Endocrine Abstracts

Background: Pituitary adenomas (PAs)/Pituitary Neuroendocrine Tumors (PitNETs) are a complex and heterogeneous group of lesions. Genetic and epigenetic studies have been performed to identify predictors of treatment outcome.Study aim: To profile clinically non-aggressive (NA) and aggressive (A) PAs/PitNETs, and carcinomas for somatic mutations and epigenetic alterations of genes involved in cell proliferation/differentiation, miRNA/lncRNA-post-transcript...

Background: Endoscopic surgery (ES) performed in Pituitary Centers of Excellence (PCOE) represents the gold standard treatment for GH-secreting adenomas. However, rate of cure greatly varies according to definition criteria, follow-up duration, various patient and adenoma features, and surgeon ability.Study aim: To assess short- (3 month) and long-term (≥1 year) outcome and identify predictors of ES, in a large and homogeneous cohort of acromegaly ...

Pituitary apoplexy (PA) is a rare clinical syndrome due to sudden haemorrhage and/or infarction of the pituitary gland, usually within a pre-existent pituitary tumour. Even though some sporadic cases of PA associated with rare sellar lesions (such as Rathke cleft cysts) have been reported, in the vast majority of cases the syndrome occurs within a pituitary adenoma. At presentation, patients with PA usually complain of sudden and severe headache, often associated with visual l...

Introduction: The management of craniopharyngioma (CR) remains a challenge. The introduction of endoscopic technique in the surgical approach to the sellar/suprasellar region would have profound implications for treatment. The aim of the study was to analyze results, advantages and limits of endoscopic endonasal approach (EEA).Design/methods: From 1998 to 2012, 95 patients underwent surgery for CR. Trancranial approach was chosen for 33 patients (35%) on...

Over the last decade 824 pituitary tumours have been removed in our centre. Of these, 114 (13.8%) were corticotroph adenomas. We present four unusual cases of corticotroph adenoma showing transition from Cushing’s disease to a hormonally inactive adenoma (case 1 and 2) or vice versa (case 3 and 4).Case 1: A 51-year-old man was admitted with a 2-year history of weight gain, arterial hypertension and chiasmatic syndrome. Cushing’s disease (CD) du...

The main aims of treatment of acromegaly are reversing symptoms and signs, removing the tumour, preventing disease recurrence, and improving survival. Increased mortality associated with acromegaly can be diminished if treatment is successful in reducing GH <2–2.5 ng/ml. We carried out a prospective study to assess whether recent advances in surgical technique (namely the endoscopic approach in a specialised centre encompassing specialist pituitary surgeons working in...

Pituitary adenomas constitute the third most common intracranial neoplasm. Adenoma cells either express no hormone (null cell adenoma) or hormones of different cell lineage. About 1% of pituitary adenomas shows a plurihormonal expression pattern, which may either be attributed to one cell lineage or rarely to different cell lineages. In addition, the development of separate pituitary adenomas may be observed in 0.5–1.5% of surgical specimens and in up to 10% of autopsy ca...

Rationale and aim: The incidence of intracranial aneurysms (IA) appears increased in patients with PAs/PitNETs. Changes in hemodynamics and vascular structure secondary to mass effect, inflammation, and hormonal changes (primarily, GH hypersecretion) have been suggested as risk factors. Study aim was to define typical features, timing of occurrence and treatment, and identify risk factors in patients with PA/PitNET and IA.Patients and methods: Data of 57...

Introduction: The possible change in the pattern of hormonal secretion by pituitary tumours is a very intriguing issue indeed, notably in the case of corticotroph-cell adenomas.Methods/design: We retrospectively reviewed the records of 1259 consecutive endoscopic endonasal surgical procedures for pituitary adenomas from 1998 to 2013. Of these, 132 were ACTH-secreting adenomas associated with Cushing’s disease (CD) and 44 were silent corticotroph-cel...

Background: In vitro and animal experiments have clearly demonstrated that excessive cortisol, GH and prolactin secretion, as well as dopamine agonists (D2As) and somatostatin analogs (SSAs), often prescribed for their treatment, affect the immune response and the onset/evolution of autoimmune diseases (AIDs) through direct and indirect complex mechanisms. Data from clinical studies are very scanty.Study aim: To assess the 1) distribution of AIDs accordi...