ECE2017 Eposter Presentations: Pituitary and Neuroendocrinology Pituitary - Clinical (145 abstracts)
Aggressive pituitary tumors: a tertiary center experience
Adriana Lages 1 , Isabel Paiva 1 , Leonor Gomes 1, , Patrícia Oliveira 1 , Francisco Belo 1 , Diana Oliveira 1 , Diana Martins 1 , Mara Ventura 1 , Nelson Cunha 1 & Francisco Carrilho 1
1Coimbra Hospital and University Center, Coimbra, Portugal; 2Faculty of Medicine University of Coimbra, Coimbra, Portugal.
Background: Pituitary adenomas (PA) are common intracranial tumors that are mainly considered benign. A small group of patients exhibit clinically aggressive behavior sometimes unrelated to the histopathological or radiological features.
Methods: Twelve patients were selected harboring a PA with clinical features of aggressiveness. All the patients underwent pre and postoperative endocrinologic/neuroradiologic evaluation.
Results: 10/12 patients were male, mean age at diagnosis 38.1 years (range 12–58) and mean follow-up 14.3 years (range 5–28; died 3/12). In 9/12 cases, the first manifestation was visual impairment (visual field loss, reduction in visual acuity and/or cranial nerve palsies). All the patients had invasive pituitary macroadenomas with expansion into surrounding anatomical structures (11 cavernous sinus; 7 sphenoid sinus; 7 bone invasion). The 12 patients underwent a total of 52 surgical procedures (median 4; range 3–6). Apparently total removal was achieved in 8/12 patients at the first surgical procedure. Regarding histological subtype: 5 gonadotrophinomas; 2 null-cell adenomas; 2 corticotrophinomas; 1 thyrotrophinoma; 1 prolactinoma and 1 plurihormonal adenoma (GH/ACTH). Proliferation markers as ki67 >3% was identified in 4; >2mitoses/10 HPF in 3 and p53 IHC expression in 4/12 cases. Six patients underwent radiation therapy (RT) postoperatively (5 conventional external RT; 1 stereotactic radiosurgery). Medical therapy was tried in 4/12 patients: 3 with dopamine agonists; 1 with somatostatin analog (pasireotide); 2 with steroidogenesis inhibitors (ketoconazole and metyrapone). Possible metastatic pulmonary disease was identified only in one case; the patient died of tumor progression 10-years after the diagnosis.
Conclusion: Aggressive pituitary tumors constitute a challenging but not completely defined entity. We found an elevated number of surgical procedures by patient and smaller proportion of RT/medical treated patients compared with literature, however, with similar outcomes. Adverse results in treatment are possibly related to difficulty in early detection of this patients’ subgroup that must be treated with a multimodal approach.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more