 genes and 351 expressed sequence tags were differentially expressed among all pituitary tumour subtypes.
  • Lysosomal-associated protein transmembrane- 4-beta (LAPTM4B), a novel gene upregulated in hepatocellular carcinoma, was significantly over-expressed in adrenocorticotrophin (ACTH)-secreting adenomas and non-functioning pituitary adenomas (NFPAs).
  • Bcl-2-associated athanogene (BAG1), an anti-apoptotic protein found at high levels in a number of human cancers, was significantly over-expressed in growth hormone-secreting and prolactin-secreting adenomas and NFPAs.
  • The cyclin-dependent kinase inhibitor p18, in which murine gene deletion has been shown to produce pituitary ACTH cell hyperplasia and adenomas, was significantly under-expressed in ACTH-secreting adenomas.
  • CONCLUSIONS: Expression array analysis of pituitary adenomas using the Affymetrix GeneChip HG-U133A arrays appears to be a valid method of identifying genes that may be important in tumour pathogenesis.

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  • (PMID = 15994756.001).
  • [ISSN] 0804-4643
  • [Journal-full-title] European journal of endocrinology
  • [ISO-abbreviation] Eur. J. Endocrinol.
  • [Language] ENG
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / BCL2-associated athanogene 1 protein; 0 / CDKN2C protein, human; 0 / Cell Cycle Proteins; 0 / Cyclin-Dependent Kinase Inhibitor p18; 0 / DNA-Binding Proteins; 0 / LAPTM4B protein, human; 0 / Membrane Proteins; 0 / Oncogene Proteins; 0 / Transcription Factors; 0 / Tumor Suppressor Proteins; 9002-60-2 / Adrenocorticotropic Hormone; 9002-62-4 / Prolactin
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53. De Martin M, Pecori Giraldi F, Cavagnini F: Cushing's disease. Pituitary; 2006;9(4):279-87
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  • Cushing's disease, i.e., pituitary ACTH-secreting adenoma causing excess glucocorticoid secretion, is a rare disease with significant mortality and morbidity.
  • Measurement of plasma ACTH then allows the distinction between ACTH-dependent (e.g., pituitary or extrapituitary neuroendocrine tumors) and ACTH-independent causes (e.g., adrenal tumors).
  • The last step in the diagnostic algorithm is often the most fraught with problems as the distinction between Cushing's disease and ectopic ACTH secretion relies on judicious interpretation of several diagnostic procedures.
  • Positive responses to stimulation with CRH and inhibition by high doses of dexamethasone, if concurrent, enable a pituitary origin to be established whereas conflicting results call for inferior petrosal sinus sampling, the latter to be performed in experienced centres only.
  • Visualisation of the tumor at pituitary imaging is helpful but not required for the diagnosis, as microadenomas often remain undectected by MRI and/or CT scan and, on the other hand, visualisation of a non-secreting incidentaloma may be misleading.
  • Surgical removal of the pituitary tumor is the optimal treatment choice and should be attempted in every patient.
  • [MeSH-major] Pituitary ACTH Hypersecretion / diagnosis. Pituitary ACTH Hypersecretion / therapy
  • [MeSH-minor] ACTH Syndrome, Ectopic / diagnosis. Adrenalectomy. Adrenocorticotropic Hormone / blood. Biomarkers / blood. Biomarkers / urine. Cardiovascular Diseases / etiology. Cardiovascular Diseases / therapy. Combined Modality Therapy. Diagnosis, Differential. Diagnostic Imaging. Endocrine System Diseases / etiology. Endocrine System Diseases / therapy. Eye Diseases / etiology. Eye Diseases / therapy. Humans. Hydrocortisone / blood. Hydrocortisone / urine. Hypophysectomy. Mental Disorders / etiology. Mental Disorders / therapy. Osteoporosis / etiology. Osteoporosis / therapy. Radiotherapy, Adjuvant. Recurrence. Treatment Outcome

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  • (PMID = 17077950.001).
  • [ISSN] 1573-7403
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers; 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone
  • [Number-of-references] 90
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54. Pawlikowski M, Gruszka A, Kurnatowska I, Winczyk K, Kunert-Radek J, Radek A: Proliferating cell nuclear antigen (PCNA) expression in pituitary adenomas: relationship to the endocrine phenotype of adenoma. Folia Histochem Cytobiol; 2006;44(1):37-41
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  • [Title] Proliferating cell nuclear antigen (PCNA) expression in pituitary adenomas: relationship to the endocrine phenotype of adenoma.
  • Since proliferation rate is an important factor determining the tumor aggressiveness, the evaluation of PCNA index (the percentage of PCNA-immunopositive nuclei in the investigated tumor sample) is suggested as useful in predicting pituitary adenoma outcome.
  • Seventy three unselected, surgically removed pituitary adenomas were immunostained with antibodies against the pituitary hormones or their subunits and against the proliferating cell nuclear antigen (PCNA).
  • The highest PCNA index was found in ACTH-immunopositive tumors without the manifestation of the Cushing's disease ("silent" corticotropinomas).
  • The lowest PCNA index was noticed in monohormonal GH-secreting tumors.
  • These findings suggest that the proliferative potential of pituitary adenomas is related to the tumor recurrence and hormone expression.

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  • (PMID = 16584090.001).
  • [ISSN] 0239-8508
  • [Journal-full-title] Folia histochemica et cytobiologica
  • [ISO-abbreviation] Folia Histochem. Cytobiol.
  • [Language] ENG
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Follicle Stimulating Hormone, Human; 0 / Gonadotropins; 0 / Proliferating Cell Nuclear Antigen; 9002-60-2 / Adrenocorticotropic Hormone; 9002-62-4 / Prolactin; 9002-67-9 / Luteinizing Hormone
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55. Horiguchi K, Yamada M, Umezawa R, Satoh T, Hashimoto K, Tosaka M, Yamada S, Mori M: Somatostatin receptor subtypes mRNA in TSH-secreting pituitary adenomas: a case showing a dramatic reduction in tumor size during short octreotide treatment. Endocr J; 2007 Jun;54(3):371-8
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  • [Title] Somatostatin receptor subtypes mRNA in TSH-secreting pituitary adenomas: a case showing a dramatic reduction in tumor size during short octreotide treatment.
  • TSH-secreting adenoma is a rare pituitary adenoma, and the expression levels of the specific subtypes of somatostatin receptors (sstr) mRNAs have remained obscure.
  • To determine the quantitative expression of the sstr1-5 mRNAs in TSH-secreting adenomas that may be related to the efficacy of treatment with a somatostatin analogue, expression of the sstr1-5 mRNAs was examined and compared in TSH-secreting adenomas and other pituitary adenomas.
  • The pituitary adenomas were obtained at transsphenoidal surgery from 4 cases of TSH-secreting adenoma, including 1 patient showing a significant shrinkage of the tumor size after only 10 days of octreotide treatment, 2 patients without tumor size reduction and 1 patient without treatment, and 5 GH-secreting adenomas, 6 prolactinomas, 5 nonfunctioning adenomas, 4 ACTH-secreting adenomas and normal pituitaries at autopsy from 4 normal subjects.
  • In comparison to the normal pituitary, sstr2A>sstr1>sstr5>sstr3 mRNAs were expressed in the TSH-secreting adenomas examined.
  • The expression level of sstr2 mRNA was significantly higher than those in normal pituitary, prolactinomas, ACTH-secreting and nonfunctioning pituitary adenomas.
  • The patient with marked shrinkage of the tumor showed the highest expression of both sstr2 and sstr5 mRNAs among all the cases of pituitary adenoma.
  • A TSH-secreting tumor without shrinkage showed a similar expression level of sstr2 mRNA.
  • These findings demonstrated that TSH-secreting adenomas express sstr1, 2A, 3 and 5 mRNAs, predominantly sstr2A, and in addition to the expression of sstr2 mRNA, the expression level of sstr5 mRNA may be a factor affecting the tumor shrinkage by somatostatin analogues against TSH-secreting adenomas.
  • [MeSH-major] Adenoma / drug therapy. Adenoma / genetics. Octreotide / therapeutic use. Pituitary Neoplasms / drug therapy. Pituitary Neoplasms / genetics. Receptors, Somatostatin / genetics. Thyrotrophs / pathology. Tumor Burden / drug effects

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  • (PMID = 17420609.001).
  • [ISSN] 0918-8959
  • [Journal-full-title] Endocrine journal
  • [ISO-abbreviation] Endocr. J.
  • [Language] eng
  • [Publication-type] Case Reports; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Protein Isoforms; 0 / RNA, Messenger; 0 / Receptors, Somatostatin; RWM8CCW8GP / Octreotide
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56. Azevedo MF, Xekouki P, Keil MF, Lange E, Patronas N, Stratakis CA: An unusual presentation of pediatric Cushing disease: recurrent corticotropinoma of the posterior pituitary lobe. J Pediatr Endocrinol Metab; 2010 Jun;23(6):607-12
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  • [Title] An unusual presentation of pediatric Cushing disease: recurrent corticotropinoma of the posterior pituitary lobe.
  • We report the case of a 15-year-old girl with a recurrent corticotrophin (ACTH)-secreting adenoma, located in the posterior lobe of the pituitary gland.
  • At the age of 11, she presented with classic CS symptoms; biochemical investigation was compatible with ACTH-dependent Cushing disease, although pituitary gland imaging did not show any tumor.
  • Following transsphenoidal surgery (TSS), histopathological analysis identified an ACTH-secreting pituitary microadenoma arising from the posterior gland.
  • The patient went into remission but 4 years later she presented with recurrent CS; this time, pituitary gland imaging showed a microadenoma located in the posterior lobe, which was resected after TSS.
  • Posterior lobe pituitary adenomas are very rare and often hard to diagnose and treat; this is the first case of such a tumor causing recurrent Cushing's disease in a child.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / pathology. Adenoma / pathology. Pituitary ACTH Hypersecretion / diagnosis
  • [MeSH-minor] Child. Female. Humans. Magnetic Resonance Imaging. Neoplasm Recurrence, Local

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  • (PMID = 20662335.001).
  • [ISSN] 0334-018X
  • [Journal-full-title] Journal of pediatric endocrinology & metabolism : JPEM
  • [ISO-abbreviation] J. Pediatr. Endocrinol. Metab.
  • [Language] eng
  • [Grant] United States / Intramural NIH HHS / / ZIA HD000642-12
  • [Publication-type] Case Reports; Journal Article; Research Support, N.I.H., Intramural
  • [Publication-country] England
  • [Other-IDs] NLM/ NIHMS752367; NLM/ PMC4727444
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57. Rocha Filho PA, Galvão AC, Teixeira MJ, Rabello GD, Fortini I, Calderaro M, Carrocini D: SUNCT syndrome associated with pituitary tumor: case report. Arq Neuropsiquiatr; 2006 Jun;64(2B):507-10
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  • [Title] SUNCT syndrome associated with pituitary tumor: case report.
  • MRI revealed a pituitary tumor with little suprasellar extent.
  • The subjects serial assays of prolactin, GH, TSH and ACTH were within normal levels.
  • Following transsphenoidal hypophysectomy, with complete removal of the tumor, the subject no more presented pain.
  • The pathological diagnosis was non-secreting adenoma.
  • [MeSH-major] Adenoma / complications. Pituitary Neoplasms / complications. SUNCT Syndrome / etiology

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  • (PMID = 16917628.001).
  • [ISSN] 0004-282X
  • [Journal-full-title] Arquivos de neuro-psiquiatria
  • [ISO-abbreviation] Arq Neuropsiquiatr
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Brazil
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58. 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
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  • [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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59. Revill K, Dudley KJ, Clayton RN, McNicol AM, Farrell WE: Loss of neuronatin expression is associated with promoter hypermethylation in pituitary adenoma. Endocr Relat Cancer; 2009 Jun;16(2):537-48
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  • [Title] Loss of neuronatin expression is associated with promoter hypermethylation in pituitary adenoma.
  • The imprinted gene, neuronatin (NNAT), is one of the most abundant transcripts in the pituitary and is thought to be involved in the development and maturation of this gland.
  • In a recent whole-genome approach, exploiting a pituitary tumour cell line, we identified hypermethylation associated loss of NNAT.
  • In this report, we determined the expression pattern of NNAT in individual cell types of the normal gland and within each of the different pituitary adenoma subtypes.
  • In addition, we determined associations between expression and CpG island methylation and used colony forming efficiency assays (CFE) to gain further insight into the tumour-suppressor function of this gene.
  • Immunohistochemical (IHC) co-localization studies of normal pituitaries showed that each of the hormone secreting cells (GH, PRL, ACTH, FSH and TSH) expressed NNAT.
  • Collectively, these findings point to an important role for NNAT in the pituitary and perhaps tumour development in this gland.
  • [MeSH-major] DNA Methylation. Membrane Proteins / genetics. Nerve Tissue Proteins / genetics. Pituitary Gland / pathology. Pituitary Neoplasms / genetics. Promoter Regions, Genetic / genetics
  • [MeSH-minor] Animals. CpG Islands. Gene Silencing. Humans. Immunoenzyme Techniques. Loss of Heterozygosity. Mice. RNA, Messenger / genetics. RNA, Messenger / metabolism. Reverse Transcriptase Polymerase Chain Reaction. Tumor Cells, Cultured

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  • (PMID = 19218280.001).
  • [ISSN] 1351-0088
  • [Journal-full-title] Endocrine-related cancer
  • [ISO-abbreviation] Endocr. Relat. Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Membrane Proteins; 0 / NNAT protein, human; 0 / Nerve Tissue Proteins; 0 / RNA, Messenger
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60. 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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61. Oldfield EH, Vortmeyer AO: Development of a histological pseudocapsule and its use as a surgical capsule in the excision of pituitary tumors. J Neurosurg; 2006 Jan;104(1):7-19
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  • [Title] Development of a histological pseudocapsule and its use as a surgical capsule in the excision of pituitary tumors.
  • OBJECT: The presence of a histological pseudocapsule around pituitary tumors was noted in the early 1900s.
  • Since that time there has been no emphasis on the sequence of the stages of its development or on the relationship between these stages and the capacity to identify very small pituitary tumors at surgery in patients in whom preoperative imaging has been nondiagnostic.
  • In addition, limited emphasis has been given to the pseudocapsule's use for selective and complete resection of pituitary adenomas.
  • METHODS: The development of the pseudocapsule was examined by performing histological analysis of portions of pituitary glands removed during 805 operations for Cushing disease.
  • Twenty-five adenomas, each measuring between 0.25 and 4 mm in maximum diameter, were detected in the excised specimens; 17 were adenocorticotropic hormone-positive adenomas and eight were incidental tumors (four prolactin-secreting and four nonsecreting lesions).
  • The distribution of tumor size in relation to the presence of a histological pseudocapsule indicates a transition from the absence of a reticulin capsule (tumor diameter < or =1 mm) through the initial compression of surrounding tissue (tumor diameter 1-2 mm) to the presence of a multilayered reticulin capsule observed when adenomas become larger (tumor diameter 2-3 mm).
  • CONCLUSIONS: The absence of a reticulin capsule in cases of very small tumors may contribute to limited localization of these lesions during surgical exploration of the pituitary gland.
  • In this article the authors describe surgical techniques in which the histological pseudocapsule is used as a surgical capsule during pituitary surgery.
  • In their experience, recognition of this surgical capsule and its use at surgery has contributed to the identification of microadenomas buried in the pituitary gland, aided the recognition of subtle invasion of the pituitary capsule and contiguous dura mater, and enhanced the consistency of complete tumor excision with small and large tumors.
  • [MeSH-major] Adenoma / complications. Adenoma / pathology. Neurosurgical Procedures / methods. Pituitary Gland / pathology. Pituitary Neoplasms / complications. Pituitary Neoplasms / pathology
  • [MeSH-minor] Humans. Pituitary ACTH Hypersecretion / etiology. Pituitary ACTH Hypersecretion / surgery. Retrospective Studies

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  • [CommentIn] J Neurosurg. 2006 Jan;104(1):1-2; discussison 2-3 [16509140.001]
  • (PMID = 16509142.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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62. 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


63. Ohmori N, Nomura K, Ohmori K, Takano K: Preclinical Cushing's disease characterized by massive adrenal hyperplasia and hormonal changes after three years of metyrapone therapy. Endocr J; 2007 Jun;54(3):391-7
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  • Her plasma ACTH and serum cortisol levels were normal, but they were not suppressed by low-dose dexamethasone.
  • MRI showed no evidence of a tumor in the pituitary gland.
  • As the dose of metyrapone was increased, plasma ACTH levels gradually increased.
  • Her plasma ACTH and serum cortisol concentrations were at their highest levels.
  • A pituitary microadenoma was detected by MRI, whose source of ACTH was demonstrated by the definite step-up of central/peripheral ratio of ACTH obtained by cavernous sinus sampling.
  • Overt Cushing's disease was diagnosed, and a pituitary tumor was removed by transsphenoidal surgery.
  • [MeSH-major] Adrenal Glands / pathology. Adrenocorticotropic Hormone / blood. Hydrocortisone / blood. Metyrapone / therapeutic use. Pituitary ACTH Hypersecretion / diagnosis. Pituitary ACTH Hypersecretion / drug therapy. Pituitary ACTH Hypersecretion / etiology
  • [MeSH-minor] ACTH-Secreting Pituitary Adenoma / diagnosis. ACTH-Secreting Pituitary Adenoma / surgery. Adenoma / diagnosis. Adenoma / surgery. Aged. Antimetabolites / therapeutic use. Female. Humans. Hyperplasia / complications

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  • (PMID = 17446657.001).
  • [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] 0 / Antimetabolites; 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone; ZS9KD92H6V / Metyrapone
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64. Gejman R, Batista DL, Zhong Y, Zhou Y, Zhang X, Swearingen B, Stratakis CA, Hedley-Whyte ET, Klibanski A: Selective loss of MEG3 expression and intergenic differentially methylated region hypermethylation in the MEG3/DLK1 locus in human clinically nonfunctioning pituitary adenomas. J Clin Endocrinol Metab; 2008 Oct;93(10):4119-25
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  • [Title] Selective loss of MEG3 expression and intergenic differentially methylated region hypermethylation in the MEG3/DLK1 locus in human clinically nonfunctioning pituitary adenomas.
  • CONTEXT: MEG3 is an imprinted gene encoding a novel noncoding RNA that suppresses tumor cell growth.
  • Although highly expressed in the normal human pituitary, it is unknown which of the normal pituitary cell types and pituitary tumors express MEG3.
  • OBJECTIVES: Our objectives were 1) to investigate cell-type- and tumor-type-specific expression of MEG3 in the human pituitary and 2) to investigate whether methylation in the intergenic differentially methylated region (IG-DMR) at the DLK1/MEG3 locus is involved in the loss of MEG3 expression in tumors.
  • DESIGN AND METHODS: RT-PCR, quantitative RT-PCR, Northern blot, and a combination of in situ hybridization and immunofluorescence were used to determine the cell-type- and tumor-type-specific MEG3 expression.
  • Bisulfite treatment and PCR sequencing of genomic DNA were used to measure the CpG methylation status in the normal and tumor tissues.
  • Five normal human pituitaries and 17 clinically nonfunctioning, 11 GH-secreting, seven prolactin-secreting, and six ACTH-secreting pituitary adenomas were used.
  • RESULTS: All normal human pituitary cell types express MEG3.
  • However, loss of MEG3 expression occurs only in nonfunctioning pituitary adenomas of a gonadotroph origin.
  • All other pituitary tumor phenotypes examined express MEG3.
  • Hypermethylation of the IG-DMR at the DLK1/MEG3 locus is present in nonfunctioning pituitary adenomas.
  • CONCLUSIONS: MEG3 is the first human gene identified expressed in multiple normal human pituitary cell types with loss of expression specifically restricted to clinically nonfunctioning pituitary adenomas.

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  • (PMID = 18628527.001).
  • [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 / R01 DK040947; United States / NIDDK NIH HHS / DK / R01 DK-40947
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DLK1 protein, human; 0 / DNA, Intergenic; 0 / Intercellular Signaling Peptides and Proteins; 0 / MEG3 non-coding RNA, human; 0 / Membrane Proteins; 0 / Proteins; 0 / RNA, Long Noncoding
  • [Other-IDs] NLM/ PMC2579639
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65. Pinto EM, Bronstein MD: [Molecular aspects of pituitary tumorigenesis]. Arq Bras Endocrinol Metabol; 2008 Jun;52(4):599-610
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  • [Title] [Molecular aspects of pituitary tumorigenesis].
  • [Transliterated title] Aspectos moleculares da tumorigênese hipofisária.
  • Pituitary tumors, almost invariably adenomas, are of frequent occurrence, accounting for 10% to 15% of all the intracranial neoplasm.
  • They are classified as microadenomas (< 10 mm) or macroadenomas (> 10 mm) and as secreting or clinically non-secreting (or not functioning) adenomas.
  • These tumors are autonomously capable to release pituitary hormones such as the growth hormone (GH), prolactin (PRL), adrenocorticotropic hormone (ACTH), thyroid stimulating hormone (TSH), follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
  • The occurrence of metastases, characterizing a pituitary carcinoma, is exceedingly rare.
  • Although the pathogenesis of pituitary tumors is fully characterized, many molecular mechanisms of pituitary tumorigenesis had already been revealed.
  • This review intends to describe advances in the understanding of the involved advances that have been made in the last decade concerning pituitary tumors progression, including the participation of oncogenes, tumor suppressor genes and growth factors.
  • [MeSH-major] Genes, Tumor Suppressor / physiology. Intercellular Signaling Peptides and Proteins / genetics. Pituitary Neoplasms / genetics

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  • (PMID = 18604372.001).
  • [ISSN] 1677-9487
  • [Journal-full-title] Arquivos brasileiros de endocrinologia e metabologia
  • [ISO-abbreviation] Arq Bras Endocrinol Metabol
  • [Language] por
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Brazil
  • [Chemical-registry-number] 0 / Intercellular Signaling Peptides and Proteins
  • [Number-of-references] 73
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66. Sinha S, Sharma BS: Giant pituitary adenomas--an enigma revisited. Microsurgical treatment strategies and outcome in a series of 250 patients. Br J Neurosurg; 2010 Feb;24(1):31-9
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  • [Title] Giant pituitary adenomas--an enigma revisited. Microsurgical treatment strategies and outcome in a series of 250 patients.
  • BACKGROUND: Giant pituitary adenomas (> 4 cm) are a surgical challenge.
  • METHODS: Two hundred and fifty patients with giant pituitary adenomas were managed surgically at our center over last 13 years.
  • Among functioning adenomas, 63 patients (25.4%) had prolactinomas and 45 patients (18%) had GH-secreting adenomas; while 3 patients each had LH and ACTH- secreting adenomas.
  • The maximum tumor diameter varied from 4 to 10.5 cm, with mean diameter of 5.4 cm.
  • 23 patients (9.2%) underwent re-exploration either because of postoperative apoplexy or residual tumor.
  • Overall, near total (>90%) tumor excision could be achieved in 74%, with improved vision in 53% and good outcome in 75% patients.
  • CONCLUSIONS: The main goal of surgical treatment of giant pituitary adenoma is maximum possible tumor extirpation with minimal side effects, which can be achieved by careful preoperative planning of operative approach, based on directions of tumor extensions and invasiveness.
  • Maximal surgical removal of giant adenomas offers best chances to control tumor growth when followed with adjuvant medical and radiation therapies.
  • [MeSH-major] Adenoma / surgery. Microsurgery / methods. Pituitary Neoplasms / surgery

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  • (PMID = 20158350.001).
  • [ISSN] 1360-046X
  • [Journal-full-title] British journal of neurosurgery
  • [ISO-abbreviation] Br J Neurosurg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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67. Raverot G, Sturm N, de Fraipont F, Muller M, Salenave S, Caron P, Chabre O, Chanson P, Cortet-Rudelli C, Assaker R, Dufour H, Gaillard S, François P, Jouanneau E, Passagia JG, Bernier M, Cornélius A, Figarella-Branger D, Trouillas J, Borson-Chazot F, Brue T: Temozolomide treatment in aggressive pituitary tumors and pituitary carcinomas: a French multicenter experience. J Clin Endocrinol Metab; 2010 Oct;95(10):4592-9
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  • [Title] Temozolomide treatment in aggressive pituitary tumors and pituitary carcinomas: a French multicenter experience.
  • CONTEXT: To date only 18 patients with aggressive pituitary tumors or carcinomas treated with temozolomide have been reported.
  • OBJECTIVES: The objective of the study was to describe the antitumoral efficacy and toxicity of temozolomide in patients with aggressive pituitary tumors or carcinomas and evaluate the possible prognostic value of MGMT promoter methylation and protein expression.
  • PATIENTS: Eight patients, five with pituitary carcinomas (three prolactin (PRL) and two ACTH) and three with aggressive pituitary tumors (one PRL and two ACTH), all treated with temozolomide administered orally for four to 24 cycles, were included in our French multicenter study.
  • RESULTS: Three of the eight patients (two ACTH adenomas and one PRL carcinoma) responded to temozolomide as demonstrated by significant tumor shrinkage and reduced hormone secretion.
  • CONCLUSION: Temozolomide treatment may be an effective option for some aggressive pituitary tumors or carcinomas.
  • [MeSH-major] Carcinoma / drug therapy. Dacarbazine / analogs & derivatives. Pituitary Neoplasms / drug therapy
  • [MeSH-minor] ACTH-Secreting Pituitary Adenoma / drug therapy. ACTH-Secreting Pituitary Adenoma / genetics. ACTH-Secreting Pituitary Adenoma / pathology. Adult. Antineoplastic Agents, Alkylating / therapeutic use. DNA Methylation. Female. France. Humans. Male. Middle Aged. Neoplasm Invasiveness. O(6)-Methylguanine-DNA Methyltransferase / genetics. O(6)-Methylguanine-DNA Methyltransferase / metabolism. Prolactinoma / drug therapy. Prolactinoma / genetics. Prolactinoma / pathology. Retrospective Studies. Sequence Analysis, DNA


68. Luque-Ramírez M, Portoles GR, Varela C, Albero R, Halperin I, Moreiro J, Soto A, Casamitjana R, Spanish Multicentre Group for the Study of Acromegaly: The efficacy of octreotide LAR as firstline therapy for patients with newly diagnosed acromegaly is independent of tumor extension: predictive factors of tumor and biochemical response. Horm Metab Res; 2010 Jan;42(1):38-44
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  • [Title] The efficacy of octreotide LAR as firstline therapy for patients with newly diagnosed acromegaly is independent of tumor extension: predictive factors of tumor and biochemical response.
  • Surgical outcome of acromegaly depends on the preoperatory tumor size and extension.
  • Nevertheless, the response of GH-secreting adenomas to primary medical therapy is variable.
  • The aim of the present study was to evaluate the efficacy of octreotide LAR as primary therapy for acromegalic patients as a function of initial tumor extension.
  • Basal GH and fasting IGF-I concentrations, and tumor volume were measured at baseline and after 6 and 12 months of treatment.
  • The patients who completed the protocol showed a significant reduction of tumor volume (25+/-23%, Wilk's lambda=0.506, F=4.400, p=0.046) independently of tumor extension at study entry (Wilk's lambda=0.826, F=0.452, p=0.769).
  • A shrinkage >25% of baseline tumor volume was achieved in 8 (42%) patients with no differences between tumor extension subgroups.
  • Octreotide LAR is an effective first-line treatment for a large group of acromegalic patients independent of initial tumor extension.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / drug therapy. Acromegaly / drug therapy. Octreotide / therapeutic use. Pituitary Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Female. Humans. Male. Middle Aged. Prospective Studies. Treatment Outcome. Tumor Burden / drug effects

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  • [Copyright] Georg Thieme Verlag KG Stuttgart New York.
  • (PMID = 19798622.001).
  • [ISSN] 1439-4286
  • [Journal-full-title] Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et métabolisme
  • [ISO-abbreviation] Horm. Metab. Res.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] RWM8CCW8GP / Octreotide
  • [Investigator] Benito P; Cordido F; Lucas T; del Pozo C; García-Arnés JA; Picó A; Ruiz P; Vendrell J; Ruiz E; Webb S; Gilabert M
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69. De Menis E, Roncaroli F, Calvari V, Chiarini V, Pauletto P, Camerino G, Cremonini N: Corticotroph adenoma of the pituitary in a patient with X-linked adrenal hypoplasia congenita due to a novel mutation of the DAX-1 gene. Eur J Endocrinol; 2005 Aug;153(2):211-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Corticotroph adenoma of the pituitary in a patient with X-linked adrenal hypoplasia congenita due to a novel mutation of the DAX-1 gene.
  • We report the occurrence of an ACTH-secreting adenoma in a patient with X-linked congenital adrenal hypoplasia.
  • DESIGN AND METHODS: Detailed clinical, radiological and pathological investigation of the pituitary adenoma.
  • ACTH was 24 980 pg/ml and nuclear magnetic resonance disclosed a huge pituitary adenoma.
  • Three transsphenoidal operations and radiotherapy were necessary to remove the tumor mass and control ACTH secretion.
  • Histologically, the adenoma was composed of chromophobic and basophilic neoplastic cells with positive immunostaining for ACTH.
  • CONCLUSIONS: This case suggests that in adrenal hypoplasia congenita the development of a pituitary adenoma should be considered when a sudden rise of ACTH occurs despite adequate steroid substitution.
  • [MeSH-major] Adenoma / complications. Adrenal Insufficiency / complications. Adrenal Insufficiency / genetics. DNA-Binding Proteins / genetics. Pituitary Neoplasms / complications. Receptors, Retinoic Acid / genetics. Repressor Proteins / genetics
  • [MeSH-minor] Adrenocorticotropic Hormone / metabolism. Adult. Chromosomes, Human, X. DAX-1 Orphan Nuclear Receptor. Family Health. Female. Frameshift Mutation. Humans. Magnetic Resonance Imaging. Male. Pituitary ACTH Hypersecretion / complications. Pituitary ACTH Hypersecretion / metabolism. Pituitary ACTH Hypersecretion / pathology

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  • (PMID = 16061826.001).
  • [ISSN] 0804-4643
  • [Journal-full-title] European journal of endocrinology
  • [ISO-abbreviation] Eur. J. Endocrinol.
  • [Language] eng
  • [Grant] Italy / Telethon / / B.38
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / DAX-1 Orphan Nuclear Receptor; 0 / DNA-Binding Proteins; 0 / NR0B1 protein, human; 0 / Receptors, Retinoic Acid; 0 / Repressor Proteins; 9002-60-2 / Adrenocorticotropic Hormone
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70. Tani Y, Inoshita N, Sugiyama T, Kato M, Yamada S, Shichiri M, Hirata Y: Upregulation of CDKN2A and suppression of cyclin D1 gene expressions in ACTH-secreting pituitary adenomas. Eur J Endocrinol; 2010 Oct;163(4):523-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Upregulation of CDKN2A and suppression of cyclin D1 gene expressions in ACTH-secreting pituitary adenomas.
  • OBJECTIVE: Cushing's disease (CD) is usually caused by ACTH-secreting pituitary microadenomas, while silent corticotroph adenomas (SCA) are macroadenomas without Cushingoid features.
  • However, the molecular mechanism(s) underlying their different tumor growth remains unknown.
  • DESIGN AND METHODS: Tumor tissue specimens resected from 43 pituitary tumors were studied: CD (n=10), SCA (n=11), and NFA (n=22).
  • Thus, it is suggested that upregulated CDKN2A with the concomitant downregulated cyclin gene family is partly involved in the small size of ACTH-secreting adenoma.


71. Bucciarelli LG, Pecori Giraldi F, Cavagnini F: No mutations in TPIT, a corticotroph-specific gene, in human tumoral pituitary ACTH-secreting cells. J Endocrinol Invest; 2005 Dec;28(11):1015-8
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  • [Title] No mutations in TPIT, a corticotroph-specific gene, in human tumoral pituitary ACTH-secreting cells.
  • BACKGROUND: TPIT is a recently identified transcription factor specific to proopiomelanocortin (POMC)-expressing cells within the pituitary and plays a pivotal role in the embryonal development of POMC lineage.
  • As with other transcription factors, TPIT could theoretically also be involved in corticotroph adenomatous transformation and ACTH hypersecretion and published data indicate that TPIT is present in normal and adenomatous human corticotrophs.
  • DESIGN AND METHODS: Eight human ACTH-secreting pituitary adenomas were collected during surgery, mRNA extracted from primary cultures and reverse transcribed.
  • RESULTS: TPIT mRNA was detected in all 8 ACTH-secreting pituitary adenomas without apparent mRNA variants.
  • CONCLUSIONS: Aberrant TPIT is unlikely to play a role in corticotroph tumoral trasformation, ie, Cushing's disease, as the entire coding sequence is expressed without any mutation by human pituitary ACTH-secreting adenomas.
  • Conversely, the significance of this transcription factor in tumoral ACTH hypersecretion remains to be clarified.
  • [MeSH-major] Adrenocorticotropic Hormone / secretion. Homeodomain Proteins / genetics. Mutation / genetics. Pituitary Neoplasms / genetics. Transcription Factors / genetics
  • [MeSH-minor] Humans. RNA, Messenger / genetics. RNA, Messenger / metabolism. RNA, Neoplasm / genetics. RNA, Neoplasm / metabolism. Reverse Transcriptase Polymerase Chain Reaction. T-Box Domain Proteins. Tumor Cells, Cultured

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  • (PMID = 16483181.001).
  • [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 / Homeodomain Proteins; 0 / RNA, Messenger; 0 / RNA, Neoplasm; 0 / T-Box Domain Proteins; 0 / TBX19 protein, human; 0 / Transcription Factors; 9002-60-2 / Adrenocorticotropic Hormone
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72. 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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73. Jagannathan J, Sheehan JP, Pouratian N, Laws ER, Steiner L, Vance ML: Gamma Knife surgery for Cushing's disease. J Neurosurg; 2007 Jun;106(6):980-7
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  • OBJECT: In this study the authors address the efficacy and safety of Gamma Knife surgery (GKS) in patients with adrenocorticotropic hormone-secreting pituitary adenomas.
  • All but one patient underwent resection for a pituitary tumor, without achieving remission.
  • Patient records were also evaluated for changes in tumor volume, development of new hormone deficiencies, visual acuity, cranial nerve neuropathies, and radiation-induced imaging changes.
  • The mean dose, to the tumor margin was 23 Gy (median 25 Gy).
  • In the 49 patients in whom a tumor was visible on the planning magnetic resonance (MR) image, a decrease in tumor size occurred in 39 (80%), in seven patients there was to change in size, and tumor growth occurred in three patients.
  • These results demonstrate the value of combining two neurosurgical treatment modalities-microsurgical resection and GKS-in the management of pituitary adenomas.
  • [MeSH-major] Pituitary ACTH Hypersecretion / surgery. Pituitary Neoplasms / surgery. Radiosurgery
  • [MeSH-minor] Adrenocorticotropic Hormone / metabolism. Cranial Nerve Injuries / etiology. Endocrine System Diseases / etiology. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Neoplasm Recurrence, Local. Retrospective Studies. Treatment Outcome. Vision Disorders / etiology

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  • [CommentIn] J Neurosurg. 2007 Jun;106(6):976-7; discussion 977-9 [17564167.001]
  • (PMID = 17564168.001).
  • [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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74. 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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  • 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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75. 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
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76. Koutourousiou M, Kontogeorgos G, Wesseling P, Grotenhuis AJ, Seretis A: Collision sellar lesions: experience with eight cases and review of the literature. Pituitary; 2010;13(1):8-17
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  • The concomitant presence of a pituitary adenoma with a second sellar lesion in patients operated upon for pituitary adenoma is an uncommon entity.
  • Although rare, quite a great variety of lesions have been indentified coexisting with pituitary adenomas.
  • We present a series of eight collision sellar lesions indentified among 548 transsphenoidally resected pituitary adenomas in two Neurosurgical Departments.
  • The histological studies confirmed a case of sarcoidosis within a non-functioning pituitary adenoma, a case of intrasellar schwannoma coexisting with growth hormone (GH) secreting adenoma, two Rathke's cleft cysts combined with pituitary adenomas, three gangliocytomas associated with GH-secreting adenomas, and a case of a double pituitary adenoma.
  • Suggested hypotheses about a common embryonic origin or a potential interaction between pituitary adenomas and the immune system are presented.
  • [MeSH-major] Neoplasms, Second Primary / pathology. Pituitary Neoplasms / pathology. Sella Turcica / pathology
  • [MeSH-minor] ACTH-Secreting Pituitary Adenoma / pathology. Adult. Aged. Central Nervous System Cysts / pathology. Female. Ganglioneuroma / pathology. Histocytochemistry. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Neurilemmoma / pathology. Retrospective Studies

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  • (PMID = 19551516.001).
  • [ISSN] 1573-7403
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 67
  • [Other-IDs] NLM/ PMC2807600
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77. Hill KE, Scott-Moncrieff JC, Koshko MA, Glickman LT, Glickman NW, Nelson RW, Blevins WE, Oliver JW: Secretion of sex hormones in dogs with adrenal dysfunction. J Am Vet Med Assoc; 2005 Feb 15;226(4):556-61
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  • OBJECTIVE: To evaluate adrenal sex hormone concentrations in response to ACTH stimulation in healthy dogs, dogs with adrenal tumors, and dogs with pituitary-dependent hyperadrenocorticism (PDH).
  • ANIMALS: 11 healthy control dogs, 9 dogs with adrenal-dependent hyperadrenocorticism (adenocarcinoma [ACA] or other tumor); 11 dogs with PDH, and 6 dogs with noncortisol-secreting adrenal tumors (ATs).
  • PROCEDURE: Hyperadrenocorticism was diagnosed on the basis of clinical signs; physical examination findings; and results of ACTH stimulation test, low-dose dexamethasone suppression test, or both.
  • Dogs with noncortisol-secreting ATs did not have hyperadrenocorticism but had ultrasonographic evidence of an AT.
  • Concentrations of cortisol, androstenedione, estradiol, progesterone, testosterone, and 17-hydroxyprogesterone were measured before and 1 hour after i.m. administration of 0.25 mg of synthetic ACTH.
  • RESULTS: All dogs with ACA, 10 dogs with PDH, and 4 dogs with ATs had 1 or more sex hormone concentrations greater than the reference range after ACTH stimulation.
  • The absolute difference for progesterone, 17-hydroxyprogesterone, and testosterone concentrations (value obtained after ACTH administration minus value obtained before ACTH administration) was significantly greater for dogs with ACA, compared with the other 3 groups.
  • CONCLUSIONS AND CLINICAL RELEVANCE: Dogs with ACA secrete increased concentrations of adrenal sex hormones, compared with dogs with PDH, noncortisol-secreting ATs, and healthy dogs.
  • Dogs with noncortisol-secreting ATs also have increased concentrations of sex hormones.
  • There is great interdog variability in sex hormone concentrations in dogs with ACA after stimulation with ACTH.

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  • (PMID = 15742696.001).
  • [ISSN] 0003-1488
  • [Journal-full-title] Journal of the American Veterinary Medical Association
  • [ISO-abbreviation] J. Am. Vet. Med. Assoc.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adrenal Cortex Hormones; 3XMK78S47O / Testosterone; 4G7DS2Q64Y / Progesterone; 7S5I7G3JQL / Dexamethasone; 9002-60-2 / Adrenocorticotropic Hormone
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78. Bernreuther C, Flitsch J, Lüdecke DK, Hagel C: A 61-year-old man with hyponatremia. Brain Pathol; 2008 Apr;18(2):283-7
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  • Endocrinologically, low levels for ADH, cortisol and testosterone as well as low-normal values for ACTH, LH and FSH were detected.
  • Cranial computed tomography and MRI scans revealed an intra- and suprasellar tumor of adenoma-like appearance with elevation of the optic chiasm.
  • After transsphenoidal resection of the tumor, no additional anterior lobe insufficiencies or diabetes insipidus occurred.
  • Histological examination revealed a tumor consisting of spindle-shaped cells of uniformly high cellularity with no evidence of hypocellular areas.
  • An intrasellar cellular schwannoma clinically and radiologically mimicking a non-secreting pituitary adenoma is uncommon.
  • However, rare entities like schwannomas, melanocytomas or pituicytomas have to be considered in addition to the more common tumors like pituitary adenomas and meningiomas.

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  • (PMID = 18363939.001).
  • [ISSN] 1015-6305
  • [Journal-full-title] Brain pathology (Zurich, Switzerland)
  • [ISO-abbreviation] Brain Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] Switzerland
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79. Ben-Shlomo A, Wawrowsky KA, Proekt I, Wolkenfeld NM, Ren SG, Taylor J, Culler MD, Melmed S: Somatostatin receptor type 5 modulates somatostatin receptor type 2 regulation of adrenocorticotropin secretion. J Biol Chem; 2005 Jun 24;280(25):24011-21
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  • [Title] Somatostatin receptor type 5 modulates somatostatin receptor type 2 regulation of adrenocorticotropin secretion.
  • Somatostatin inhibits adrenocorticotropin (ACTH) secretion from pituitary tumor cells.
  • Although octreotide had similar inhibiting potency (picomolar) for cAMP accumulation and ACTH secretion as an SST2-selective agonist, somatostatin-28 exhibited a higher potency (femtomolar).
  • This may explain superior somatostatin-28 potency and provides a rationale for somatostatin ligand design to treat ACTH-secreting pituitary tumors.
  • [MeSH-minor] Adenoma / secretion. Animals. Base Sequence. Blotting, Western. Cell Line, Tumor. DNA Primers. Immunoprecipitation. Mice. Microscopy, Confocal. Microscopy, Fluorescence. Pituitary Neoplasms / secretion

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  • (PMID = 15857828.001).
  • [ISSN] 0021-9258
  • [Journal-full-title] The Journal of biological chemistry
  • [ISO-abbreviation] J. Biol. Chem.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA Primers; 0 / Receptors, Somatostatin; 0 / somatostatin receptor 2; 0 / somatostatin receptor 5; 9002-60-2 / Adrenocorticotropic Hormone
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80. Bala M, Bollheimer C, Schölmerich J, Schäffler A: [Hormone-induced spontaneous femoral neck fracture in a 28-year-old female patient]. Med Klin (Munich); 2009 Mar 15;104(3):244-8
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  • A transsphenoidal resection of the pituitary gland tumor was performed and led to a cure of the disease.
  • [MeSH-major] Cushing Syndrome / diagnosis. Femoral Neck Fractures / etiology. Fractures, Spontaneous / etiology. Osteoporosis / etiology. Pituitary ACTH Hypersecretion / diagnosis
  • [MeSH-minor] ACTH-Secreting Pituitary Adenoma / complications. ACTH-Secreting Pituitary Adenoma / diagnosis. ACTH-Secreting Pituitary Adenoma / pathology. ACTH-Secreting Pituitary Adenoma / surgery. Adult. Bone Density Conservation Agents / therapeutic use. Calcium / administration & dosage. Cholecalciferol / administration & dosage. Combined Modality Therapy. Diagnosis, Differential. Female. Humans. Hypophysectomy. Magnetic Resonance Imaging. Pituitary Function Tests. Pituitary Neoplasms / complications. Pituitary Neoplasms / diagnosis. Pituitary Neoplasms / pathology. Pituitary Neoplasms / surgery

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  • [Cites] Lancet. 1982 Sep 18;2(8299):646-9 [6125785.001]
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  • (PMID = 19337715.001).
  • [ISSN] 1615-6722
  • [Journal-full-title] Medizinische Klinik (Munich, Germany : 1983)
  • [ISO-abbreviation] Med. Klin. (Munich)
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Bone Density Conservation Agents; 1C6V77QF41 / Cholecalciferol; SY7Q814VUP / Calcium
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81. Munir A, Song F, Ince P, Walters SJ, Ross R, Newell-Price J: Ineffectiveness of rosiglitazone therapy in Nelson's syndrome. J Clin Endocrinol Metab; 2007 May;92(5):1758-63
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  • BACKGROUND: Peroxisome proliferator-activated receptor (PPAR)-gamma agonists have been proposed as therapy to lower plasma ACTH in Cushing's disease.
  • Cyclical secretion of ACTH may, however, explain some of the responses seen.
  • Patients with Nelson's syndrome have persistently high levels of ACTH and may be a better model for examining new therapies to elevated ACTH levels.
  • OBJECTIVE: The objective of the study was to assess whether high-dose rosiglitazone therapy reduces circulating ACTH levels in Nelson's syndrome, a model of ACTH hypersecretion for which no established medical therapy exists.
  • OUTCOME MEASURE: Plasma ACTH was measured before (0830 h) and 120 min after morning dosing with hydrocortisone (HC).
  • There was no evidence that ACTH levels changed over time (P = 0.864).
  • The average ACTH level was 1187 ng/liter (95% confidence interval 928-1446) for patients before the HC dose and 432 ng/liter (95% confidence interval 172-692) after the HC dose.
  • PPAR-gamma immunoreactivity was positive in three ACTH-secreting tumors available.
  • CONCLUSIONS: Rosiglitazone 12 mg/d did not change circulating ACTH over time, despite PPAR-gamma receptor expression in the tumor tissue.
  • [MeSH-minor] ACTH-Secreting Pituitary Adenoma / complications. ACTH-Secreting Pituitary Adenoma / pathology. ACTH-Secreting Pituitary Adenoma / radiography. Adrenocorticotropic Hormone / blood. Adult. Aged. Anti-Inflammatory Agents / therapeutic use. Female. Fludrocortisone / therapeutic use. Humans. Hydrocortisone / therapeutic use. Magnetic Resonance Imaging. Male. PPAR gamma / biosynthesis. PPAR gamma / drug effects. Pancreatitis / complications. Pituitary ACTH Hypersecretion / complications. Pituitary Gland / pathology. Pituitary Gland / radiography. Pituitary Gland / surgery. Pituitary Neoplasms / complications. Pituitary Neoplasms / pathology. Pituitary Neoplasms / radiography. Tomography, X-Ray Computed

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  • (PMID = 17311852.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anti-Inflammatory Agents; 0 / Hypoglycemic Agents; 0 / PPAR gamma; 0 / Thiazolidinediones; 05V02F2KDG / rosiglitazone; 9002-60-2 / Adrenocorticotropic Hormone; U0476M545B / Fludrocortisone; WI4X0X7BPJ / Hydrocortisone
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82. Batista D, Courkoutsakis NA, Oldfield EH, Griffin KJ, Keil M, Patronas NJ, Stratakis CA: Detection of adrenocorticotropin-secreting pituitary adenomas by magnetic resonance imaging in children and adolescents with cushing disease. J Clin Endocrinol Metab; 2005 Sep;90(9):5134-40
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Detection of adrenocorticotropin-secreting pituitary adenomas by magnetic resonance imaging in children and adolescents with cushing disease.
  • CONTEXT: We recently showed that pre- and postcontrast spoiled gradient-recalled acquisition in the steady-state (SPGR) was superior to conventional pre- and postcontrast T-1 weighted spin echo (SE) acquisition magnetic resonance imaging (MRI) for the diagnostic evaluation of pituitary tumors in adult patients.
  • OBJECTIVE: The present investigation assessed the use of SPGR vs. SE-MRI in the diagnostic evaluation of ACTH-secreting tumors in children and adolescents with Cushing disease.
  • Postcontrast SPGR-MRI identified the location of the tumor in 18 of 28 patients, whereas postcontrast SE-MRI identified the location and accurately estimated the size of the tumor in only five patients (P < 0.001).
  • CONCLUSIONS: We conclude that conventional MRI, even with contrast enhancement, mostly failed to identify ACTH-secreting microadenomas in children and adolescents with Cushing disease.
  • Postcontrast SPGR-MRI was superior to SE-MRI and should be used in addition to conventional SE-MRI in the pituitary evaluation of children and adolescents with suspected Cushing disease.
  • [MeSH-major] Adenoma / diagnosis. Adenoma / secretion. Adrenocorticotropic Hormone / secretion. Cushing Syndrome / diagnosis. Magnetic Resonance Imaging. Pituitary Neoplasms / diagnosis. Pituitary Neoplasms / secretion

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  • (PMID = 15941871.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone
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83. Maïza JC, Caron P: [Pituitary carcinomas and aggressive adenomas: an overview and new therapeutic options]. Ann Endocrinol (Paris); 2009 Sep;70 Suppl 1:S12-9
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  • [Title] [Pituitary carcinomas and aggressive adenomas: an overview and new therapeutic options].
  • Pituitary carcinomas are a rare disease with an estimated prevalence around 0.2 % of the pituitary tumours.
  • They are defined by the presence of intra or extra-cranial metastases but initially they can share the same features as aggressive pituitary adenomas.
  • The majority of carcinomas are prolactin or ACTH-secreting tumors.
  • Carcinomas require often repeated surgery and radiotherapy fail to control the tumor.
  • [MeSH-major] Adenoma / therapy. Pituitary Neoplasms / therapy

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  • (PMID = 19878763.001).
  • [ISSN] 0003-4266
  • [Journal-full-title] Annales d'endocrinologie
  • [ISO-abbreviation] Ann. Endocrinol. (Paris)
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Antineoplastic Agents
  • [Number-of-references] 36
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84. Mannelli M, Cantini G, Poli G, Mangoni M, Nesi G, Canu L, Rapizzi E, Borgogni E, Ercolino T, Piccini V, Luconi M: Role of the PPAR-γ system in normal and tumoral pituitary corticotropic cells and adrenal cells. Neuroendocrinology; 2010;92 Suppl 1:23-7
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  • [Title] Role of the PPAR-γ system in normal and tumoral pituitary corticotropic cells and adrenal cells.
  • In this minireview, we summarize the current knowledge on PPAR-γ in normal and tumoral corticotropic pituitary and adrenal cells.
  • The receptor expression has been shown in ACTH-secreting cells in both normal and adenomal pituitary as well as in normal and tumor adrenal cortex.
  • Preclinical studies conducted both in vitro on tumor cells and in vivo on xenograft tumor models obtained by subcutaneous injection of cancer cells have evidenced the anticancer properties of TZD, in particular rosiglitazone (RGZ) and pioglitazone (PIO).
  • In both pituitary and adrenocortical cancer, RGZ treatment results in inhibition of cell proliferation, through G0/G1 cell-cycle arrest and induction of cell apoptosis, leading to significant inhibition of tumor growth in the xenograft tumor models.
  • In addition, since RGZ can reduce ACTH and corticosterone secretion in mouse corticotropic pituitary tumors, both RGZ and PIO have been used in the treatment of Cushing's disease with variable but generally unsatisfactory results.
  • [MeSH-major] Adrenal Cortex / metabolism. Corticotrophs / metabolism. PPAR gamma / metabolism. Pituitary ACTH Hypersecretion / metabolism. Pituitary Gland / metabolism
  • [MeSH-minor] Adrenal Cortex Neoplasms / drug therapy. Adrenal Cortex Neoplasms / metabolism. Humans. Pituitary Neoplasms / drug therapy. Pituitary Neoplasms / metabolism. Thiazolidinediones / therapeutic use

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  • [Copyright] Copyright © 2010 S. Karger AG, Basel.
  • (PMID = 20829614.001).
  • [ISSN] 1423-0194
  • [Journal-full-title] Neuroendocrinology
  • [ISO-abbreviation] Neuroendocrinology
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / PPAR gamma; 0 / Thiazolidinediones; X4OV71U42S / pioglitazone
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85. Colao A, Ochoa AS, Auriemma RS, Faggiano A, Pivonello R, Lombardi G: Pituitary carcinomas. Front Horm Res; 2010;38:94-108
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  • [Title] Pituitary carcinomas.
  • Pituitary carcinoma is a extremely rare and is characterized by a very poor prognosis.
  • Even if at diagnosis the presence of metastases is required to define a pituitary carcinoma, the lesion was almost invariably diagnosed first as a benign pituitary tumor, that after a variable period of latency, ranging from few months to many years, changed its natural course to an aggressive pituitary tumor poorly responsive to therapy.
  • Most pituitary carcinomas are functioning, and ACTH- and PRL-secreting carcinomas are the most frequent.
  • [MeSH-major] Pituitary Neoplasms / therapy
  • [MeSH-minor] Biomarkers, Tumor / analysis. Genes, Tumor Suppressor. Humans. Oncogenes

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  • [Copyright] Copyright (c) 2010 S. Karger AG, Basel.
  • (PMID = 20616500.001).
  • [ISSN] 0301-3073
  • [Journal-full-title] Frontiers of hormone research
  • [ISO-abbreviation] Front Horm Res
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Number-of-references] 88
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86. Brown RL, Wollman R, Weiss RE: Transformation of a pituitary macroadenoma into to a corticotropin-secreting carcinoma over 16 years. Endocr Pract; 2007 Sep;13(5):463-71
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  • [Title] Transformation of a pituitary macroadenoma into to a corticotropin-secreting carcinoma over 16 years.
  • OBJECTIVE: To describe a case of a pituitary macroadenoma that differentiated into a corticotropin (ACTH)-secreting carcinoma with metastasis to the thigh.
  • METHODS: We present a case report with a 16-year follow-up that includes anatomic and endocrine documentation of the history of an ACTH-secreting carcinoma.
  • The patient underwent surgical debulking followed by a course of radiation directed to the pituitary.
  • Results from retrospective immunohistochemical staining with antibodies against ACTH, prolactin, and MIB-1 were negative.
  • In 1995, she developed left facial palsy and diplopia caused by tumor growth.
  • The patient's clinical status continued to deteriorate because of local mass effect from tumor growth and uncontrolled hypercortisolism.
  • Biopsy results of the obturator muscle revealed metastatic tumor of neuroendocrine origin with strong reactivity to ACTH antibodies and MIB-1 labeling in 8% of tumor cell nuclei.
  • CONCLUSION: A pituitary tumor can transform into an ACTH-secreting carcinoma in an indolent manner.
  • Patients with invasive pituitary adenomas require long-term surveillance to monitor for differentiation into pituitary carcinoma.
  • [MeSH-major] ACTH-Secreting Pituitary Adenoma / pathology. ACTH-Secreting Pituitary Adenoma / secretion. Adenoma / pathology. Adenoma / secretion. Adrenocorticotropic Hormone / secretion

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  • (PMID = 17872347.001).
  • [ISSN] 1934-2403
  • [Journal-full-title] Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
  • [ISO-abbreviation] Endocr Pract
  • [Language] eng
  • [Grant] United States / NIDDK NIH HHS / DK / DK07011; United States / NCRR NIH HHS / RR / RR00055; United States / NCRR NIH HHS / RR / RR18372
  • [Publication-type] Case Reports; Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 9002-60-2 / Adrenocorticotropic Hormone
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87. Schroeder HW, Nehlsen M: Value of high-definition imaging in neuroendoscopy. Neurosurg Rev; 2009 Jul;32(3):303-8; discussion 308
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  • Both cameras were used while performing one endoscopic third ventriculostomy, one endoscope-assisted microvascular decompression, one endoscope-assisted removal of a vestibular schwannoma, and two endonasal pituitary surgeries.
  • Especially in pituitary surgery, the difference was striking when the tumor had to be differentiated from the normal pituitary tissue.
  • [MeSH-minor] ACTH-Secreting Pituitary Adenoma / pathology. Endocrine Surgical Procedures / instrumentation. Endoscopes. Facial Nerve / pathology. Humans. Hydrocephalus / pathology. Image Processing, Computer-Assisted. Lens, Crystalline / pathology. Neuroma, Acoustic / pathology. Neuroma, Acoustic / surgery. Neurosurgical Procedures. Pituitary Neoplasms / pathology. Pituitary Neoplasms / surgery. Retinal Rod Photoreceptor Cells / pathology. Skull Base Neoplasms / pathology. Skull Base Neoplasms / surgery. Ventriculostomy

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  • (PMID = 19370368.001).
  • [ISSN] 1437-2320
  • [Journal-full-title] Neurosurgical review
  • [ISO-abbreviation] Neurosurg Rev
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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88. 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).