Endocrine Abstracts

Empty Sella (ES) represents a heterogeneous syndrome, with a completely unknown pathogenesis. Defects in the organogenesis or hypoplasia of the sellar diaphragm (associated with stable or intermittent variation of intracranial pressure and/or with pituitary volume variation) can facile the herniation of the arachnoid space into pituitary fossa and the consequently pituitary compression. ES can be the sequel of necrosis of pituitary adenomas, of hypophysitis or of brain/head tr...

Introduction: Pregnancy results in a significant change in pituitary gland size and function.Due to this physiological adaptation, management of pituitary adenomas during pregnancy represents a particularly complex challenge. Aim of this study was to focus on a single referral institution experience with special attention to this subgroup of patients: pregnant woman affected by pituitary adenoma.Materials and methods: This is a des...

Introduction: Pasireotide long acting release (LAR) is approved for second line treatment of acromegaly. We present 3 patients with aggressive acromegaly treated with a personalized de-escalation approach.Case 1: A 61-year-old female affected by acromegaly reisistant on first-line SSAs. In 2015 therapy was switched to pasireotide LAR 60 mg every 28 days. After two years, the IGF-I level touched the lower age range and therapy was downscaled to pasireotid...

Background: Cushing’s disease, the most common cause of endogenous Cushing’s syndrome, is caused by a pituitary tumor secreting adrenocorticotropic hormone (ACTH). Careful selection of treatment and management of the disease and associated comorbidities are necessary to improve prognosis.Case Presentation: A 32-year-old patient came to our observation for appearance of weight gain with abdominal obesity, hirsutism and amenorrhea. On suspicion o...

Introduction: Non functioning pituitary adenomas (NFPAs) are the most common type of pituitary tumors and are often invasive, resulting in high relapse rates. The post-surgical treatment for NFPAs remains a debated issue and include radiation therapy and additional surgery. Several clinical studies have demonstrated that dopaminergic and somatostatin receptors (SSTRs) are widely expressed in NFPAs. Furthermore, recent studies have shown the potential effectiveness of somatosta...

Teratomas comprise 0.5% of all intracranial tumors. 15 cases of sellar teratoma have been described in the last 24 years (yrs). A 29-yrs female pan-hypopituitaric patient (pt) was admitted to our Pituitary Unit. At 6-yrs age, for polyuria and growth delay, an endocrine evaluation revealed diabetes insipidus and hypopituitarism. Cranial contrasted-MRI (cc-MRI) showed pituitary stalk thickening and a low intensity suprasellar lesion. Histological examination (HE) was suggestive ...

Endocan has been reported as specific of endothelial tumor cells and was shown to be expressed by tip cells during angiogenesis process.The principal aims of the study are the assessment of immunohistochemical VEGF and Endocan expression in functioning and non functioning pNETs and the comparison of these markers with clinical features, Ki67 and TNM staging.We collected a total number of 79 pNETs surgical specimens for immunohistoc...

Acromegalic osteopathy is an emerging complication of chronic GH excess characterized by increase in bone turnover, deterioration in bone microarchitecture and high risk of vertebral fractures (VFs). Medical therapies may exert direct effects on peripheral targets leading to improvement of clinical outcomes regardless of biochemical control of acromegaly. In this longitudinal study, we compared the effects pegvisomant (PegV) and somatostatin receptor ligands (SRLs) on VF risk ...

Pasireotide, a multireceptor-targeted somatostatin analogue, was approved for the treatment of acromegaly, after being studied in two large, randomised, multi-center clinical trials. We reported the history of a 76 years old man affected by acromegaly, treated with Pasireotide long acting release (LAR) as first line therapy. Acromegaly was diagnosed in 2009, as the result of endocrinological investigation suggested by altered facial appearance and macroglossia. Hormonal assays...

Introduction: In 2004, the WHO defined atypical pituitary adenomas (APAs) those with Ki-67 >3%, excessive p53 expression and increased mitotic activity. The usefulness of this classification is still controversial.Aim: To compare the clinical and prognostic features in a series of typical and atypical pituitary adenomas.Materials and methods: We retrospectively reviewed 343 consecutive PAs. APAs represented 18.7% of the cases. ...