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1. Taboada GF, Luque RM, Neto LV, Machado Ede O, Sbaffi BC, Domingues RC, Marcondes JB, Chimelli LM, Fontes R, Niemeyer P, de Carvalho DP, Kineman RD, Gadelha MR: Quantitative analysis of somatostatin receptor subtypes (1-5) gene expression levels in somatotropinomas and correlation to in vivo hormonal and tumor volume responses to treatment with octreotide LAR. Eur J Endocrinol; 2008 Mar;158(3):295-303
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  • [Title] Quantitative analysis of somatostatin receptor subtypes (1-5) gene expression levels in somatotropinomas and correlation to in vivo hormonal and tumor volume responses to treatment with octreotide LAR.
  • OBJECTIVE: To determine whether the somatostatin receptor subtype (SSTR) expression profile correlates with hormonal and tumor volume responses to postsurgical octreotide long acting repeatable (OCT LAR) treatment.
  • DESIGN AND METHODS: Quantitative real-time RT-PCR was used to evaluate the absolute mRNA copy numbers for all five SSTR subtypes in 22 somatotropinomas.
  • Response to OCT LAR was studied by hormone levels (GH and IGF-I) and tumor volume (sella turcica magnetic resonance imaging).
  • A positive correlation was also found between SSTR2 mRNA levels and the percentage decrease in tumor volume after 6 months of OCT LAR (r=0.79, P=0.002, n=12).
  • CONCLUSIONS: Somatostatin receptor subtype 2 mRNA expression levels in somatotropinomas correlate positively with in vivo hormonal and tumor volume responses to OCT LAR.

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  • (PMID = 18299461.001).
  • [ISSN] 1479-683X
  • [Journal-full-title] European journal of endocrinology
  • [ISO-abbreviation] Eur. J. Endocrinol.
  • [Language] ENG
  • [Grant] United States / PHS HHS / / NIDDK 30677
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Membrane Proteins; 0 / RNA, Messenger; 0 / Receptors, Somatostatin; 0 / somatostatin receptor 2; 0 / somatostatin receptor 3; 0 / somatostatin receptor 5; 0 / somatostatin receptor subtype-4; 0 / somatostatin receptor type 1; 9002-72-6 / Growth Hormone; RWM8CCW8GP / Octreotide
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2. Park C, Yang I, Woo J, Kim S, Kim J, Kim Y, Sohn S, Kim E, Lee M, Park H, Jung J, Park S: Somatostatin (SRIF) receptor subtype 2 and 5 gene expression in growth hormone-secreting pituitary adenomas: the relationship with endogenous srif activity and response to octreotide. Endocr J; 2004 Apr;51(2):227-36
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  • [Title] Somatostatin (SRIF) receptor subtype 2 and 5 gene expression in growth hormone-secreting pituitary adenomas: the relationship with endogenous srif activity and response to octreotide.
  • To investigate the potential pathophysiologic role of human SRIF receptor gene expression in GH-secreting adenomas in acromegalic patients, we studied the relationship between the SRIF receptor gene expression, endogenous SRIF activity and exogenous response to octreotide in 16 acromagalic patients.
  • Pituitary tumor SRIF receptor subtype 2 and 5 (sst2 and sst5) mRNA levels were measured by real-time RT-PCR.
  • These results suggest common transcriptional and/or post-transcriptonal regulatory mechanisms for these SRIF receptor subtypes within GH-secreting pituitary adenomas.
  • The functional observations suggest that the degree (or level) of sst2 and sst5 expression is critical for the ultimate GH response of somatotropinomas to endogenous SRIF tone and exogenous SRIF analogue therapy.
  • [MeSH-major] Adenoma / drug therapy. Adenoma / metabolism. Antineoplastic Agents, Hormonal / therapeutic use. Octreotide / therapeutic use. Pituitary Neoplasms / drug therapy. Pituitary Neoplasms / metabolism. Receptors, Somatostatin / metabolism
  • [MeSH-minor] Acromegaly / drug therapy. Adult. Female. Gene Expression. Human Growth Hormone / secretion. Humans. Male. Middle Aged. Treatment Outcome

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  • (PMID = 15118275.001).
  • [ISSN] 0918-8959
  • [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 / Antineoplastic Agents, Hormonal; 0 / Receptors, Somatostatin; 0 / somatostatin receptor 2; 0 / somatostatin receptor 5; 12629-01-5 / Human Growth Hormone; RWM8CCW8GP / Octreotide
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3. Nasr C, Mason A, Mayberg M, Staugaitis SM, Asa SL: Acromegaly and somatotroph hyperplasia with adenomatous transformation due to pituitary metastasis of a growth hormone-releasing hormone-secreting pulmonary endocrine carcinoma. J Clin Endocrinol Metab; 2006 Dec;91(12):4776-80
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  • [Title] Acromegaly and somatotroph hyperplasia with adenomatous transformation due to pituitary metastasis of a growth hormone-releasing hormone-secreting pulmonary endocrine carcinoma.
  • Hypothalamic gangliocytomas producing GHRH are also known to be associated with pituitary adenomas causing acromegaly.
  • OBJECTIVES: The objective of this study was to describe a case of acromegaly due to a pulmonary GHRH-secreting endocrine carcinoma with metastasis to the pituitary gland and to look at the peculiar histological features of this case.
  • SUBJECT: The patient was a 44-yr-old woman who was diagnosed with a biopsy-proven metastatic pulmonary endocrine tumor during pregnancy.
  • After delivery, she underwent radiation and chemotherapy for pulmonary and skeletal metastases.
  • Her disease was clinically stable for 7 yr until she developed bitemporal hemianopia.
  • The patient underwent uneventful transsphenoidal resection of the sellar tumor.
  • Histological examination confirmed metastatic endocrine carcinoma to the pituitary, and immunohistochemistry localized GHRH to the tumor cells.
  • The adjacent pituitary exhibited somatotroph hyperplasia with abundant reactivity for GH and alpha-subunit.
  • CONCLUSION: This is the first report of a GHRH-producing endocrine tumor metastasizing to the pituitary and causing local hyperstimulation with somatotroph hyperplasia and adenomatous transformation.
  • [MeSH-major] Acromegaly / complications. Acromegaly / etiology. Adenoma / etiology. Carcinoma / complications. Growth Hormone-Releasing Hormone / secretion. Lung Neoplasms / complications. Paraneoplastic Endocrine Syndromes / complications. Pituitary Neoplasms / secondary. Somatotrophs / pathology

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  • (PMID = 16968791.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Hormones, Ectopic; 0 / Indium Radioisotopes; 9034-39-3 / Growth Hormone-Releasing Hormone
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4. Lee EJ, Jameson JL: Cell-specific Cre-mediated activation of the diphtheria toxin gene in pituitary tumor cells: potential for cytotoxic gene therapy. Hum Gene Ther; 2002 Mar 1;13(4):533-42
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  • [Title] Cell-specific Cre-mediated activation of the diphtheria toxin gene in pituitary tumor cells: potential for cytotoxic gene therapy.
  • Diphtheria toxin has been suggested for the treatment of malignant cancer.
  • In this paper, we describe a strategy for targeting the expression of the diphtheria toxin gene to growth hormone (GH)-producing pituitary tumor cells using adenoviral vectors.
  • We generated adenoviral vectors in which a stuffer DNA fragment, flanked by two loxP sequences, was placed between the GH or cytomegalovirus (CMV) promoters and the diphtheria toxin gene (GH-loxP-DT, and CMV-loxP-DT) or the beta-Gal gene (GH-loxP-Gal, and CMV-loxP-Gal).
  • Co-infection of GH-loxP-DT with either CMV-Cre or GH-Cre induced cytotoxicity that was limited to GH4 cells.
  • Intratumoral co-injection of adenoviruses carrying diphtheria toxin (GH-loxP-DT, and CMV-loxP-DT) and Cre recombinase (GH-Cre, and CMV-Cre) caused rapid regression of the transplanted GH4 tumors.
  • These results indicate that Cre-mediated activation of a loxP-repressed form of the DT gene provides a useful strategy for targeted suicide gene therapy.
  • This approach may be useful for GH-secreting adenomas and should be applicable to other neoplastic disorders.
  • [MeSH-major] Diphtheria Toxin / genetics. Integrases / genetics. Pituitary Neoplasms / genetics. Viral Proteins / genetics
  • [MeSH-minor] Adenoviridae. Animals. Cell Death / genetics. Gene Expression Regulation, Neoplastic. Gene Transfer Techniques. Genetic Therapy. Genetic Vectors. Growth Hormone / biosynthesis. Growth Hormone / genetics. Mice. Mice, Nude. Mice, Transgenic. Promoter Regions, Genetic. Tumor Cells, Cultured

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  • (PMID = 11874631.001).
  • [ISSN] 1043-0342
  • [Journal-full-title] Human gene therapy
  • [ISO-abbreviation] Hum. Gene Ther.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Diphtheria Toxin; 0 / Viral Proteins; 9002-72-6 / Growth Hormone; EC 2.7.7.- / Cre recombinase; EC 2.7.7.- / Integrases
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5. Clemmons DR, Chihara K, Freda PU, Ho KK, Klibanski A, Melmed S, Shalet SM, Strasburger CJ, Trainer PJ, Thorner MO: Optimizing control of acromegaly: integrating a growth hormone receptor antagonist into the treatment algorithm. J Clin Endocrinol Metab; 2003 Oct;88(10):4759-67
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  • [Title] Optimizing control of acromegaly: integrating a growth hormone receptor antagonist into the treatment algorithm.
  • Current guidelines for the treatment of acromegaly have not considered recent advances in medical therapy, in particular, the place of pegvisomant, a GH receptor antagonist.
  • Treatment goals include normalizing biochemical markers, controlling tumor mass, preserving pituitary function, and relieving signs and symptoms.
  • Surgery reduces tumor volume and is considered first-line therapy.
  • Radiation reduces tumor volume and GH and IGF-I levels, but the onset of action is slow and hypopituitarism typically develops.
  • Therefore, pharmacotherapy is often used following surgery or as first-line therapy for nonresectable tumors.
  • Dopamine agonists can be considered in patients exhibiting minimal disease or those with GH-prolactin-cosecreting tumors but will not achieve hormone normalization in most patients.
  • Pegvisomant, the newest therapeutic option, blocks GH action at peripheral receptors, normalizes IGF-I levels, reduces signs and symptoms, and corrects metabolic defects.
  • Pegvisomant does not appear to affect tumor size and has few adverse effects.
  • Pegvisomant is the most effective drug treatment for acromegaly in normalizing IGF-I and producing a clinical response; it is the preferred agent in patients resistant to or intolerant of somatostatin analogs.
  • [MeSH-major] Acromegaly / drug therapy. Growth Hormone / antagonists & inhibitors. Human Growth Hormone / therapeutic use
  • [MeSH-minor] Algorithms. Dopamine Agonists / therapeutic use. Humans

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  • (PMID = 14557452.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Dopamine Agonists; 0 / pegvisomant; 12629-01-5 / Human Growth Hormone; 9002-72-6 / Growth Hormone
  • [Number-of-references] 92
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6. Pawlikowski M, Melen-Mucha G: Perspectives of new potential therapeutic applications of somatostatin analogs. Neuro Endocrinol Lett; 2003 Feb-Apr;24(1-2):21-7
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  • [Title] Perspectives of new potential therapeutic applications of somatostatin analogs.
  • At the present time only two long-acting somatostatin (SS) analogs, octreotide and lanreotide, are commonly used in the routine therapy.
  • The established indications for SS analogs treatment include acromegaly, neuroendocrine tumors of the pancreas and gastrointestinal tract, and some gastro-enterologic diseases (pancreatitis, gastrointestinal bleedings, refractory diarrheas, pancreatic and intestinal fistulas).
  • The recent investigations allow to predict the enlargement of therapeutic applications of SS analogs.
  • It concerns pituitary tumors other than somatotropinoma, tumors of other endocrine glands like thyroid and adrenal gland, as well as some non-endocrine tumors.
  • The pre- or postoperative in vivo imaging of SS receptors by means of the receptor scintigraphy, as well as the post-operative identification of SS receptor subtypes in the excised tumor tissues using immunohistochemistry, should play an important role in the prediction of the effects of SS analog treatment.
  • Beside oncology, new therapeutic applications of SS analogs could be presumed among others in ophthalmology; it concerns the treatment of progressive Graves-Basedow ophtalmopathy, diabetic retinopathy, glaucoma and corneal diseases connected with corneal vascularization.
  • [MeSH-major] Hormone Antagonists / therapeutic use. Somatostatin / analogs & derivatives. Somatostatin / therapeutic use
  • [MeSH-minor] Acromegaly / drug therapy. Animals. Antineoplastic Agents, Hormonal / therapeutic use. Endocrine Gland Neoplasms / drug therapy. Humans. Receptors, Somatostatin / drug effects

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  • (PMID = 12743527.001).
  • [ISSN] 0172-780X
  • [Journal-full-title] Neuro endocrinology letters
  • [ISO-abbreviation] Neuro Endocrinol. Lett.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Sweden
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Hormone Antagonists; 0 / Receptors, Somatostatin; 51110-01-1 / Somatostatin
  • [Number-of-references] 72
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7. Boulis NM, Noordmans AJ, Barkan A, Hassing J, Chandler WF: Somatotropinoma infarction during octreotide therapy leading to bilateral cavernous sinus syndrome. Pituitary; 2000 Nov;3(3):185-8
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  • [Title] Somatotropinoma infarction during octreotide therapy leading to bilateral cavernous sinus syndrome.
  • The cyclic somatostatin analog, octreotide, forms the mainstay of medical treatment for acromegaly.
  • In addition to lowering circulating growth hormone levels and shrinking tumor size, octreotide may provide symptomatic relief of headaches associated with growth hormone secreting tumors.
  • The majority of reported complications of octreotide therapy are gastrointestinal and metabolic.
  • The present case illustrates the development of acute bilateral cavernous sinus syndrome with loss of eye movement bilaterally during octreotide therapy.
  • Serial MRI examination suggest tumor infarction as the etiology.
  • The symptoms resolved over 2 months as the tumor shrunk in size and growth hormone was dramatically reduced.
  • [MeSH-major] Cavernous Sinus. Cerebral Infarction / chemically induced. Cranial Nerve Diseases / chemically induced. Human Growth Hormone / secretion. Octreotide / adverse effects. Ophthalmoplegia / chemically induced. Pituitary Neoplasms / chemically induced. Pituitary Neoplasms / secretion
  • [MeSH-minor] Abducens Nerve / drug effects. Child. Female. Humans. Magnetic Resonance Imaging. Oculomotor Nerve / drug effects. Syndrome

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  • (PMID = 11383484.001).
  • [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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8. 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.
  • Pharmacotherapy using PPARgamma agonists, dopamine receptor agonists, retinoic acid or somatostatin analogs is still experimental.
  • Curcumin, a commonly used food additive in South Asian cooking, has potent growth inhibitory effects on cell proliferation.
  • 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.
  • The curcumin-induced growth inhibition was accompanied by decreased NFkappaB activity.
  • 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
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / NF-kappa B; 9002-60-2 / Adrenocorticotropic Hormone; IT942ZTH98 / Curcumin
  • [Other-IDs] NLM/ PMC2854133
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9. Biermasz NR, Smit JW, Pereira AM, Frölich M, Romijn JA, Roelfsema F: Acromegaly caused by growth hormone-releasing hormone-producing tumors: long-term observational studies in three patients. Pituitary; 2007;10(3):237-49
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  • [Title] Acromegaly caused by growth hormone-releasing hormone-producing tumors: long-term observational studies in three patients.
  • We report on three newly diagnosed patients with extracranial ectopic GHRH-associated acromegaly with long-term follow-up after surgery of the primary tumor.
  • One patient with a pancreatic tumor and two parathyroid adenomas was the index case of a large kindred of MEN-I syndrome.
  • During medical treatment basal GH secretion remained (slightly) elevated and secretory regularity was decreased in 24 h blood sampling studies.
  • We did not observe development of tachyphylaxis towards the drug or radiological evidence of (growing) metastases.
  • We propose life-long suppressive therapy with somatostatin analogs in cases with persisting elevated serum GHRH concentrations after removal of the primary tumor.
  • [MeSH-major] Acromegaly / etiology. Adenoma / secretion. Carcinoid Tumor / secretion. Human Growth Hormone / secretion. Lung Neoplasms / secretion. Pancreatic Neoplasms / secretion. Paraneoplastic Endocrine Syndromes / metabolism. Parathyroid Neoplasms / secretion
  • [MeSH-minor] Adult. Entropy. Female. Hormones / blood. Humans. Longitudinal Studies. Magnetic Resonance Imaging. Male. Middle Aged. Octreotide. Pituitary Gland / pathology. Positron-Emission Tomography. Tomography, X-Ray Computed. Treatment Outcome

  • Genetic Alliance. consumer health - Acromegaly.
  • MedlinePlus Health Information. consumer health - Carcinoid Tumors.
  • MedlinePlus Health Information. consumer health - Lung Cancer.
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  • (PMID = 17541749.001).
  • [ISSN] 1386-341X
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Hormones; 12629-01-5 / Human Growth Hormone; RWM8CCW8GP / Octreotide
  • [Other-IDs] NLM/ PMC2045692
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10. Carmichael JD, Bonert VS: Medical therapy: options and uses. Rev Endocr Metab Disord; 2008 Mar;9(1):71-81
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  • [Title] Medical therapy: options and uses.
  • Since the initial use of medical treatment for acromegaly, several advances have been made in the understanding of the pathophysiology of growth hormone producing tumors, resulting in the development of multiple medical options and novel treatments.
  • Currently there are three major classes of medication available for the treatment of acromegaly: somatostatin receptor ligands, growth hormone receptor antagonists, and dopamine agonists.
  • Somatostatin receptor ligands are the treatment of choice for acromegaly due to their effectiveness in controlling growth hormone excess in approximately 60% of patients and their beneficial effects on tumor volume.
  • Dopamine agonists are inexpensive, but their use is hampered by their lack of efficacy compared to other medications.
  • Medical therapy has an established role as adjuvant therapy after non-curative surgery, as well as primary therapy for selected patients unsuitable for surgical resection.
  • Medical treatment to control growth hormone hypersecretion is often needed after radiation therapy until the effects are evident.
  • Preliminary data suggest a potential role for medical treatment prior to surgical resection, surgical debulking to improve medical efficacy, and combination therapy with multiple medications from the three classes.
  • With the available therapies, disease control can be achieved in nearly all patients with acromegaly.
  • [MeSH-major] Acromegaly / drug therapy. Receptors, Somatostatin / antagonists & inhibitors. Receptors, Somatotropin / antagonists & inhibitors
  • [MeSH-minor] Dopamine Agonists / therapeutic use. Drug Therapy, Combination. Growth Hormone / adverse effects. Growth Hormone / blood. Humans. Ligands

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  • (PMID = 18163211.001).
  • [ISSN] 1389-9155
  • [Journal-full-title] Reviews in endocrine & metabolic disorders
  • [ISO-abbreviation] Rev Endocr Metab Disord
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Dopamine Agonists; 0 / Ligands; 0 / Receptors, Somatostatin; 0 / Receptors, Somatotropin; 9002-72-6 / Growth Hormone
  • [Number-of-references] 98
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11. Kobayashi T, Mori Y, Uchiyama Y, Kida Y, Fujitani S: Long-term results of gamma knife surgery for growth hormone-producing pituitary adenoma: is the disease difficult to cure? J Neurosurg; 2005 Jan;102 Suppl:119-23
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  • [Title] Long-term results of gamma knife surgery for growth hormone-producing pituitary adenoma: is the disease difficult to cure?
  • OBJECT: The authors conducted a study to determine the long-term results of gamma knife surgery for residual or recurrent growth hormine (GH)-producing pituitary adenomas and to compare the results with those after treatment of other pituitary adenomas.
  • The mean tumor diameter was 19.2 mm and volume was 5.4 cm3.
  • The mean maximum dose was 35.3 Gy and the mean margin dose was 18.9 Gy.
  • The tumor resolution rate was 2%, the response rate 68.3%, and the control rate 100%.
  • Growth hormone normalization (GH < 1.0 ng/ml) was found in 4.8%, nearly normal (< 2.0 ng/ml) in 11.9%, significantly decreased (< 5.0 ng/ml) in 23.8%, decreased in 21.4%, unchanged in 21.4%, and increased in 16.7%.
  • Serum insulin-like growth factor (IGF)-1 was significantly decreased (IGF-1 < 400 ng/ml) in 40.7%, decreased in 29.6%, unchanged in 18.5%, and increased in 11.1%, which was almost parallel to the GH changes.
  • Gamma knife radiosurgery is thus indicated for small tumors after surgery or medication therapy when a relatively high-dose radiation is required.
  • [MeSH-major] Adenoma / secretion. Adenoma / surgery. Human Growth Hormone / secretion. Pituitary Neoplasms / secretion. Pituitary Neoplasms / surgery. Radiosurgery / instrumentation
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Recurrence, Local. Outcome Assessment (Health Care). Pituitary ACTH Hypersecretion / pathology. Pituitary ACTH Hypersecretion / surgery. Prolactinoma / pathology. Prolactinoma / surgery

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  • (PMID = 15662793.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone
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12. Donangelo I, Rodacki M, Peixoto MC, Vaisman M, Caldas NR, Gadelha MR: Dependency and analgesia related to treatment with subcutaneous octreotide in patients with growth hormone-secreting tumors. Endocr Pract; 2004 Mar-Apr;10(2):107-11
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  • [Title] Dependency and analgesia related to treatment with subcutaneous octreotide in patients with growth hormone-secreting tumors.
  • OBJECTIVE: To describe three patients diagnosed with somatotropinomas in whom the analgesic effect of octreotide was observed, along with dependency to the drug.
  • METHODS: These patients had pituitary macroadenomas treated with transphenoidal surgery and pituitary radiotherapy, and received high daily doses (>900 microg/day) of subcutaneous octreotide because of persistent high levels of growth hormone and insulin-like growth factor I (IGF-I).
  • RESULTS: Headache occurred prior to drug administration in all three cases, with relief soon after.
  • We also observed tolerance to octreotide's analgesic and anti-secretory actions (one patient), craving for the drug (two patients), withdrawal syndrome (one patient), and drug abuse (one patient).
  • CONCLUSION: Dependency syndrome may occur when high doses of octreotide are used, sometimes leading to drug abuse.
  • Tolerance to the growth hormone anti-secretory effect of the drug may encourage physicians to increase doses to levels at which drug dependency has been observed.
  • [MeSH-major] Adenoma / drug therapy. Adenoma / secretion. Antineoplastic Agents, Hormonal / adverse effects. Human Growth Hormone / secretion. Octreotide / adverse effects. Pituitary Neoplasms / drug therapy. Pituitary Neoplasms / secretion. Substance-Related Disorders
  • [MeSH-minor] Adolescent. Adult. Combined Modality Therapy. Drug Tolerance. Female. Humans. Middle Aged

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  • (PMID = 15256326.001).
  • [ISSN] 1530-891X
  • [Journal-full-title] Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
  • [ISO-abbreviation] Endocr Pract
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 12629-01-5 / Human Growth Hormone; RWM8CCW8GP / Octreotide
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13. Kobayashi T, Mori Y, Uchiyama Y, Kida Y, Fujitani S: Long-term results of gamma knife surgery for growth hormone-producing pituitary adenoma: is the disease difficult to cure? J Neurosurg; 2005 Jan;102(s_supplement):119-123
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term results of gamma knife surgery for growth hormone-producing pituitary adenoma: is the disease difficult to cure?
  • OBJECT: The authors conducted a study to determine the long-term results of gamma knife surgery for residual or recurrent growth hormine (GH)-producing pituitary adenomas and to compare the results with those after treatment of other pituitary adenomas.
  • The mean tumor diameter was 19.2 mm and volume was 5.4 cm<sup>3</sup>.
  • The mean maximum dose was 35.3 Gy and the mean margin dose was 18.9 Gy.
  • The tumor resolution rate was 2%, the response rate 68.3%, and the control rate 100%.
  • Growth hormone normalization (GH < 1.0 ng/ml) was found in 4.8%, nearly normal (< 2.0 ng/ml) in 11.9%, significantly decreased (< 5.0 ng/ml) in 23.8%, decreased in 21.4%, unchanged in 21.4%, and increased in 16.7%.
  • Serum insulin-like growth factor (IGF)-1 was significantly decreased (IGF-1 < 400 ng/ml) in 40.7%, decreased in 29.6%, unchanged in 18.5%, and increased in 11.1%, which was almost parallel to the GH changes.
  • Gamma knife radiosurgery is thus indicated for small tumors after surgery or medication therapy when a relatively high-dose radiation is required.

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  • (PMID = 28306435.001).
  • [ISSN] 1933-0693
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Keywords] NOTNLM ; gamma knife surgery / growth hormone—producing pituitary adenoma / insulin-like growth factor
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14. Ahtiainen P, Sharp V, Rulli SB, Rivero-Müller A, Mamaeva V, Röyttä M, Huhtaniemi I: Enhanced LH action in transgenic female mice expressing hCGbeta-subunit induces pituitary prolactinomas; the role of high progesterone levels. Endocr Relat Cancer; 2010 Sep;17(3):611-21
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  • [Title] Enhanced LH action in transgenic female mice expressing hCGbeta-subunit induces pituitary prolactinomas; the role of high progesterone levels.
  • The etiology of pituitary adenomas remains largely unknown, with the exception of involvement of estrogens in the formation of prolactinomas.
  • We have examined the molecular pathogenesis of prolactin-producing pituitary adenomas in transgenic female mice expressing the human choriongonadotropin (hCG) beta-subunit.
  • Curiously, despite normal estrogen levels, large prolactinomas developed in these mice, and we provide here several lines of evidence that the elevated P(4) levels are involved in the growth of these estrogen-dependent tumors.
  • The antiprogestin mifepristone inhibited tumor growth, and combined postgonadectomy estradiol/P(4) treatment was more effective than estrogen alone in inducing tumor growth.
  • Evidence for direct growth-promoting effect of P(4) was obtained from cultures of primary mouse pituitary cells and rat somatomammotroph GH3 cells.
  • The mouse tumors and cultured cells revealed stimulation of the cyclin D1/cyclin-dependent kinase 4/retinoblastoma protein/transcription factor E2F1 pathway in the growth response to P(4).
  • If extrapolated to humans, and given the importance of endogenous P(4) and synthetic progestins in female reproductive functions and their pharmacotherapy, it is relevant to revisit the potential role of these hormones in the origin and growth of prolactinomas.

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  • (PMID = 20453081.001).
  • [ISSN] 1479-6821
  • [Journal-full-title] Endocrine-related cancer
  • [ISO-abbreviation] Endocr. Relat. Cancer
  • [Language] ENG
  • [Grant] United Kingdom / Wellcome Trust / / 063552; United Kingdom / Wellcome Trust / / 082101
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin, beta Subunit, Human; 4G7DS2Q64Y / Progesterone; 9002-62-4 / Prolactin; 9002-67-9 / Luteinizing Hormone; EC 2.7.11.22 / Cyclin-Dependent Kinase 4
  • [Other-IDs] NLM/ PMC2881531
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15. Waśko R, Bolko P, Kostrzewski J, Horst-Sikorska W, Liebert W, Sowiński J: [Estimation of efficacy of the octreotide LAR administration in the patients with somatotropinoma]. Pol Arch Med Wewn; 2001 Aug;106(2):693-8
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  • [Title] [Estimation of efficacy of the octreotide LAR administration in the patients with somatotropinoma].
  • [Transliterated title] Ocena skuteczności stosowania oktreotydu LAR u pacjentów z guzami przysadki typu somatotropinoma.
  • Acromegaly is caused by excessive secretion of growth hormone by a hypophyseal adenoma type of somatotropinoma.
  • Treatment of adenomas, which secrete GH, involves pharmacotherapy followed by surgery.
  • Modern pharmacotherapy leaning is based on somatostatin analogues (factor restrictive secretion GH): octreotide, octreotide LAR and lanreotide.
  • The aim of our study was estimation of efficiency of octreotide LAR in the patients with somatotropinoma prepared to neurosurgery intervention.
  • The presence of pituitary adenoma in all patients was confirmed by MRI.
  • The concentration of GH before octreotide LAR therapy in all patients increased remarkable and ranged from 15.6 to 78.6 ng/ml, mean: 31.20 +/- 16.84 (norm: 0-10 ng/ml), also, in all cases the serum IGF-I level was increased and ranged from 451 to 1107.6 ng/ml, mean: 801.75 +/- 207.82 (norm: 100-400 ng/ml).
  • Long acting somatostatin analogues--octreotide LAR is particular efficient in lowering of growth hormone and IGF-I in patients with somatotropinoma and shows efficiency in normalization of increased prolactin concentration.
  • Because of extreme effectiveness of octreotide LAR, it should be used the routine treatment at the patients suffering from active acromegaly and preparing to neurosurgical treatment.
  • [MeSH-major] Acromegaly / drug therapy. Antineoplastic Agents, Hormonal / administration & dosage. Human Growth Hormone / blood. Insulin-Like Growth Factor I / metabolism. Octreotide / administration & dosage. Peptides, Cyclic / administration & dosage. Prolactin / blood. Somatostatin / administration & dosage
  • [MeSH-minor] Adult. Aged. Female. Hormones / administration & dosage. Humans. Male. Middle Aged. Pituitary Neoplasms / diagnostic imaging. Radiography. Treatment Outcome

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  • (PMID = 11926144.001).
  • [Journal-full-title] Polskie Archiwum Medycyny Wewnetrznej
  • [ISO-abbreviation] Pol. Arch. Med. Wewn.
  • [Language] pol
  • [Publication-type] Journal Article
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Hormones; 0 / Peptides, Cyclic; 0G3DE8943Y / lanreotide; 12629-01-5 / Human Growth Hormone; 51110-01-1 / Somatostatin; 67763-96-6 / Insulin-Like Growth Factor I; 9002-62-4 / Prolactin; RWM8CCW8GP / Octreotide
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16. Zangeneh F, Young WF Jr, Lloyd RV, Chiang M, Kurczynski E, Zangeneh F: Cushing's syndrome due to ectopic production of corticotropin-releasing hormone in an infant with ganglioneuroblastoma. Endocr Pract; 2003 Sep-Oct;9(5):394-9
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  • [Title] Cushing's syndrome due to ectopic production of corticotropin-releasing hormone in an infant with ganglioneuroblastoma.
  • OBJECTIVE: To report the first recognized case of Cushing's syndrome due to a corticotropin-releasing hormone (CRH)-secreting ganglioneuroblastoma, which was found in an 18-month-old boy with hypertensive encephalopathy.
  • The patient had generalized obesity, decelerated linear growth, hypertrichosis, hypertension (144/103 mm Hg), hypokalemia, and proteinuria.
  • The serum adrenocorticotropic hormone (ACTH) concentration was 7 pg/mL (normal, 10 to 60), and the CRH level was 439 pg/mL (normal, 24 to 40).
  • Despite discordant dynamic endocrine testing and negative somatostatin receptor scintigraphy, computed tomography showed a right 3.6- by 3.0-cm extra-adrenal retroperitoneal mass with central calcification extending 7 cm cephalocaudally.
  • The patient underwent exploratory laparotomy, followed by chemotherapy.
  • Because most CRH-producing tumors also secrete ACTH, the ectopic production may represent a paracrine phenomenon in addition to an endocrine phenomenon.
  • The ectopic CRH may also indirectly provoke pituitary ACTH secretion.
  • This dual mechanism may explain the resistance of the tumor to feedback inhibition and a CRH-stimulation response indistinguishable from that observed in pituitary-dependent Cushing's syndrome.
  • [MeSH-major] Corticotropin-Releasing Hormone / metabolism. Cushing Syndrome / etiology. Ganglioneuroblastoma / complications. Retroperitoneal Neoplasms / complications
  • [MeSH-minor] Humans. Immunohistochemistry. Infant. Male. Tomography, X-Ray Computed

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  • (PMID = 14583423.001).
  • [ISSN] 1530-891X
  • [Journal-full-title] Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
  • [ISO-abbreviation] Endocr Pract
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 9015-71-8 / Corticotropin-Releasing Hormone
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17. Mezosi E, Nemes O: [Treatment of pituitary adenomas]. Orv Hetil; 2009 Sep 27;150(39):1803-10
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Treatment of pituitary adenomas].
  • According to epidemiological studies, the prevalence of pituitary adenomas is 16.5% and the majority of them are "incidentalomas".
  • The symptoms of pituitary disorders are often non-specific; disturbances of pituitary function, compression symptoms, hypophysis apoplexy or accidental findings may help the diagnosis.
  • The hormonal evaluation of pituitary adenomas is different from the algorithm used in the disorders of peripheral endocrine organs.
  • The first-line therapy of prolactinomas are the dopamine agonists, and the aims of the treatment are to normalize the prolactin level, restore fertility in child-bearing age, decrease tumor mass, save or improve the residual pituitary function and inhibit the relapse of the disease.
  • In case of tumors with good therapeutic response, medical therapy can be withdrawn after 3-5 years; hyperprolactinemia will not recur in 2/3 of these patients.
  • Neurosurgery is the primary therapy of GH-, ACTH-, TSH-producing and inactive adenomas.
  • Acromegalic patients with unresectable tumors have a great benefit from somatostatin analog treatment.
  • The growth hormone receptor antagonist pegvisomant is the newest modality for the treatment of acromegaly.
  • The medical therapy of Cushing's disease is still based on the inhibition of steroid production.
  • The rare TSH-producing tumor can respond to both dopamine agonist and somatostatin analog therapy.
  • The application of conventional radiotherapy has decreased; radiotherapy is mainly used in the treatment of invasive, incurable or malignant tumors.
  • Further studies are needed to elucidate the exact role of radiosurgery and fractionated stereotaxic irradiation in the treatment of pituitary tumors.
  • [MeSH-major] Adenoma / therapy. Pituitary Hormones / blood. Pituitary Neoplasms / therapy
  • [MeSH-minor] ACTH-Secreting Pituitary Adenoma / therapy. Acromegaly / drug therapy. Acromegaly / etiology. Adrenocorticotropic Hormone / blood. Aminoquinolines / therapeutic use. Bromocriptine / therapeutic use. Cushing Syndrome / drug therapy. Cushing Syndrome / etiology. Dopamine Agonists / therapeutic use. Female. Growth Hormone-Secreting Pituitary Adenoma / therapy. Human Growth Hormone / analogs & derivatives. Human Growth Hormone / blood. Human Growth Hormone / therapeutic use. Humans. Hypophysectomy. Incidental Findings. Male. Pregnancy. Pregnancy Complications, Neoplastic / therapy. Prolactinoma / therapy. Radiosurgery. Receptors, Somatotropin / antagonists & inhibitors. Somatostatin / analogs & derivatives. Somatostatin / therapeutic use. Thyrotropin / blood

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  • (PMID = 19758960.001).
  • [ISSN] 0030-6002
  • [Journal-full-title] Orvosi hetilap
  • [ISO-abbreviation] Orv Hetil
  • [Language] hun
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Hungary
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Dopamine Agonists; 0 / Pituitary Hormones; 0 / Receptors, Somatotropin; 0 / pegvisomant; 12629-01-5 / Human Growth Hormone; 3A64E3G5ZO / Bromocriptine; 51110-01-1 / Somatostatin; 80Q9QWN15M / quinagolide; 9002-60-2 / Adrenocorticotropic Hormone; 9002-71-5 / Thyrotropin; 98H1T17066 / pasireotide
  • [Number-of-references] 28
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18. Miyoshi T, Otsuka F, Otani H, Inagaki K, Goto J, Yamashita M, Ogura T, Iwasaki Y, Makino H: Involvement of bone morphogenetic protein-4 in GH regulation by octreotide and bromocriptine in rat pituitary GH3 cells. J Endocrinol; 2008 Apr;197(1):159-69
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  • [Title] Involvement of bone morphogenetic protein-4 in GH regulation by octreotide and bromocriptine in rat pituitary GH3 cells.
  • Here we investigated roles of the pituitary bone morphogenetic protein (BMP) system in modulating GH production regulated by a somatostatin analog, octreotide (OCT) and a dopamine agonist, bromocriptine (BRC) in rat pituitary somatolactotrope tumor GH3 cells.
  • The GH3 cells were found to express BMP ligands, including BMP-4 and BMP-6; BMP type-1 and type-2 receptors (except the type-1 receptor, activin receptor-like kinase (ALK)-6); and Smad signaling molecules.
  • Individual treatment with OCT and BRC reduced forskolin-induced GH secretion.
  • These findings may explain the mechanism of resistance of GH reduction to a combination therapy with OCT and BRC for GH-producing pituitary adenomas.
  • [MeSH-major] Bone Morphogenetic Protein 4 / physiology. Bromocriptine / pharmacology. Growth Hormone / biosynthesis. Octreotide / pharmacology
  • [MeSH-minor] Animals. Bone Morphogenetic Protein 6 / genetics. Bone Morphogenetic Protein 6 / physiology. Bone Morphogenetic Protein Receptors / analysis. Bone Morphogenetic Protein Receptors / genetics. Cell Line, Tumor. Colforsin / pharmacology. Cyclic AMP / biosynthesis. Dose-Response Relationship, Drug. Rats. Receptors, Somatostatin / genetics

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  • (PMID = 18372242.001).
  • [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 / Bmp6 protein, rat; 0 / Bone Morphogenetic Protein 4; 0 / Bone Morphogenetic Protein 6; 0 / Receptors, Somatostatin; 1F7A44V6OU / Colforsin; 3A64E3G5ZO / Bromocriptine; 9002-72-6 / Growth Hormone; E0399OZS9N / Cyclic AMP; EC 2.7.11.30 / Bone Morphogenetic Protein Receptors; RWM8CCW8GP / Octreotide
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19. Rozhivanov RV, Kurbatov DG: [Sexual function rehabilitation of men with pituitary tumors]. Urologiia; 2010 Jul-Aug;(4):48, 50-3
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  • [Title] [Sexual function rehabilitation of men with pituitary tumors].
  • A prospective trial of the methods of sexual rehabilitation of 31 men with pituitary tumors has shown that therapy with testosterone and chorionic gonadotropin effectively corrects hypogonadism and sexual disorders.
  • Both methods of treatment had no negative effect on the size of the prostatic gland and PSA level except 2 patients with somatotropinoma on testosterone.
  • In the course of chorionic gonadotropin treatment pituitary tumor increased in size in 3 patients.
  • [MeSH-major] Androgens / therapeutic use. Chorionic Gonadotropin / therapeutic use. Erectile Dysfunction / drug therapy. Hormone Replacement Therapy / methods. Pituitary Neoplasms / complications. Testosterone / therapeutic use
  • [MeSH-minor] Adult. Cohort Studies. Humans. Libido / drug effects. Male. Middle Aged. Prospective Studies. Treatment Outcome


20. Waśko R, Bolko P, Owecki M, Jaskuła M, Sowiński J: The efficacy of octreotide LAR (long acting release) treatment in patients with somatotropinoma, and mixed pituitary tumours. Pharm World Sci; 2004 Dec;26(6):324-7
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  • [Title] The efficacy of octreotide LAR (long acting release) treatment in patients with somatotropinoma, and mixed pituitary tumours.
  • OBJECTIVE: The efficacy of somatostatin analogues in the treatment of acromegaly is not always equal and therefore we wanted to evaluate the efficacy of therapy with octreotide long acting release (LAR) in patients with monohormonal tumours (somatotropinomas) in comparison to individuals with mixed pituitary tumours secreting alpha-subunit.
  • METHOD: The 35 acromegalic patients (18 males and 17 females), aged 41.8 +/- 8.8 years, were divided into 2 groups according to the secreted hormones: 1 with mixed pituitary tumours with elevated growth hormone and alpha-subunit concentrations, the other with isolated growth hormone hypersecretion and normal alpha-subunit levels.
  • RESULTS: The decrease of GH and IGF-I levels after octreotide LAR treatment were observed in both groups.
  • CONCLUSIONS: After octreotide LAR treatment, the decrease of GH level and of mean IGF-I values was greater in patients with mixed pituitary tumours and high alpha-subunit concentrations than in patients with isolated GH hypersecretion and normal alpha-subunit levels.
  • [MeSH-major] Adenoma / drug therapy. Antineoplastic Agents, Hormonal / therapeutic use. Octreotide / therapeutic use. Pituitary Neoplasms / drug therapy
  • [MeSH-minor] Acromegaly / drug therapy. Acromegaly / etiology. Adult. Delayed-Action Preparations. Female. Human Growth Hormone / blood. Humans. Insulin-Like Growth Factor I / metabolism. Male. Middle Aged

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  • (PMID = 15683101.001).
  • [ISSN] 0928-1231
  • [Journal-full-title] Pharmacy world & science : PWS
  • [ISO-abbreviation] Pharm World Sci
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Delayed-Action Preparations; 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I; RWM8CCW8GP / Octreotide
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21. Ning S, Knox SJ, Harsh GR, Culler MD, Katznelson L: Lanreotide promotes apoptosis and is not radioprotective in GH3 cells. Endocr Relat Cancer; 2009 Sep;16(3):1045-55
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  • Somatostatin analogs are a mainstay of medical therapy in patients with GH producing human pituitary tumors, and it has been suggested that somatostatin analogs may be radioprotective.
  • We utilized GH secreting rat GH3 cells to investigate whether a somatostatin analog may limit the effects of radiation on proliferation and apoptosis in vitro and on tumor growth in vivo.
  • Treatment with lanreotide alone at doses of either 100 or 1000 nM for 48 h reduced clonogenic survival by 5-10%.
  • In a mouse GH3 tumor xenograft model, lanreotide 10 mg/kg moderately inhibited the growth of GH3 tumors, with a 4x tumor growth delay (TGD) time that ranged from 4.5 to 8.3 days.
  • Fractionated local tumor radiation alone significantly inhibited tumor growth and produced a TGD of 35.1+/-5.7 days for 250 cGy fractions.
  • The combination of lanreotide, either antecedent to or concurrent, with radiation of 250, 200 or 150 cGy/fraction for 5 days inhibited tumor growth and produced the TGD times that were similar to radiation alone (P>0.05).
  • [MeSH-major] Adenoma / pathology. Apoptosis / drug effects. Growth Hormone-Secreting Pituitary Adenoma / pathology. Peptides, Cyclic / pharmacology. Radiation Tolerance / drug effects. Somatostatin / analogs & derivatives. Somatotrophs / pathology
  • [MeSH-minor] Animals. Antineoplastic Agents / pharmacology. Cell Line, Tumor. Cell Survival / drug effects. Cell Survival / radiation effects. Dose-Response Relationship, Drug. Gamma Rays. Male. Mice. Mice, Nude. Radiation Dosage. Radiation-Protective Agents / pharmacology. Rats. Xenograft Model Antitumor Assays

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  • (PMID = 19528243.001).
  • [ISSN] 1479-6821
  • [Journal-full-title] Endocrine-related cancer
  • [ISO-abbreviation] Endocr. Relat. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Peptides, Cyclic; 0 / Radiation-Protective Agents; 118992-92-0 / lanreotide; 51110-01-1 / Somatostatin
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22. Gola M, Doga M, Bonadonna S, Mazziotti G, Vescovi PP, Giustina A: Neuroendocrine tumors secreting growth hormone-releasing hormone: Pathophysiological and clinical aspects. Pituitary; 2006;9(3):221-9
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  • [Title] Neuroendocrine tumors secreting growth hormone-releasing hormone: Pathophysiological and clinical aspects.
  • Hypothalamic GHRH is secreted into the portal system, binds to specific surface receptors of the somatotroph cell and elicits intracellular signals that modulate pituitary GH synthesis and/or secretion.
  • Moreover, GHRH is synthesized and expressed in multiple extrapituitary tissues.
  • Excessive peripheral production of GHRH by a tumor source would therefore be expected to cause somatotroph cell hyperstimulation, increased GH secretion and eventually pituitary acromegaly.
  • The distinction of pituitary vs. extrapituitary acromegaly is extremely important in planning effective management.
  • Dynamic pituitary tests are not helpful in distinguishing acromegalic patients with pituitary tumors from those harbouring extrapituitary tumors.
  • Plasma GHRH levels are usually elevated in patients with peripheral GHRH-secreting tumors, and are normal or low in patients with pituitary acromegaly.
  • Unique and unexpected clinical features in an acromegalic patient, including respiratory wheezing or dyspnea, facial flushing, peptic ulcers, or renal stones sometimes are helpful in alerting the physician to diagnosing non pituitary endocrine tumors.
  • If no facility to measure plasma GHRH is available, and in the absence of MRI evidence of pituitary adenoma, a CT scan of the thorax and abdominal ultrasound could be performed to exclude with good approximation the possibility of an ectopic GHRH syndrome.
  • Surgical resection of the tumor secreting ectopic GHRH should be the logical approach to a patient with ectopic GHRH syndrome.
  • Standard chemotherapy directed at GHRH-producing carcinoid tumors is generally unsuccessful in controlling the activated GH axis.
  • In fact, long-acting somatostatin analogs may be able to control not only the ectopic hormonal secretion syndrome, but also, in some instances, tumor growth.
  • Therefore, although cytotoxic chemotherapy, pituitary surgery, or irradiation still remain available therapeutic options, long-acting somatostatin analogs are now preferred as a second-line therapy in patients with carcinoid tumors and ectopic GHRH-syndrome.
  • [MeSH-major] Acromegaly / etiology. Adenoma / secretion. Carcinoid Tumor / secretion. Growth Hormone-Releasing Hormone / secretion. Growth Hormone-Secreting Pituitary Adenoma / secretion. Neuroendocrine Tumors / secretion. Paraneoplastic Endocrine Syndromes / etiology
  • [MeSH-minor] Animals. Biomarkers, Tumor / blood. Diagnosis, Differential. Human Growth Hormone / blood. Humans. Insulin-Like Growth Factor I / metabolism. Treatment Outcome. Up-Regulation

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  • (PMID = 17036195.001).
  • [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, Tumor; 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I; 9034-39-3 / Growth Hormone-Releasing Hormone
  • [Number-of-references] 101
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23. Vance ML: Medical treatment of functional pituitary tumors. Neurosurg Clin N Am; 2003 Jan;14(1):81-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Medical treatment of functional pituitary tumors.
  • Medical therapy with a dopamine agonist is the most effective for treatment of a prolactin-producing adenoma and is considered as primary treatment.
  • Surgery and pituitary radiation are reserved for patients who either do not tolerate or do not respond to a dopamine agonist drug.
  • A somatostatin analogue is effective medical therapy for patients with acromegaly, and this is usually administered if there is persistent GH hypersecretion after surgical resection.
  • Medical treatment for patients with Cushing's disease is directed at the adrenal glands to reduce cortisol hypersecretion.
  • Unfortunately, there is no effective medical therapy to reduce pituitary corticotropin production.
  • Medical therapy for a gonadotrope adenoma with a dopamine agonist or somatostatin analogue has limited utility but is employed in patients who are unable to undergo surgery and may delay or prevent additional tumor growth.
  • Many patients with a pituitary adenoma can be successfully treated with one treatment, either a dopamine agonist for a prolactinoma or surgery for other types of tumors.
  • A substantial number of patients require multimodality therapy, however, including medical therapy, surgery, and pituitary radiation.
  • Because the biologic behavior of pituitary adenomas varies considerably, a patient with a pituitary adenoma requires lifelong regular monitoring for hormone hypersecretion, tumor recurrence, and development of new pituitary hormone deficiency.
  • [MeSH-major] Adenoma / drug therapy. Pituitary Neoplasms / drug therapy

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  • (PMID = 12690980.001).
  • [ISSN] 1042-3680
  • [Journal-full-title] Neurosurgery clinics of North America
  • [ISO-abbreviation] Neurosurg. Clin. N. Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 53
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24. Drake WM, Berney DM, Kovacs K, Monson JP: Markers of cell proliferation in a GH-producing adenoma of a patient treated with pegvisomant. Eur J Endocrinol; 2005 Aug;153(2):203-5
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  • [Title] Markers of cell proliferation in a GH-producing adenoma of a patient treated with pegvisomant.
  • We report our findings on markers of cell proliferation (Ki-67 labelling index and topoisomerase-alpha expression) in a somatotroph pituitary tumour before and after exposure to pegvisomant, a GH receptor antagonist developed for the treatment of acromegaly.
  • Specimens from two separate pituitary operations, separated by a period of 17 years that included 4 years of pegvisomant treatment, were stained for markers of cellular proliferation.
  • Ki-67 labelling index and topoisomerase-alpha expression were both markedly greater (1-3% compared with 0-0.5% and 15-80% compared with 2-10% respectively) in the pegvisomant-exposed tumour compared with the earlier specimen.
  • Clearly, caution must be exercised when interpreting findings from a single case, particularly one sufficiently refractory to conventional therapies to require treatment with pegvisomant.
  • However, our data reinforce the requirement for careful radiological surveillance of the pituitary in the context of a drug that does not target the tumour responsible and where serum GH cannot serve as a marker of disease activity or tumour size.

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  • (PMID = 16061824.001).
  • [ISSN] 0804-4643
  • [Journal-full-title] European journal of endocrinology
  • [ISO-abbreviation] Eur. J. Endocrinol.
  • [Language] ENG
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / Biomarkers, Tumor; 0 / DNA-Binding Proteins; 0 / Ki-67 Antigen; 0 / Receptors, Somatotropin; 0 / pegvisomant; 12629-01-5 / Human Growth Hormone; EC 5.99.1.3 / DNA Topoisomerases, Type II; EC 5.99.1.3 / DNA topoisomerase II alpha
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