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Items 1 to 36 of about 36
1. Syro LV, Scheithauer BW, Ortiz LD, Fadul CE, Horvath E, Rotondo F, Kovacs K: Effect of temozolomide in a patient with recurring oncocytic gonadotrophic pituitary adenoma. Hormones (Athens); 2009 Oct-Dec;8(4):303-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Effect of temozolomide in a patient with recurring oncocytic gonadotrophic pituitary adenoma.
  • The patient was a 70-year-old man with a recurrent pituitary tumor.
  • Three surgeries were performed but the tumor recurred.
  • Based on histologic, immunohistochemical and ultrastructural studies, the diagnosis of oncocytic gonadotrophic pituitary adenoma was made.
  • The tumor was a macroadenoma partly immunopositive for LH.
  • After recurrence following operations, the patient was treated with Temozolomide, an imidazotetrazine derivative, DNA-alkylating drug.
  • Following Temozolomide administration the MRI demonstrated significant tumor necrosis.
  • The present case indicates that benign, typically slow-growing pituitary adenomas of oncocytic gonadotrophic type may respond to Temozolomide even when the tumor consists of an admixture of MGMT immunopositive and immunonegative cells.
  • [MeSH-major] Adenoma / drug therapy. Antineoplastic Agents, Alkylating / therapeutic use. Dacarbazine / analogs & derivatives. Neoplasm Recurrence, Local / drug therapy. Pituitary Neoplasms / drug therapy
  • [MeSH-minor] Aged. Fatal Outcome. Humans. Magnetic Resonance Imaging. Male. Treatment Outcome

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  • (PMID = 20045804.001).
  • [ISSN] 1109-3099
  • [Journal-full-title] Hormones (Athens, Greece)
  • [ISO-abbreviation] Hormones (Athens)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide
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2. Alén JF, Boto GR, Lagares A, de la Lama A, Gómez PA, Lobato RD: Intratumoural bleomycin as a treatment for recurrent cystic craniopharyngioma. Case report and review of the literature. Neurocirugia (Astur); 2002 Dec;13(6):479-85; discussion 485
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  • [Title] Intratumoural bleomycin as a treatment for recurrent cystic craniopharyngioma. Case report and review of the literature.
  • Only several authors have reported the use of bleomycin for the treatment of cystic CF.
  • CASE REPORT: The authors present the case of a nineteen years old patient with a recurrent cystic CF who was treated with intratumoral injections of bleomycin.
  • The patient had been operated on three times before because of regrowth of the tumor.
  • This last time he had a severe disturbance of his visual acuity and a huge regrowth of the cystic CF.
  • No complications were detected during and after the procedure.
  • A MR performed 4 months after treatment showed a clear reduction in the size of the cyst but 10 months later a new regrowth of the cyst was detected by MR with no new signs or symptoms.
  • The MR 18 months after the first treatment showed the reduction in size of the tumor.
  • DISCUSSION: Although there is not an stablished protocol for the indication and the form of application of intracystic bleomycin, results with this treatment for cystic CF seem good in the literature.
  • CONCLUSION: Intracystic administration of bleomycin is a valid option as adjuvant therapy for CF in patients with recurrences that are not surgical candidates because of the high risk of complications.
  • The role of bleomycin as a primary treatment for CF and treatment protocols remain to be stablished with additional studies.
  • [MeSH-major] Antibiotics, Antineoplastic / therapeutic use. Bleomycin / therapeutic use. Brain Diseases / complications. Craniopharyngioma / complications. Craniopharyngioma / drug therapy. Cysts / complications. Pituitary Neoplasms / complications. Pituitary Neoplasms / drug therapy
  • [MeSH-minor] Adult. Drug Administration Routes. Humans. Magnetic Resonance Imaging. Male. Neoplasm Recurrence, Local. Tomography, X-Ray Computed

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  • (PMID = 12529778.001).
  • [ISSN] 1130-1473
  • [Journal-full-title] Neurocirugía (Asturias, Spain)
  • [ISO-abbreviation] Neurocirugia (Astur)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Spain
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 11056-06-7 / Bleomycin
  • [Number-of-references] 24
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3. Petrossians P, Ronci N, Valdés Socin H, Kalife A, Stevenaert A, Bloch B, Tabarin A, Beckers A: ACTH silent adenoma shrinking under cabergoline. Eur J Endocrinol; 2001 Jan;144(1):51-7
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  • OBJECTIVES: The authors present a case report that proposes the use of cabergoline treatment in silent ACTH adenoma, an unusual member of the heterogeneous group of the so-called clinically non-functioning pituitary adenomas.
  • DESIGN: Following the clinical and radiological improvement of a recurrent silent ACTH adenoma in a 77-year-old patient treated with cabergoline (0.5 mg every 2 days for 2 years), in vitro studies of the original tumor were performed.
  • METHODS: The original tumor from the patient was studied by in situ hybridization and dopamine D2 receptor autoradiography.
  • We demonstrate in vitro, the presence of D2 receptors in the primitive tumor in concentrations similar to those found in control prolactinomas.
  • These results suggest that therapeutic trials with cabergoline might be undertaken in recurring cases of ACTH silent tumors and more generally, non-functioning pituitary adenomas.

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  • (PMID = 11174837.001).
  • [ISSN] 0804-4643
  • [Journal-full-title] European journal of endocrinology
  • [ISO-abbreviation] Eur. J. Endocrinol.
  • [Language] ENG
  • [Publication-type] Case Reports; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Ergolines; 0 / RNA, Messenger; 0 / Receptors, Dopamine D2; 9002-60-2 / Adrenocorticotropic Hormone; LL60K9J05T / cabergoline
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4. Becker G, Kocher M, Kortmann RD, Paulsen F, Jeremic B, Müller RP, Bamberg M: Radiation therapy in the multimodal treatment approach of pituitary adenoma. Strahlenther Onkol; 2002 Apr;178(4):173-86
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  • [Title] Radiation therapy in the multimodal treatment approach of pituitary adenoma.
  • BACKGROUND: Pituitary tumors are relatively uncommon, comprising 10-12% of all intracranial tumors.
  • The treatment consisting of surgery, radiotherapy and drug therapy or a combination of these modalities is aimed at the control of tumor cell proliferation and--in endocrine active tumors--the reduction of hormone secretion.
  • However, the slow proliferation characteristics of pituitary tumors necessitate long-term studies for the evaluation of the treatment results.
  • In the last decade there has been continuous improvement in surgical procedures, radiotherapy techniques and drug generation.
  • In this paper, literature will be reviewed to assess the role of modern radiotherapy and radiosurgery in the management of pituitary adenomas.
  • MATERIAL AND METHODS: Nowadays, magnetic resonance imaging for the definition of the target volume and a real three-dimensional (3-D) treatment planning with field conformation and the possibility for non-coplanar irradiation has to be recommended.
  • Most groups irradiate these benign tumors with single doses of 1.8-2.0 Gy up to a total dose of 45 Gy or 50.4 Gy in extensive parasellar adenomas.
  • Adenomas are mostly small, well circumscribed lesions, and have, therefore, attracted the use of stereotactically guided high-precision irradiation techniques which allow extreme focussing and provide steep dose gradients with selective treatment of the target and optimal protection of the surrounding brain tissue.
  • RESULTS: Radiation therapy controls tumor growth in 80-98% of patients with non-secreting adenomas and 67-89% for endocrine active tumors.
  • In cases of microprolactinoma primary therapy consists of dopamine agonists.
  • Irradiation should be preferred in patients with macroprolactinomas, when drug therapy and/or surgery failed or for patients medically unsuitable for surgery.
  • Hypopituitarism is the most common side effect of pituitary irradiation with an incidence of 13-56%.
  • Other side effects are rare too, and do also depend on the damage produced by tumor itself or preceding surgery.
  • They include deterioration of vision in 1.7% of all cases, vascular changes in 6.3%, neuropsychological disorders such as dementia in 0.7% and secondary malignancies in 0.8%, if single doses of 2.0 Gy and total doses of 50 Gy are not exceeded.
  • CONCLUSION: Conventional radiation therapy of pituitary adenoma is highly effective.
  • It is recommended after subtotal resection of primary tumors such as macroadenomas, after gross total resection from endocrine active adenomas with postsurgical hormone secretion and for recurrent tumors.
  • Radiosurgery seems to be a possible treatment alternative in experienced centers, and only in patients with adenomas smaller than 25-30 mm with a minimum distance of 2-3 mm to the chiasm.
  • [MeSH-major] Adenoma / radiotherapy. Pituitary Neoplasms / radiotherapy. Prolactinoma / radiotherapy. Radiosurgery
  • [MeSH-minor] Acromegaly / etiology. Adult. Brain Diseases / etiology. Brain Neoplasms / etiology. Brain Neoplasms / secondary. Child. Combined Modality Therapy. Cushing Syndrome / etiology. Dose Fractionation. Female. Follow-Up Studies. Humans. Male. Neoplasm Recurrence, Local. Neoplasms, Radiation-Induced / etiology. Postoperative Care. Radiotherapy / adverse effects. Radiotherapy Dosage. Radiotherapy, Conformal. Stroke / etiology. Time Factors

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  • (PMID = 12040754.001).
  • [ISSN] 0179-7158
  • [Journal-full-title] Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]
  • [ISO-abbreviation] Strahlenther Onkol
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 103
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5. Yoffe R, Khakoo Y, Dunkel IJ, Souweidane M, Lis E, Sklar C: Recurrent ependymoma treated with high-dose tamoxifen in a peripubertal female: Impact on tumor and the pituitary-ovarian axis. Pediatr Blood Cancer; 2007 Oct 15;49(5):758-60
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  • [Title] Recurrent ependymoma treated with high-dose tamoxifen in a peripubertal female: Impact on tumor and the pituitary-ovarian axis.
  • Anecdotal evidence suggests that tamoxifen may have a role in the treatment of these tumors.
  • We present a case of a child with recurrent ependymoma treated with tamoxifen who showed tumor regression on two separate occasions.
  • However, treatment with tamoxifen resulted in the development of large ovarian cysts associated with supraphysiological plasma concentrations of estradiol.
  • [MeSH-major] Ependymoma / complications. Ependymoma / drug therapy. Ovarian Cysts / chemically induced. Tamoxifen / pharmacology
  • [MeSH-minor] Child. Estradiol / blood. Female. Humans. Puberty. Recurrence. Tumor Burden / drug effects

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  • [Copyright] (c) 2007 Wiley-Liss, Inc.
  • (PMID = 16261561.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 094ZI81Y45 / Tamoxifen; 4TI98Z838E / Estradiol
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6. 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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  • [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%.
  • 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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7. Uchino Y, Saeki N, Iwadate Y, Yasuda T, Konda S, Watanabe T, Wada K, Kazukawa I, Higuchi Y, Iuchi T, Tatsuno I, Yamaura A: Recurrence of sellar and suprasellar tumors in children treated with hGH--relation to immunohistochemical study on GH receptor. Endocr J; 2000 Mar;47 Suppl:S33-6
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  • PURPOSE: GH replacement therapy is required in the majority of children with GH deficiency after treatment of sellar and suprasellar tumors.
  • Owing to the high cell proliferative ability of human GH (hGH), its influence on tumor recurrence has been debated.
  • We retrospectively studied the immunohistochemical expression of the GH receptor in various tumor tissues, in order to investigate the relation between tumor recurrence and hGH replacement.
  • METHODS: GH replacement therapy was performed in 25 patients (8 boys and 17 girls) after the treatment.
  • Tumor recurrence was noted in 4 patients (craniopharyngioma: 2 patients, pilocytic astrocytoma and germinoma: 1 each).
  • Immunohistochemical study of GH receptor in tumor tissue was carried out in those recurrent and recurrence-free cases, by using MAb 263 as a primary antibody.
  • RESULTS: Two patients with recurrent craniopharyngioma were positive for MAb 263, but 1 recurrence-free patient was negative.
  • Patients with pilocytic astrocytoma (recurrent and recurrence-free: 1 each) were all positive.
  • CONCLUSION: In the patients with craniopharyngioma treated with GH, a positive immunohistochemical expression of GH receptor in tumor tissue may indicate a high probability of recurrence.
  • It is therefore speculated that each brain tumor may have its specificity in GH receptor expression.
  • [MeSH-major] Astrocytoma / drug therapy. Brain Neoplasms / drug therapy. Craniopharyngioma / drug therapy. Germinoma / drug therapy. Human Growth Hormone / therapeutic use. Pituitary Neoplasms / drug therapy

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  • (PMID = 10890179.001).
  • [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 / Receptors, Somatotropin; 12629-01-5 / Human Growth Hormone
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8. Colao A, Di Sarno A, Cappabianca P, Di Somma C, Pivonello R, Lombardi G: Withdrawal of long-term cabergoline therapy for tumoral and nontumoral hyperprolactinemia. N Engl J Med; 2003 Nov 20;349(21):2023-33
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  • [Title] Withdrawal of long-term cabergoline therapy for tumoral and nontumoral hyperprolactinemia.
  • BACKGROUND: Whether the withdrawal of treatment in patients with nontumoral hyperprolactinemia, microprolactinomas, or macroprolactinomas is safe and effective has been unclear.
  • Withdrawal of cabergoline was considered if prolactin levels were normal, magnetic resonance imaging (MRI) showed no tumor (or tumor reduction of 50 percent or more, with the tumor at a distance of more than 5 mm from the optic chiasm, and no invasion of the cavernous sinuses or other critical areas), and if follow-up after withdrawal could be continued for at least 24 months.
  • Renewed tumor growth did not occur in any patient; in 10 female patients (22 percent) and 7 male patients (39 percent) with recurrent hyperprolactinemia, gonadal dysfunction redeveloped.
  • In all diagnostic groups, prolactin levels at the time of recurrence were significantly lower than at diagnosis (P<0.001).
  • The Kaplan-Meier estimated rate of recurrence at five years was higher among patients with macroprolactinomas and those with microprolactinomas who had small remnant tumors visible on MRI at the time of treatment withdrawal than among patients whose MRI scans showed no evidence of tumor at the time of withdrawal (patients with macroprolactinomas, 78 percent vs. 33 percent, P=0.001; patients with microprolactinomas, 42 percent vs. 26 percent, P=0.02).
  • CONCLUSIONS: Cabergoline can be safely withdrawn in patients with normalized prolactin levels and no evidence of tumor.
  • However, because the length of follow-up in our study was insufficient to rule out a delayed increase in the size of the tumor, we suggest that patients be closely monitored, particularly those with macroprolactinomas, in whom renewed growth of the tumor may compromise vision.
  • [MeSH-major] Dopamine Agonists / therapeutic use. Ergolines / therapeutic use. Hyperprolactinemia / drug therapy. Pituitary Neoplasms / drug therapy. Prolactinoma / drug therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Agents / therapeutic use. Female. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Prolactin / blood. Prospective Studies. Recurrence. Withholding Treatment

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  • [Copyright] Copyright 2003 Massachusetts Medical Society
  • [CommentIn] N Engl J Med. 2004 Mar 4;350(10):1054-7; author reply 1054-7 [14999121.001]
  • [CommentIn] N Engl J Med. 2004 Mar 4;350(10):1054-7; author reply 1054-7 [15002121.001]
  • (PMID = 14627787.001).
  • [ISSN] 1533-4406
  • [Journal-full-title] The New England journal of medicine
  • [ISO-abbreviation] N. Engl. J. Med.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Dopamine Agonists; 0 / Ergolines; 9002-62-4 / Prolactin; LL60K9J05T / cabergoline
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9. Laws ER Jr, Morris AM, Maartens N: Gliadel for pituitary adenomas and craniopharyngiomas. Neurosurgery; 2003 Aug;53(2):255-69; discussion 259-60
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  • [Title] Gliadel for pituitary adenomas and craniopharyngiomas.
  • OBJECTIVE: We developed a protocol for a clinical trial of postresection implantation of Gliadel wafers in patients with aggressive, relentlessly recurring pituitary adenomas and craniopharyngiomas.
  • METHODS: Ten patients, nine with pituitary adenomas and one with a craniopharyngioma, underwent implantation of from two to eight Gliadel wafers.
  • Four patients have been free of recurrent or residual tumor, two have stable residual disease, and one has experienced tumor progression.
  • CONCLUSION: The results of this study suggest a role for Gliadel implantation in patients with recurring aggressive pituitary adenomas and craniopharyngiomas.
  • [MeSH-major] Adenoma / drug therapy. Adenoma / surgery. Antineoplastic Agents, Alkylating / therapeutic use. Carmustine / therapeutic use. Craniopharyngioma / drug therapy. Craniopharyngioma / surgery. Drug Implants / therapeutic use. Pituitary Neoplasms / drug therapy. Pituitary Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Drug Carriers / administration & dosage. Drug Carriers / therapeutic use. Feasibility Studies. Female. Follow-Up Studies. Humans. Male. Middle Aged. Outcome Assessment (Health Care). Survival Rate

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  • (PMID = 12925239.001).
  • [ISSN] 0148-396X
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 0 / Drug Carriers; 0 / Drug Implants; U68WG3173Y / Carmustine
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10. Lau Q, Scheithauer B, Kovacs K, Horvath E, Syro LV, Lloyd R: MGMT immunoexpression in aggressive pituitary adenoma and carcinoma. Pituitary; 2010 Dec;13(4):367-79
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  • [Title] MGMT immunoexpression in aggressive pituitary adenoma and carcinoma.
  • Recent case reports have documented the efficacy of temozolomide therapy in some aggressive pituitary adenomas and pituitary carcinomas resistant to multimodality therapy.
  • Evidence suggests that low O6-methylguanine-DNA methyltransferase (MGMT) immunoexpression correlates with response to temozolomide chemotherapy.
  • Herein, we aimed to study MGMT immunoexpression in a spectrum of pituitary tumors, indolent, aggressive and malignant.
  • A literature review of the use of temozolomide in pituitary tumors was also performed.
  • Immunohistochemistry for MGMT was performed on 60 pituitary tumors identified in the Mayo Clinic Tissue Registry and the consultation files of one of us (BWS).
  • The group included 30 pituitary carcinomas (15 ACTH, 10 PRL, 1 FSH/LH, 1 TSH, 1 silent subtype 3 and 2 null cell).
  • Tissue from recurrences was available in 17 cases.
  • In addition, 30 functionally different pituitary adenomas were studied, including 15 invasive and 15 non-invasive adenomas.
  • Overall, 32 cases of pituitary tumors (54%) demonstrated low MGMT immunoexpression.
  • This included 17 of 30 (57%) carcinomas, 9 of 15 (60%) invasive adenomas, and 6 of 15 cases (40%) of non-invasive pituitary adenomas.
  • There was no significant change in MGMT immunoexpression between primary and recurrent tumors.
  • A significant proportion of pituitary adenomas and carcinomas demonstrate low MGMT immunoexpression.
  • In an effort to anticipate the likelihood of a temozolomide response, all cases of aggressive pituitary tumors should be assessed for MGMT expression.
  • [MeSH-major] DNA Modification Methylases / metabolism. DNA Repair Enzymes / metabolism. Pituitary Neoplasms / immunology. Tumor Suppressor Proteins / metabolism
  • [MeSH-minor] Adult. Aged. Antineoplastic Agents, Alkylating / therapeutic use. Dacarbazine / analogs & derivatives. Dacarbazine / therapeutic use. Humans. Immunohistochemistry. Immunosuppression. Male

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  • (PMID = 20740317.001).
  • [ISSN] 1573-7403
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 0 / Tumor Suppressor Proteins; 7GR28W0FJI / Dacarbazine; EC 2.1.1.- / DNA Modification Methylases; EC 2.1.1.63 / MGMT protein, human; EC 6.5.1.- / DNA Repair Enzymes; YF1K15M17Y / temozolomide
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11. Takahashi H, Yamaguchi F, Teramoto A: Long-term outcome and reconsideration of intracystic chemotherapy with bleomycin for craniopharyngioma in children. Childs Nerv Syst; 2005 Aug;21(8-9):701-4
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  • [Title] Long-term outcome and reconsideration of intracystic chemotherapy with bleomycin for craniopharyngioma in children.
  • OBJECT: We first reported postoperative intratumoral chemotherapy with bleomycin for craniopharyngiomas in 1985.
  • However, this local bleomycin chemotherapy has not yet been used very frequently.
  • It seems to be necessary for us to report long-term outcome and reconsideration of this treatment.
  • METHODS AND RESULTS: Local bleomycin chemotherapy was performed on 7 children (to 1985) and 11 children (from 1988 to 2004).
  • A total of 11 pediatric patients with recurrent cystic craniopharyngioma was treated by intracystic injection of bleomycin after 1988 and followed up from 3 to 16 years.
  • This patient has never had recurrent tumor until now.
  • CONCLUSION: Our results indicate that local bleomycin chemotherapy is effective and that recurrence does not occur after follow-up, which ranged in duration from 3 to 16 years.
  • [MeSH-major] Antibiotics, Antineoplastic / therapeutic use. Bleomycin / therapeutic use. Craniopharyngioma / drug therapy. Cysts / drug therapy. Drug Therapy / methods. Pituitary Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Female. Follow-Up Studies. Humans. Male. Retrospective Studies. Tomography, X-Ray Computed / methods. Treatment Outcome

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  • (PMID = 15928963.001).
  • [ISSN] 0256-7040
  • [Journal-full-title] Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
  • [ISO-abbreviation] Childs Nerv Syst
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 11056-06-7 / Bleomycin
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12. Vecil GG, Papadopoulos NV, Vassilopoulou-Sellin R, McCutcheon IE: Interferon-induced hypothyroidism causing reversible pituitary enlargement. Endocr Pract; 2008 Mar;14(2):219-23
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  • [Title] Interferon-induced hypothyroidism causing reversible pituitary enlargement.
  • OBJECTIVE: To present the first reported case of interferon-induced hypothyroidism with radiographic confirmation of secondary pituitary hyperplasia.
  • METHODS: We describe the case of a woman with recurrent malignant melanoma, outline the details of her endocrine work-up, and illustrate the serial findings on magnetic resonance imaging of the head.
  • Metastatic work-up revealed evidence of tumor involvement in the cervical and mediastinal lymph nodes.
  • After treatment with interferon for 1 year, persistent fatigue and menstrual irregularities led to the laboratory diagnosis of hypothyroidism, and magnetic resonance imaging revealed pituitary enlargement.
  • Both her endocrinopathy and the pituitary hyperplasia resolved with discontinuation of the interferon treatment and with institution of thyroid replacement therapy.
  • CONCLUSION: Clinicians should be aware of the potential adverse effects of interferon therapy to avoid inappropriate diagnosis of a pituitary adenoma or metastatic lesion in patients with cancer who are treated with interferon.
  • [MeSH-major] Hypothyroidism / chemically induced. Interferons / adverse effects. Pituitary Gland / drug effects

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  • (PMID = 18308662.001).
  • [ISSN] 1934-2403
  • [Journal-full-title] Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
  • [ISO-abbreviation] Endocr Pract
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 9008-11-1 / Interferons
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13. Plotkin M, Amthauer H, Eisenacher J, Wurm R, Michel R, Wust P, Stockhammer F, Röttgen R, Gutberlet M, Ruf J, Felix R: Value of 123I-IMT SPECT for diagnosis of recurrent non-astrocytic intracranial tumours. Neuroradiology; 2005 Jan;47(1):18-26
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  • [Title] Value of 123I-IMT SPECT for diagnosis of recurrent non-astrocytic intracranial tumours.
  • The value of single-photon emission tomography (SPECT) using iodine-123-alpha-methyl-tyrosine (IMT) for the diagnosis of recurrent or residual gliomas is well established.
  • The study included 22 patients with suspected recurrent intracranial tumours of non-astrocytic origin (12 brain metastases, one supratentorial primitive neuroendocrine tumour (PNET), one rhabdoid tumour, two clivus chordomas, three ependymomas, two pituitary tumours, one anaplastic meningioma) who had previously been treated by surgery and/or radio/chemotherapy.
  • We concluded that the IMT-SPECT is a promising complementary imaging tool for the detection of recurrences of non-astrocytic intracranial tumours and their distinguishing from treatment-induced changes.
  • The limitation of the IMT-SPECT is its low sensitivity for the detection of small lesions.
  • [MeSH-major] Brain Neoplasms / diagnostic imaging. Iodine Radioisotopes. Methyltyrosines. Neoplasm Recurrence, Local / diagnostic imaging. Radiopharmaceuticals. Tomography, Emission-Computed, Single-Photon / methods
  • [MeSH-minor] Adolescent. Adult. Aged. Chordoma / diagnostic imaging. Ependymoma / diagnostic imaging. False Negative Reactions. False Positive Reactions. Female. Follow-Up Studies. Glioma / diagnostic imaging. Humans. Magnetic Resonance Imaging. Male. Meningioma / diagnostic imaging. Middle Aged. Neuroendocrine Tumors / diagnostic imaging. Pituitary Neoplasms / diagnostic imaging. Retrospective Studies. Rhabdoid Tumor / diagnostic imaging. Sensitivity and Specificity. Supratentorial Neoplasms / diagnostic imaging

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  • (PMID = 15630586.001).
  • [ISSN] 0028-3940
  • [Journal-full-title] Neuroradiology
  • [ISO-abbreviation] Neuroradiology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Iodine Radioisotopes; 0 / Methyltyrosines; 0 / Radiopharmaceuticals; A77N8J5H5T / 3-iodo-alpha-methyltyrosine
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14. Perrin G, Stevenaert A, Jouanneau E: [Technical aspects and surgical strategy for removal of corticotroph pituitary adenoma]. Neurochirurgie; 2002 May;48(2-3 Pt 2):186-214
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  • [Title] [Technical aspects and surgical strategy for removal of corticotroph pituitary adenoma].
  • [Transliterated title] Aspects techniques et conduite de l'exérèse de l'adénome hypophysaire corticotrope.
  • The development of transsphenoidal microsurgery and the refinement of endocrinological and radiological diagnostic procedures have afforded therapeutic options appropriate for each individual case in patients with pituitary-dependent hypercortisolism.
  • Compared with other secreting pituitary tumors, the corticotroph adenoma seems to be the most biologically active tumor.
  • Clinical evidence of hypercortisolism mainly occurs at an early stage of tumor growth when the tumor is very small, below the detection threshold of modern imaging techniques.
  • While the treatment of large tumors remains difficult due to the non-discrete boundary lines of the tumor and extension or invasion, surgical removal of very tiny tumors requires reliable preoperative or peroperative identification in order to achieve total tumor resection for clinical remission and pituitary preservation to prevent hypopituitarism.
  • We report here the state-of-the-art of surgical management of corticotroph pituitary adenoma focusing on preoperative radiological and biological data required for performing guided intrasellar surgical exploration and reliable tumor identification.
  • Different technical aspects of the nasosphenoidal approaches are reported as well as the modified transdiaphragmatic or transtubercular transcisternal approaches to tumors in a suprasellar localization or lying along the pituitary stalk.
  • Adapted surgical techniques for second transnasal surgery indicated for recurrent tumors are described.
  • Guidelines are given for peroperative tumor identification with macroscopic assessment or histological control with frozen section biopsies.
  • Different techniques for tumor removal are discussed from selective microadenomectomy to enlarged pituitary resection and total hypophysectomy.
  • Methods for preoperative guidance of total tumor removal are proposed including histological or biological assessment of normal adjacent pituitary tissue. the strategy of surgical intrasellar exploration and tumor resection is outlined using a set of algorithms.
  • The first is devoted to positive preoperative documentation of the tumor.
  • The second is proposed for the surgical scenario where there is no preoperative MRI evidence of the tumor.
  • Revision surgical management after surgical failure or tumor recurrence is described.
  • Special guidelines for surgical treatment of large clinically silent corticotroph macroadenomas are given with emphasis on the high risk of recurrence in comparison with other silent pituitary tumors such as gonadotroph or immunonegative adenomas.
  • [MeSH-major] Adenoma / surgery. Cushing Syndrome / surgery. Hypophysectomy / methods. Pituitary Neoplasms / surgery
  • [MeSH-minor] ACTH Syndrome, Ectopic / complications. ACTH Syndrome, Ectopic / surgery. Adrenocorticotropic Hormone / secretion. Anti-Bacterial Agents / therapeutic use. Cortisone / therapeutic use. Deamino Arginine Vasopressin / therapeutic use. Diabetes Insipidus / drug therapy. Diabetes Insipidus / etiology. Diagnostic Imaging. Endoscopy. Humans. Magnetic Resonance Imaging. Petrosal Sinus Sampling. Postoperative Complications / prevention & control. Premedication. Reoperation

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  • (PMID = 12058125.001).
  • [ISSN] 0028-3770
  • [Journal-full-title] Neuro-Chirurgie
  • [ISO-abbreviation] Neurochirurgie
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Anti-Bacterial Agents; 9002-60-2 / Adrenocorticotropic Hormone; ENR1LLB0FP / Deamino Arginine Vasopressin; V27W9254FZ / Cortisone
  • [Number-of-references] 191
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15. Harms E, Siggelkow H, Buchfelder M, Saeger W, Hüfner M: [Macroadenoma of the pituitary gland with moderate hyperprolactinaemia]. Dtsch Med Wochenschr; 2003 Mar 28;128(13):667-70
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  • [Title] [Macroadenoma of the pituitary gland with moderate hyperprolactinaemia].
  • [Transliterated title] Makroadenom der Hypophyse mit mässiger Hyperprolaktinämie.
  • HISTORY AND CLINICAL FINDINGS: A 46-year-old woman was referred to the neurosurgery department for treatment of a macroadenoma of the pituitary.
  • She had complained of recurrent galactorrhoea for 7 years; a hysterectomy was performed 4 years ago.
  • INVESTIGATIONS: The endocrinological work-up revealed a moderately elevated prolactin level of 3133 mU/l (147 ng/ml) with intact pituitary functions.
  • She had no visual impairment and the MRI depicted a pituitary tumor with a maximal diameter of 1.9 cm and both intra- and suprasellar extension.
  • DIAGNOSIS, TREATMENT AND CLINICAL COURSE: The diagnosis of a nonfunctioning macrodenoma with functional hyperprolactinemia was made and a selective transsphenoidal adenomectomy was performed.
  • In the meantime, because of persistent galactorrhea and elevated prolactin levels, treatment with cabergolin 0.5 mg/week was started.
  • A follow-up MRI after 3 months of treatment showed a significant shrinkage of the residual tumor.
  • We therefore suggest a drug treatment trial with dopamine agonists in all macroadenoms with hyperprolactinemia, particularly in those with prolactin levels above 2000 mU/l (100 ng/ml).
  • [MeSH-major] Hyperprolactinemia / surgery. Pituitary Neoplasms / surgery. Prolactinoma / surgery
  • [MeSH-minor] Diagnosis, Differential. Ergolines / therapeutic use. Female. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Middle Aged. Neoplasm, Residual / drug therapy. Pituitary Gland / pathology. Pituitary Gland / surgery. Postoperative Complications / drug therapy

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  • (PMID = 12660899.001).
  • [ISSN] 0012-0472
  • [Journal-full-title] Deutsche medizinische Wochenschrift (1946)
  • [ISO-abbreviation] Dtsch. Med. Wochenschr.
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Ergolines; LL60K9J05T / cabergoline
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16. Zatelli MC, Minoia M, Filieri C, Tagliati F, Buratto M, Ambrosio MR, Lapparelli M, Scanarini M, Degli Uberti EC: Effect of everolimus on cell viability in nonfunctioning pituitary adenomas. J Clin Endocrinol Metab; 2010 Feb;95(2):968-76
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  • [Title] Effect of everolimus on cell viability in nonfunctioning pituitary adenomas.
  • CONTEXT: Pituitary adenomas can cause specific syndromes due to hormone excess and/or determine sellar mass symptoms.
  • Pituitary cell growth can sometimes be influenced by medical therapy, such as for somatotroph adenomas treated with somatostatin analogs or prolactinomas treated with dopaminergic drugs.
  • However, nonfunctioning pituitary adenomas (NFAs) are still orphans of medical therapy.
  • Everolimus (RAD001), a derivative of rapamycin, is a well-known immunosuppressant drug, which has been recently shown to have antineoplastic activity in several human cancers.
  • In selected tissues cotreatment with SOM230, but not cabergoline, exerted an additive effect.
  • CONCLUSIONS: Everolimus reduced NFA cell viability by inducing apoptosis, with a mechanism likely involving IGF-I signaling but not VEGF secretion, suggesting that it might represent a possible medical treatment of invasive/recurrent NFAs.
  • [MeSH-major] Adenoma / drug therapy. Immunosuppressive Agents / pharmacology. Pituitary Neoplasms / drug therapy. Sirolimus / analogs & derivatives
  • [MeSH-minor] Aged. Apoptosis / drug effects. Cell Line, Tumor. Cell Survival / drug effects. Ergolines / pharmacology. Everolimus. Female. Humans. Male. Middle Aged. Receptors, Somatostatin / physiology. Ribosomal Protein S6 Kinases, 70-kDa / metabolism. Somatostatin / analogs & derivatives. Somatostatin / pharmacology. Vascular Endothelial Growth Factor A / secretion

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  • (PMID = 19965918.001).
  • [ISSN] 1945-7197
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Ergolines; 0 / Immunosuppressive Agents; 0 / Receptors, Somatostatin; 0 / Vascular Endothelial Growth Factor A; 0 / somatostatin receptor 2; 51110-01-1 / Somatostatin; 98H1T17066 / pasireotide; 9HW64Q8G6G / Everolimus; EC 2.7.11.1 / Ribosomal Protein S6 Kinases, 70-kDa; LL60K9J05T / cabergoline; W36ZG6FT64 / Sirolimus
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17. Prabhu SS, Aldape KD, Gagel RF, Benjamin RS, Trent JC, McCutcheon IE: Sarcomatous change after sellar irradiation in a growth hormone-secreting pituitary adenoma. Can J Neurol Sci; 2003 Nov;30(4):378-83
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  • [Title] Sarcomatous change after sellar irradiation in a growth hormone-secreting pituitary adenoma.
  • BACKGROUND: Although the benefits of radiotherapy for pituitary adenomas are well-documented, post-irradiation sarcomas of the sella are rarely seen, with only 20 cases (mainly of fibrosarcoma) reported in the medical literature.
  • METHOD: We describe a case of post-irradiation sarcoma five years after surgery followed by external-beam irradiation for an extensive and locally invasive growth hormone-secreting tumor.
  • RESULTS: The patient underwent transsphenoidal resection of the recurrent tumor, followed by adjuvant chemotherapy.
  • This led to significant relief in the patient's symptoms including radiological evidence of tumor shrinkage, but the tumor regrew when, owing to dose-limiting toxicity, chemotherapy was stopped.
  • CONCLUSIONS: Post-irradiation sarcomas of the pituitary are well-recognized but rare.
  • They should be suspected in patients following sellar irradiation who show abrupt onset of new symptoms and appropriate radiological findings, and such tumors may respond to cytotoxic chemotherapy.
  • [MeSH-major] Adenoma / pathology. Gliosarcoma / pathology. Growth Hormone / secretion. Pituitary Neoplasms / pathology

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  • (PMID = 14672272.001).
  • [ISSN] 0317-1671
  • [Journal-full-title] The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques
  • [ISO-abbreviation] Can J Neurol Sci
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Canada
  • [Chemical-registry-number] 9002-72-6 / Growth Hormone
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18. Chibbaro S, Benvenuti L, Carnesecchi S, Faggionato F, Gagliardi R: An interesting case of a pituitary adenoma apoplexy mimicking an acute meningitis. Case report. J Neurosurg Sci; 2007 Jun;51(2):65-9; discussion 68-9
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  • [Title] An interesting case of a pituitary adenoma apoplexy mimicking an acute meningitis. Case report.
  • Apoplexy of a pituitary adenoma is a rare and under-diagnosed clinical occurrence.
  • It results from either infarction or haemorrhage into an adenoma of the pituitary gland.
  • A 33-year-old male suffered a pituitary macroadenoma apoplexy, clinically indistinguishable from an infectious meningitis at presentation.
  • Three days after surgery, the patient developed a left ophthalmoplegia due to 3(rd) nerve palsy, which fully resolved within 2 months.
  • A right pterional craniotomy was performed during which complete tumour removal was achieved.
  • In conclusion the authors believe that, despite many reports in the literature, encouraging conservative management in pituitary apoplexy by administering intravenous steroids, surgery should be undertaken in order to avoid eventual visual field defects, relieve pituitary gland compression and prevent a possible recurrent apoplectic episode or tumor re-growth.
  • [MeSH-major] Adenoma / complications. Meningitis / diagnosis. Pituitary Apoplexy / diagnosis. Pituitary Gland / pathology. Pituitary Neoplasms / complications
  • [MeSH-minor] Acute Disease. Adult. Brain Infarction / complications. Brain Infarction / etiology. Brain Infarction / pathology. Diagnosis, Differential. Headache / etiology. Humans. Hydrocortisone / therapeutic use. Hypopituitarism / drug therapy. Hypopituitarism / etiology. Hypopituitarism / pathology. Magnetic Resonance Imaging. Male. Neck Pain / etiology. Neurosurgical Procedures / methods. Oculomotor Nerve Diseases / etiology. Postoperative Complications / etiology. Tomography, X-Ray Computed. Treatment Outcome. Unconsciousness / etiology. Vomiting / etiology

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  • (PMID = 17571037.001).
  • [ISSN] 0390-5616
  • [Journal-full-title] Journal of neurosurgical sciences
  • [ISO-abbreviation] J Neurosurg Sci
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] WI4X0X7BPJ / Hydrocortisone
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19. 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%.
  • 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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20. Prosch H, Grois N, Bökkerink J, Prayer D, Leuschner I, Minkov M, Gadner H: Central diabetes insipidus: Is it Langerhans cell histiocytosis of the pituitary stalk? A diagnostic pitfall. Pediatr Blood Cancer; 2006 Mar;46(3):363-6
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  • [Title] Central diabetes insipidus: Is it Langerhans cell histiocytosis of the pituitary stalk? A diagnostic pitfall.
  • To avoid a potentially hazardous biopsy of the hypothalamic pituitary region it is recommended to evaluate patients with CDI carefully to identify potential extracranial lesions.
  • We report on a 9(1/2) year old girl who presented with central diabetes insipidus and a thickening of the pituitary stalk on magnetic resonance imaging.
  • Diagnostic workup revealed a history of recurrent ear infections and a compressed 6th thoracic vertebral body on radiographs.
  • Upon growth of the pituitary stalk lesion the patient was treated with LCH standard chemotherapy.
  • After an initial shrinkage of the lesion, a further growth of the pituitary stalk lesion was observed and the tumor was resected.
  • This case underscores the importance of a istopathologically proven diagnosis in patients with HPR tumors before the initiation of a specific therapy, even if the clinical findings are highly suggestive.
  • [MeSH-major] Diabetes Insipidus, Neurogenic / pathology. Germinoma / pathology. Histiocytosis, Langerhans-Cell / pathology. Pituitary Gland / pathology. Pituitary Neoplasms / pathology


21. Freda PU, Chung WK, Matsuoka N, Walsh JE, Kanibir MN, Kleinman G, Wang Y, Bruce JN, Post KD: Analysis of GNAS mutations in 60 growth hormone secreting pituitary tumors: correlation with clinical and pathological characteristics and surgical outcome based on highly sensitive GH and IGF-I criteria for remission. Pituitary; 2007;10(3):275-82
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  • [Title] Analysis of GNAS mutations in 60 growth hormone secreting pituitary tumors: correlation with clinical and pathological characteristics and surgical outcome based on highly sensitive GH and IGF-I criteria for remission.
  • Although the molecular mechanisms underlying GH secreting pituitary tumor formation are not well understood, mutations in the alpha-subunit of the stimulatory G gene, GNAS, have been identified in up to 40%.
  • As these mutations could play a role in tumor growth, we screened 60 GH secreting tumors for GNAS mutations and assessed whether mutation status correlated with their clinical and pathological characteristics.
  • Tumor specimens obtained at surgery were snap frozen.
  • Tumor DNA was extracted, and PCR was used to amplify regions containing 2 sites of recurrent activating somatic mutations in codons 201 and 227 in GNAS.
  • IGF-I normalization rate with somatostatin analog therapy was similar in positive (3 of 6) vs. negative (3 of 7) patients.
  • Presence of a GNAS mutation did not predict a difference in a proliferation marker, surgical remission or response to somatostatin analog therapy.
  • [MeSH-major] GTP-Binding Protein alpha Subunits, Gs / genetics. Growth Hormone-Secreting Pituitary Adenoma / genetics. Growth Hormone-Secreting Pituitary Adenoma / pathology. Human Growth Hormone / blood. Insulin-Like Growth Factor I / metabolism. Mutation / physiology. Pituitary Neoplasms / genetics. Pituitary Neoplasms / pathology
  • [MeSH-minor] Acromegaly / etiology. Adult. Aged. Cell Proliferation / drug effects. Chromogranins. Cohort Studies. Female. Humans. Male. Middle Aged. Remission Induction. Retrospective Studies. Reverse Transcriptase Polymerase Chain Reaction. Treatment Outcome

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  • (PMID = 17594522.001).
  • [ISSN] 1386-341X
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Grant] United States / NIDDK NIH HHS / DK / DK 073040; United States / NIDDK NIH HHS / DK / DK02561; United States / NIDDK NIH HHS / DK / DK064720; United States / NCRR NIH HHS / RR / RR-00645; United States / NIDDK NIH HHS / DK / R01 DK064720; United States / NIDDK NIH HHS / DK / K24 DK073040
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chromogranins; 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I; EC 3.6.1.- / GNAS protein, human; EC 3.6.5.1 / GTP-Binding Protein alpha Subunits, Gs
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22. Eom KS, Kim JM, Kim TY: Mixed germ cell tumors in septum pellucidum after radiochemotherapy of suprasellar germinoma: de novo metachronous or recurrent neoplasms? Childs Nerv Syst; 2008 Nov;24(11):1355-9
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  • [Title] Mixed germ cell tumors in septum pellucidum after radiochemotherapy of suprasellar germinoma: de novo metachronous or recurrent neoplasms?
  • Five years ago, he received five cycles of chemotherapy using cisplatin and ectoposide and 24G of local radiotherapy for clinical diagnosis of suprasellar germinoma in another hospital.
  • The tumor was then completely resolute.
  • Magnetic resonance imaging in our hospital revealed a large fatty mass located primarily in the septum pellucidum and some portions of the corpus callosum; a heterogeneous enhancing tumor was observed in the surrounding area.
  • The second tumor was completely removed.
  • CONCLUSION: This case is characterized by a second GCT occurring at a different site and with a different histological type, long after complete resolution of suprasellar germinoma.
  • [MeSH-minor] Adolescent. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Humans. Immunohistochemistry. Magnetic Resonance Imaging. Male. Neurosurgical Procedures. Pituitary Neoplasms / pathology. Pituitary Neoplasms / therapy. Radiotherapy

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23. Lindsay JR, Harding JA, Ellis PK, Sheridan B, Atkinson AB: Sustained improvement in vision in a recurrent growth hormone secreting macroadenoma during treatment with octreotide in the absence of marked tumour shrinkage. Pituitary; 2003;6(4):209-14
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  • [Title] Sustained improvement in vision in a recurrent growth hormone secreting macroadenoma during treatment with octreotide in the absence of marked tumour shrinkage.
  • Visual improvement following octreotide for growth hormone secreting pituitary macroadenomas is uncommon without tumour shrinkage.
  • Visual assessment revealed a bitemporal hemianopia and CT scan demonstrated a large pituitary tumour with lateral and suprasellar extension.
  • Post-operatively she had anterior pituitary hormone deficiency.
  • As GH and IGF-1 levels remained elevated she underwent external pituitary irradiation.
  • CT scanning demonstrated tumour shrinkage associated with a modest fall in GH levels.
  • An MRI demonstrated a large pituitary adenoma.
  • A decision was made to proceed to surgery in the event of deterioration or lack of improvement after a short trial over 5-7 days.
  • MRI after 1 week showed shrinkage of the tumour by a few millimetres.
  • Five months later repeat MRI failed to show any further improvement in tumour size.
  • However she remains well 29 months from treatment with normal vision and is being monitored carefully as her chosen form of therapy.
  • Somatostatin analogues may be effective as therapy in a selected group of patients with acromegaly and visual loss who are not suitable for pituitary surgery.
  • If used in this way the drug must be given cautiously with frequent detailed ongoing visual assessments.
  • In this present case there has been a restoration of vision but the long-term outlook remains guarded without significant tumor shrinkage.
  • [MeSH-major] Adenoma / physiopathology. Antineoplastic Agents, Hormonal / therapeutic use. Human Growth Hormone / secretion. Octreotide / therapeutic use. Pituitary Neoplasms / physiopathology. Vision, Ocular

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  • (PMID = 15237932.001).
  • [ISSN] 1386-341X
  • [Journal-full-title] Pituitary
  • [ISO-abbreviation] Pituitary
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
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  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 12629-01-5 / Human Growth Hormone; RWM8CCW8GP / Octreotide
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24. 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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  • 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.
  • Somatostatin analogs provide an effective option for medical management of carcinoid patients, especially those with recurrent disease.
  • 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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25. Chaidarun SS, Klibanski A: Gonadotropinomas. Semin Reprod Med; 2002 Nov;20(4):339-48
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  • Advances in immunocytochemistry, electron microscopy, cell culture, and molecular techniques have demonstrated that 80 to 90% of the clinically nonfunctioning pituitary adenomas are gonadotrope-derived and recently recognized as gonadotropinomas, which account for as many as 40 to 50% of all pituitary macroadenomas.
  • Commonly, the tumor is found incidentally.
  • The tumors can be divided into two broad categories: functioning gonadotropinomas with positive immunostaining for follicle-stimulating hormone, leutinizing hormone, and/or their subunits; and nonfunctioning gonadotropinomas or null cell tumors with negative immunostaining for all pituitary hormones but positive nuclear immunostaining for steroid factor-1 or DAX-1 characteristic of gonadotrope differentiation, with evidence of gonadotropin production or gene expression at the mRNA level.
  • A new pituitary oncogene, pituitary tumor transforming gene, has recently been found to be overexpressed in about two thirds of these tumors but it is also detected in all other pituitary tumor subtypes.
  • Alterations of tumor hormone receptors and local growth factors may also play a role in the tumor development and/or progression.
  • Transphenoidal surgery remains the principal therapy for the macroadenomas.
  • Radiosurgery using gamma knife, the linear accelerator, or proton beam therapy showed promising results, especially for controlling the residual or recurrent tumors.
  • Medical therapy with somatostatin analogs, dopamine agonists, and gonadotropin-releasing hormone agonists and antagonists are rarely effective in reducing tumor size.
  • Experimental therapy with intraoperative local chemotherapy or potential gene therapy requires further investigation.
  • [MeSH-major] Adenoma / diagnosis. Adenoma / etiology. Gonadotropins, Pituitary / metabolism. Pituitary Neoplasms / diagnosis. Pituitary Neoplasms / etiology

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  • (PMID = 12536357.001).
  • [ISSN] 1526-8004
  • [Journal-full-title] Seminars in reproductive medicine
  • [ISO-abbreviation] Semin. Reprod. Med.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Gonadotropins, Pituitary
  • [Number-of-references] 88
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26. Yaman E, Benekli M, Coskun U, Sezer K, Ozturk B, Kaya AO, Yildiz R, Uluoglu O, Buyukberber S: Intrasellar plasmacytoma: an unusual presentation of multiple myeloma. Acta Neurochir (Wien); 2008 Sep;150(9):921-4; discussion 924
MedlinePlus Health Information. consumer health - Pituitary Tumors.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • DISCUSSION: A 70-year-old woman presented with a recurrent hypophysial mass.
  • Initial diagnosis of a nonfunctioning pituitary adenoma was later overruled by a repeat biopsy, which showed a plasmacytoma.
  • The tumor stained positively for CD138 and kappa light chain.
  • The patient was successfully treated with radiotherapy followed by systemic chemotherapy.
  • Because they have different therapeutic implications, extramedullary plasmacytomas involving pituitary gland should be considered in the differential diagnosis of a nonfunctioning pituitary mass.
  • [MeSH-major] Multiple Myeloma / complications. Multiple Myeloma / diagnosis. Pituitary Neoplasms / diagnosis. Pituitary Neoplasms / etiology. Plasmacytoma / diagnosis. Plasmacytoma / etiology

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  • (PMID = 18726062.001).
  • [ISSN] 0942-0940
  • [Journal-full-title] Acta neurochirurgica
  • [ISO-abbreviation] Acta Neurochir (Wien)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Austria
  • [Chemical-registry-number] 0 / Immunoglobulin kappa-Chains; 0 / Syndecan-1
  • [Number-of-references] 24
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27. Negoro K, Kawai M, Tada Y, Ogasawara J, Misumi S, Morimatsu M: A case of postprandial cluster-like headache with prolactinoma: dramatic response to cabergoline. Headache; 2005 May;45(5):604-6
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  • A 17-year-old boy without a significant past medical history presented with recurrent cluster-like headaches induced by meals for 3 years.
  • Magnetic resonance images showed a pituitary tumor.
  • Just after starting treatment with cabergoline, the headaches resolved completely and the patient has been absolutely free from such headache attacks for 2 years.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Cluster Headache / etiology. Ergolines / therapeutic use. Pituitary Neoplasms / drug therapy. Prolactinoma / drug therapy
  • [MeSH-minor] Adolescent. Eating. Humans. Male. Recurrence. Treatment Outcome

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  • (PMID = 15953282.001).
  • [ISSN] 0017-8748
  • [Journal-full-title] Headache
  • [ISO-abbreviation] Headache
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Ergolines; LL60K9J05T / cabergoline
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28. Bauditz J, Lochs H, Ventz M: [Long-term follow-up of patients with suprasellar germinomas]. Med Klin (Munich); 2007 Oct 15;102(10):803-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Transliterated title] Langzeitverlauf bei Patienten mit suprasellären Germinomen.
  • PATIENTS AND METHODS: The clinical, hormonal and morphological findings as well as treatment and complications were investigated in seven patients (six male, one female) with germinomas.
  • All patients were treated by transcranial radiation with a dose of 40-54 Gy.
  • One patient received additional chemotherapy with cisplatin, etoposide, and ifosfamide (PEI).
  • Panhypopituitarism and diabetes insipidus were seen in all patients after treatment.
  • One patient developed epilepsy and persistent cognitive impairment.
  • Long-term follow-up shows that two patients died from recurrent disease and decompensated liver cirrhosis, respectively.
  • CONCLUSION: Suprasellar germinomas cause endocrine symptoms during early tumor stages, however, diagnosis is generally established when ocular symptoms related to tumor compression are already present.
  • [MeSH-major] Germinoma / diagnosis. Pituitary Neoplasms / diagnosis
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Combined Modality Therapy. Diabetes Insipidus / etiology. Disease Progression. Etoposide / administration & dosage. Female. Follow-Up Studies. Humans. Hypopituitarism / etiology. Ifosfamide / administration & dosage. Male. Neoplasm Recurrence, Local / etiology. Paraneoplastic Endocrine Syndromes / diagnosis. Paraneoplastic Endocrine Syndromes / drug therapy. Paraneoplastic Endocrine Syndromes / mortality. Paraneoplastic Endocrine Syndromes / radiotherapy. Pituitary Irradiation. Survival Rate

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  • (PMID = 17928963.001).
  • [ISSN] 0723-5003
  • [Journal-full-title] Medizinische Klinik (Munich, Germany : 1983)
  • [ISO-abbreviation] Med. Klin. (Munich)
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide; ICE protocol 1
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29. Paulino AC, Simon JH, Zhen W, Wen BC: Long-term effects in children treated with radiotherapy for head and neck rhabdomyosarcoma. Int J Radiat Oncol Biol Phys; 2000 Dec 1;48(5):1489-95
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PURPOSE: To examine the long-term effects of treatment in children receiving radiotherapy for head and neck rhabdomyosarcoma.
  • There were 11 males and 6 females, with a median age of 5.7 years (range 2.2-11.6) at the time of radiotherapy.
  • Tumor location was orbit in 6 patients, infratemporal fossa in 4, paranasal sinuses in 2, and supraglottic larynx in 2; the nasopharynx, pterygopalatine fossa, and parotid gland were sites for the remaining children.
  • The Intergroup Rhabdomyosarcoma Study (IRS) Group was I in 2, II in 3, and III in 11 children; 1 patient had a recurrent tumor after surgery alone.
  • Radiotherapy volume was the primary tumor or tumor bed in 13, tumor and whole brain in 3, and tumor and craniospinal axis in 1.
  • All but 1 were treated with 150-200-cGy fractions; 1 patient received 250-cGy fractions for a tumor in the larynx.
  • Chemotherapy was vincristine (V), actinomycin-D (A), and cyclophosphamide (C) in 10 patients, VAC + adriamycin in 2, VA in 1, VA + ifosfamide in 1, VC + adriamycin in 1, and none in 2.
  • One patient had salvage chemotherapy consisting of cisplatin and etoposide.
  • Median follow-up time was 20 years (range 7.5-33).
  • RESULTS: Late effects of treatment were seen in all patients and included facial growth retardation in 11, neuroendocrine dysfunction in 9, visual/orbital problems in 9, dental abnormalities in 7, hearing loss in 6, and hypothyroidism in 3.
  • While neuroendocrine, thyroid, dental, and cognitive sequelae were primarily attributed to radiotherapy, hearing loss was thought to be a direct result of tumor destruction and, in 1 case, cisplatin chemotherapy.
  • CONCLUSION: Late effects of treatment in children receiving radiotherapy for head and neck rhabdomyosarcoma are frequent.
  • Late toxicity of treatment beyond 10 years is not as frequent as those occurring within 10 years of therapy.
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Child, Preschool. Cochlea / drug effects. Cochlea / radiation effects. Cognition / radiation effects. Combined Modality Therapy. Cranial Irradiation / adverse effects. Dentition. Educational Status. Facial Asymmetry / etiology. Female. Follow-Up Studies. Growth / radiation effects. Growth Hormone / deficiency. Growth Hormone / radiation effects. Humans. Hypothalamus / radiation effects. Male. Orbital Neoplasms / radiotherapy. Pituitary Gland / radiation effects. Radiotherapy Dosage. Time Factors. Vision Disorders / etiology

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  • (PMID = 11121653.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 9002-72-6 / Growth Hormone
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30. Zheng X, Liu W, Yang X, Gong J, Shen F, Shen G, Shen H, Zheng X, Fu W: Endoscope-assisted supraorbital keyhole approach for the resection of benign tumors of the sellar region. Minim Invasive Ther Allied Technol; 2007;16(6):363-6
MedlinePlus Health Information. consumer health - Pituitary Tumors.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The objective of the study was to evaluate the effectiveness of the supraorbital "keyhole" approach with endoscope assistance in surgical treatment of benign tumors around the sellar region.
  • Thirty-five patients, including 19 pituitary tumors, 11 craniopharyngiomas and five tuberculum sellae meningiomas, were enrolled in this study.
  • There was no patient with evidence of residual or recurrent tumor during the follow-up period.
  • Though some patients suffered from insipidus, hyperprolactinemia, subcutaneous edema or other postoperative complications, they eventually recovered with or without drug administration.
  • The supraorbital "keyhole" approach with endoscopic assistance in the surgical treatment of benign tumors around the sellar region is an ideal pattern.
  • [MeSH-major] Endoscopy. Neoplasms / surgery. Pituitary Neoplasms / surgery. Treatment Outcome

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  • (PMID = 17852733.001).
  • [ISSN] 1364-5706
  • [Journal-full-title] Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy
  • [ISO-abbreviation] Minim Invasive Ther Allied Technol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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31. Cole LA, Khanlian SA, Giddings A, Butler SA, Muller CY, Hammond C, Kohorn E: Gestational trophoblastic diseases: 4. Presentation with persistent low positive human chorionic gonadotropin test results. Gynecol Oncol; 2006 Aug;102(2):165-72
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • OBJECTIVES: A high proportion of women with persistent low levels of hCG, in the absence of pregnancy or any evidence of tumor, have received chemotherapy and hysterectomy for assumed malignancy.
  • Such chemotherapy and surgery were ineffective and unwarranted.
  • This study identifies the causes of persistent low level of hCG and provides guidelines for the management of these patients, preventing unnecessary treatment in the future.
  • Thirteen (7.6%) of the 170 patients had true malignancy, 5 had placental site trophoblastic tumor, 3 had other gestational trophoblastic neoplasms (GTN), and 5 had non-trophoblastic malignancies.
  • The remaining 157 patients had false-positive hCG, quiescent gestational trophoblastic disease (quiescent GTD), or pituitary hCG (hCG of pituitary origin).
  • Of 71 patients with false-positive hCG, 47 patients received chemotherapy and 9 had surgery that had no effect on the level of hCG.
  • Of 69 patients who had quiescent GTD, 41 received chemotherapy and 9 underwent hysterectomy.
  • All these therapies were unnecessary and ineffective.
  • While 21 patients with quiescent GTD followed incidental pregnancy tests, the majority were discovered while monitoring patients after treatment for hydatidiform mole or GTN/choriocarcinoma (n = 48).
  • Seventeen cases of pituitary hCG were found among those women who were peri- or post-menopause.
  • Two patients also received chemotherapy for assumed malignancy which was not present.
  • CONCLUSION: Clinicians frequently assume that an elevated hCG implies that a patient is pregnant or has GTD or recurrent GTN, even when apart from the pregnancy test, no clinical evidence was found to support such a diagnosis.
  • In most of these cases of persistent low hCG etiologies, all therapies were found unnecessary and ineffective.
  • It is essential to demonstrate a malignancy clinically and with readily available biochemical tests before initiating therapy.
  • [MeSH-minor] Adult. Aged. Choriocarcinoma / blood. Choriocarcinoma / diagnosis. Choriocarcinoma / therapy. False Positive Reactions. Female. Humans. Middle Aged. Pregnancy

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  • (PMID = 16631243.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin; 0 / glycosylated HCG
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32. Khanlian SA, Cole LA: Management of gestational trophoblastic disease and other cases with low serum levels of human chorionic gonadotropin. J Reprod Med; 2006 Oct;51(10):812-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Recent publications show that the measurements of particular human chorionic gonadotropin (hCG) variants are extremely beneficial in the diagnosis, monitoring and treatment of gestational trophoblastic disease (GTD).
  • Here we review the possible sources of hCG and the use of commercial tests in the optimal management of GTD, quiescent GTD,false positive hCG results, placental site trophoblastic tumor (PSTT) detection, nontrophoblastic neoplasms and pituitary hCG.
  • Hyperglycosylated hCG (hCG-H) measurements are ideal for discriminating active (invasive) from inactive (quiescent or benign) disease. hCG-H testing is also more sensitive than regular hCG in detecting recurrent or persistent disease.
  • After excluding false positive hCG results, and in the absence of any radiographic evidence of tumor, hCG-H should be measured before starting chemotherapy or surgery in women presenting with low hCG (<1,000 mIU/mL) with or without a history of GTD.
  • The hCG free beta assay is an invaluable test in discriminating PSTT from other GTDs, thereby aiding the determination of appropriate treatment options.

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  • (PMID = 17086809.001).
  • [ISSN] 0024-7758
  • [Journal-full-title] The Journal of reproductive medicine
  • [ISO-abbreviation] J Reprod Med
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin
  • [Number-of-references] 44
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33. Lafay-Cousin L, Bartels U, Raybaud C, Kulkarni AV, Guger S, Huang A, Bouffet E: Neuroradiological findings of bleomycin leakage in cystic craniopharyngioma. Report of three cases. J Neurosurg; 2007 Oct;107(4 Suppl):318-23
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  • Intracystic bleomycin therapy has been proposed as a treatment for predominantly cystic craniopharyngioma.
  • The risks of using this therapy, however, have not been clearly identified.
  • The authors report on three children treated with intracystic bleomycin who developed initially mild symptoms during their course of therapy.
  • They describe the neuroimaging findings from computed tomography (CT) scans and magnetic resonance (MR) images and the medical management of these three cases.
  • Two patients in whom craniopharyngioma was recently diagnosed and one patient with recurrent craniopharyngioma were treated with a course of 3 mg of intracystic bleomycin three times a week for 5 weeks, followed by once every week for 10 weeks.
  • All patients had a negative reservoir permeability test prior to beginning intracystic bleomycin therapy.
  • Patients were asymptomatic or had mild symptoms at the time of neuroimaging.
  • The edema occurred near the time of the 12th injection in two patients, and at the end of treatment in the remaining patient.
  • Subsequently, two patients developed further symptoms suggestive of hypothalamic injury.
  • Bleomycin therapy requires close clinical monitoring.
  • Imaging evaluation should be performed using MR imaging during treatment to ensure the safety of the therapy.
  • [MeSH-major] Antibiotics, Antineoplastic / adverse effects. Bleomycin / adverse effects. Brain Edema / chemically induced. Craniopharyngioma / drug therapy. Cysts / drug therapy. Pituitary Neoplasms / drug therapy
  • [MeSH-minor] Adrenal Cortex Hormones / therapeutic use. Child. Child, Preschool. Female. Humans. Injections, Intralesional. Magnetic Resonance Imaging. Male. Tomography, X-Ray Computed

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  • (PMID = 17941498.001).
  • [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] 0 / Adrenal Cortex Hormones; 0 / Antibiotics, Antineoplastic; 11056-06-7 / Bleomycin
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34. Nieman LK, Ilias I: Evaluation and treatment of Cushing's syndrome. Am J Med; 2005 Dec;118(12):1340-6
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  • [Title] Evaluation and treatment of Cushing's syndrome.
  • Cushing's syndrome results from sustained pathologic hypercortisolism caused by excessive corticotropin (ACTH) secretion by tumors in the pituitary gland (Cushing's disease, 70%) or elsewhere (15%), or by ACTH-independent cortisol secretion from adrenal tumors (15%).
  • In ACTH-dependent patients, bilateral inferior petrosal sinus sampling with measurement of ACTH before and after administration of ACTH-releasing hormone most accurately distinguishes pituitary from ectopic ACTH secretion.
  • Surgical resection of tumor is the optimal treatment for all forms of Cushing's syndrome; bilateral adrenalectomy, medical treatment, or radiotherapy are sought in inoperable or recurrent cases.
  • The medical treatment of choice is ketoconazole.
  • [MeSH-major] Adrenocorticotropic Hormone / blood. Cushing Syndrome / diagnosis. Cushing Syndrome / drug therapy
  • [MeSH-minor] Adrenalectomy. Adult. Antifungal Agents / therapeutic use. Child. Diagnosis, Differential. Humans. Ketoconazole / therapeutic use. Prognosis. Recurrence. Survival Analysis

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  • (PMID = 16378774.001).
  • [ISSN] 1555-7162
  • [Journal-full-title] The American journal of medicine
  • [ISO-abbreviation] Am. J. Med.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antifungal Agents; 9002-60-2 / Adrenocorticotropic Hormone; R9400W927I / Ketoconazole
  • [Number-of-references] 100
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35. Binder G, Weber S, Ehrismann M, Zaiser N, Meisner C, Ranke MB, Maier L, Wudy SA, Hartmann MF, Heinrich U, Bettendorf M, Doerr HG, Pfaeffle RW, Keller E, South German Working Group for Pediatric Endocrinology: Effects of dehydroepiandrosterone therapy on pubic hair growth and psychological well-being in adolescent girls and young women with central adrenal insufficiency: a double-blind, randomized, placebo-controlled phase III trial. J Clin Endocrinol Metab; 2009 Apr;94(4):1182-90
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Effects of dehydroepiandrosterone therapy on pubic hair growth and psychological well-being in adolescent girls and young women with central adrenal insufficiency: a double-blind, randomized, placebo-controlled phase III trial.
  • CONTEXT AND OBJECTIVE: The efficacy of oral dehydroepiandrosterone (DHEA) in the treatment of atrichia pubis and psychological distress in young females with central adrenal insufficiency is unknown.
  • Our study aimed to evaluate this therapy.
  • Inclusion criteria were ACTH deficiency plus two or more additional pituitary deficiencies, serum DHEA less than 400 ng/ml, and pubertal stage more than B2.
  • Exclusion criteria were cerebral radiation with more than 30 Gy, tumor remission less than 1 yr, amaurosis, hypothalamic obesity, psychiatric disorders, and unstable hormone medication.
  • INTERVENTION: Patients were randomized to placebo (n = 12) or 25 mg HPLC-purified DHEA/d (n = 11) orally for 12 months after stratification into a nontumor (n = 7) and a tumor group (n = 16).
  • RESULTS: In the placebo group, four patients dropped out because of recurrence of craniopharyngioma, manifestation of type 1 diabetes, and change of residence (n = 2); in the DHEA group, one patient dropped out because of recurrent anxiety attacks.
  • DHEA substitution resulted in normalization of DHEA sulfate and androstanediol glucuronide morning serum levels 2 h after drug intake (P < 0.006), and of its 24 h urinary metabolite levels (P < 0.0001), placebo had no effect.
  • [MeSH-major] Adrenal Insufficiency / drug therapy. Adrenocorticotropic Hormone / deficiency. Dehydroepiandrosterone / therapeutic use. Hair / growth & development. Hypopituitarism / drug therapy
  • [MeSH-minor] Adolescent. Adult. Blood Pressure / drug effects. Blood Pressure / physiology. Brain Neoplasms / epidemiology. Double-Blind Method. Female. Humans. Hydrocortisone / therapeutic use. Obesity / epidemiology. Young Adult

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  • (PMID = 19126625.001).
  • [ISSN] 1945-7197
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase III; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 459AG36T1B / Dehydroepiandrosterone; 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone
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36. Bombardieri E, Seregni E, Villano C, Aliberti G, Mattavelli F: Recombinant human thyrotropin (rhTSH) in the follow-up and treatment of patients with thyroid cancer. Tumori; 2003 Sep-Oct;89(5):533-6
Hazardous Substances Data Bank. THYROGLOBULIN .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Recombinant human thyrotropin (rhTSH) in the follow-up and treatment of patients with thyroid cancer.
  • The follow-up of thyroid cancer is based on the detection of residual and recurrent thyroid carcinoma.
  • Tg serum levels and the uptake of 131I on a whole body scan (WBS) depend on TSH stimulation, which in thyroidectomized patients can be obtained either by withdrawal of thyroid hormone treatment (thyroxine) or by administration of exogenous TSH.
  • At a recent International Consensus Conference on the follow-up of differentiated thyroid carcinoma it was proposed to carry out only Tg measurement after rhTSH stimulation; moreover, it was stated that 131I whole body scan has to be discouraged in patients submitted to radical surgery and radioiodine ablation with no clinical evidence of residual tumor and with undetectable levels of Tg during hormonal suppression of TSH.
  • However, the availability of rhTSH will definitely change the management of papillary and follicular thyroid carcinoma, also with regard to iodine treatment.
  • In fact, rhTSH can be used during radioiodine treatment to enhance the 131I uptake by the cancer cells in particular groups of patients.
  • 1) patients in whom thyroxine withdrawal may be dangerous because of the effects of long-term TSH stimulation on the tumor mass (brain metastases, vertebral metastases, presence of neurological signs, heart diseases);.
  • 3) patients with hypothalamic-pituitary alterations.
  • The potential efficiency of rhTSH in radiometabolic treatment is an important issue that has been studied in a limited number of patients, but is worthy of further investigations in large perspective.
  • [MeSH-major] Thyroid Neoplasms / blood. Thyroid Neoplasms / drug therapy. Thyrotropin / blood. Thyrotropin / therapeutic use
  • [MeSH-minor] Humans. Recombinant Proteins / therapeutic use. Thyroglobulin / blood

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  • (PMID = 14870779.001).
  • [ISSN] 0300-8916
  • [Journal-full-title] Tumori
  • [ISO-abbreviation] Tumori
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Recombinant Proteins; 9002-71-5 / Thyrotropin; 9010-34-8 / Thyroglobulin
  • [Number-of-references] 32
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