1
|
Satou M, Wang J, Nakano-Tateno T, Teramachi M, Aoki S, Sugimoto H, Chik C, Tateno T. Autophagy inhibition suppresses hormone production and cell growth in pituitary tumor cells: A potential approach to pituitary tumors. Mol Cell Endocrinol 2024; 586:112196. [PMID: 38462123 DOI: 10.1016/j.mce.2024.112196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/12/2024]
Abstract
Pituitary tumors (PTs) represent about 10% of all intracranial tumors, and most are benign. However, some PTs exhibit continued growth despite multimodal therapies. Although temozolomide (TMZ), an alkylating chemotherapeutic agent, is a first-line medical treatment for aggressive PTs, some PTs are resistant to TMZ. Existing literature indicated the involvement of autophagy in cell growth in several types of tumors, including PTs, and autophagy inhibitors have anti-tumor effects. In this study, the expression of several autophagy-inducible genes, including Atg3, Beclin1, Map1lc3A, Map1lc3b, Ulk1, Wipi2, and Tfe3 in two PT cell lines, the mouse corticotroph AtT-20 cells and the rat mammosomatotroph GH4 cells were identified. Down regulation of Tfe3, a master switch of basal autophagy, using RNA interference, suppressed cell proliferation in AtT-20 cells, suggesting basal autophagy contributes to the maintenance of cellular functions in PT cells. Expectedly, treatment with bafilomycin A1, an autophagy inhibitor, suppressed cell proliferation, increased the cleavage of PARP1, and reduced ACTH production in AtT-20 cells. Treatment with two additional autophagy inhibitors, chloroquine (CQ) and monensin, demonstrated similar effects on cell proliferation, apoptosis, and ACTH production in AtT-20 cells. Also, treatment with CQ suppressed cell proliferation and growth hormone production in GH4 cells. Moreover, the combination of CQ and TMZ had an additive effect on the inhibition of cell proliferation in AtT-20 and GH4 cells. The additive effect of anti-cancer drugs such as CQ alone or in combination with TMZ may represent a novel therapeutic approach for PTs, in particular tumors with resistance to TMZ.
Collapse
Affiliation(s)
- Motoyasu Satou
- Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Biochemistry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Jason Wang
- Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Tae Nakano-Tateno
- Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Mariko Teramachi
- Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Shigeki Aoki
- Laboratory of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Chiba University, Chiba, Japan
| | - Hiroyuki Sugimoto
- Department of Biochemistry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Constance Chik
- Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Toru Tateno
- Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
| |
Collapse
|
2
|
Findlay MC, Drexler R, Azab M, Karbe A, Rotermund R, Ricklefs FL, Flitsch J, Smith TR, Kilgallon JL, Honegger J, Nasi-Kordhishti I, Gardner PA, Gersey ZC, Abdallah HM, Jane JA, Marino AC, Knappe UJ, Uksul N, Rzaev JA, Bervitskiy AV, Schroeder HWS, Eördögh M, Losa M, Mortini P, Gerlach R, Antunes ACM, Couldwell WT, Budohoski KP, Rennert RC, Karsy M. Crooke Cell Adenoma Confers Poorer Endocrinological Outcomes Compared with Corticotroph Adenoma: Results of a Multicenter, International Analysis. World Neurosurg 2023; 180:e376-e391. [PMID: 37757948 DOI: 10.1016/j.wneu.2023.09.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/16/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Crooke cell adenomas (CCAs) are a rare, aggressive subset of secretory pituitary corticotroph adenomas (sCTAs) found in 5%-10% of patients with Cushing disease. Multiple studies support worse outcomes in CCAs but are limited by small sample size and single-institution databases. We compared outcomes in CCA and sCTA using a multicenter, international retrospective database of high-volume skull base centers. METHODS Patients surgically treated for pituitary adenoma from January 2017 through December 2020 were included. RESULTS Among 2826 patients from 12 international centers, 20 patients with CCA and 480 patients with sCTA were identified. No difference in baseline demographics, tumor characteristics, or postoperative complications was seen. Microsurgical approaches (60% CCA vs. 62.3% sCTA) were most common. Gross total resection was higher in CCA patients (100% vs. 83%, P = 0.05). Among patients with gross total resection according to intraoperative findings, fewer CCA patients had postoperative hormone normalization of pituitary function (50% vs. 77.8%, P < 0.01) and remission of hypersecretion by 3-6 months (75% vs. 84.3%, P < 0.01). This was the case despite CCA having better local control rates (100% vs. 96%, P < 0.01) and fewer patients with remnant on magnetic resonance imaging (0% vs. 7.2%, P < 0.01). A systematic literature review of 35 studies reporting on various treatment strategies reiterated the high rate of residual tumor, persistent hypercortisolism, and tumor-related mortality in CCA patients. CONCLUSIONS This modern, multicenter series of patients with CCA reflects their poor prognosis and reduced postsurgical hormonal normalization. Further work is necessary to better understand the pathophysiology of CCA to devise more targeted treatment approaches.
Collapse
Affiliation(s)
- Matthew C Findlay
- School of Medicine, University of Utah, Salt Lake City, Utah, USA; Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA
| | - Richard Drexler
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mohammed Azab
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA; Boise State University, Boise, Idaho, USA
| | - Arian Karbe
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Roman Rotermund
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franz L Ricklefs
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jörg Flitsch
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Timothy R Smith
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - John L Kilgallon
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jürgen Honegger
- Department of Neurosurgery, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Tübingen, Germany
| | - Isabella Nasi-Kordhishti
- Department of Neurosurgery, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Tübingen, Germany
| | - Paul A Gardner
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Zachary C Gersey
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Hussein M Abdallah
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - John A Jane
- Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Alexandria C Marino
- Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Ulrich J Knappe
- Department of Neurosurgery, Johannes Wesling Hospital Minden, Minden, Germany
| | - Nesrin Uksul
- Department of Neurosurgery, Johannes Wesling Hospital Minden, Minden, Germany
| | - Jamil A Rzaev
- Federal Center of Neurosurgery, Novosibirsk, Russia; Novosibirsk State Medical University, Novosibirsk, Russia
| | - Anatoliy V Bervitskiy
- Federal Center of Neurosurgery, Novosibirsk, Russia; Novosibirsk State Medical University, Novosibirsk, Russia
| | - Henry W S Schroeder
- Department of Neurosurgery, University Medicine Greifswald, Greifswald, Germany
| | - Márton Eördögh
- Department of Neurosurgery, University Medicine Greifswald, Greifswald, Germany
| | - Marco Losa
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Pietro Mortini
- Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Rüdiger Gerlach
- Department of Neurosurgery, Helios Kliniken, Erfurt, Germany
| | - Apio C M Antunes
- Departments of Neurosurgery Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | - Robert C Rennert
- School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Michael Karsy
- Global Neurosciences Institute, Philadelphia, Pennsylvania, USA; Department of Neurosurgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
| |
Collapse
|
3
|
Osamura RY, Inomoto C, Tahara S, Oyama KI, Matsuno A, Teramoto A. Pathology of Crooke Cells in the Human Pituitaries: A Timely Review. Appl Immunohistochem Mol Morphol 2023; 31:485-489. [PMID: 36251979 DOI: 10.1097/pai.0000000000001070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 09/09/2022] [Indexed: 11/02/2022]
Abstract
Crooke cell change was first found in the regressed and suppressed corticotroph (adrenocorticotropic hormone-producing) cells, and now is known to occur in pituitary tumors. The tumor cells of this type can be recognized by morphology with immunohistochemistry, and are well known to predict aggressive behavior such as invasion and rare metastases. This is one of the representative neuroendocrine tumors in the pituitary which is now considered to have malignant potential as proposed in the pancreas and gastrointestinal tracts. It is important to emphasize the pituitary tumor pathology such as Crooke cell change for prognostication and appropriate therapies. This review article describes the evolution from the Crooke cells to Crooke cell tumors which is timely along with the Fifth WHO classification 2022 published online.
Collapse
Affiliation(s)
- Robert Y Osamura
- Nippon Koukan Hospital, Kawasaki
- Keio University School of Medicine
| | | | | | | | | | | |
Collapse
|
4
|
Zhu D, Wang Z, Tian T, Wu X, He D, Zhu Y, Liu D, Wang H. Prevalence and clinical characteristics of Crooke's cell adenomas in 101 patients with T-PIT-positive pituitary adenomas: Case series and literature review. Front Endocrinol (Lausanne) 2022; 13:947085. [PMID: 36060980 PMCID: PMC9437488 DOI: 10.3389/fendo.2022.947085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/03/2022] [Indexed: 11/17/2022] Open
Abstract
PURPOSE We aimed to perform a retrospective analysis of a rare subtype of corticotroph adenoma, Crooke's cell adenoma, to better understand its clinical features. METHODS We collected T-PIT-positive pituitary adenomas and screened Crooke's cell adenomas from January 2020 to December 2021 in our center. Case reports of such tumors were also collected through a literature search. Clinical data such as biochemical tests, imaging examinations, and pathological data of the above cases were analyzed. RESULTS A total of 101 T-PIT-positive patients were treated in our center in the last 2 years, and 4 were finally pathologically diagnosed with Crooke's cell adenomas. All of these patients were male with elevated adrenocorticotropic hormone levels, and 50.0% presented with hypercortisolemia, Cushing's syndrome, visual impairment, and headache. The tumor diameter was significantly larger in these 4 patients (37.0 mm) than in the other patients (26.0 mm), and their tumor invasive behavior was more pronounced. Cases reported in the literature were mainly female (72.8%), and the clinical presentation was also dominated by Cushing's syndrome (65.1%) and hormonal dysfunction. Tumors were more common as macroadenomas (33.2 mm) and suprasellar growths (63.8%). The tumor recurrence rate was as high as 55.6%, with 6 cases progressing to pituitary carcinomas and 7.7% of tumor-related deaths. Our further integrated analysis of our center and reported cases revealed that gender, Cushing's syndrome, visual dysfunction, hormonal disorders, and tumor growth characteristics were statistically different in different tumor categories. CONCLUSION Crooke's cell adenoma is a tumor subtype with obvious clinical aggressive behavior, and an in-depth analysis of its clinical characteristics may assist in developing a comprehensive treatment plan.
Collapse
Affiliation(s)
- Dimin Zhu
- Department of Neurosurgery and Pituitary Tumor Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zongming Wang
- Department of Neurosurgery and Pituitary Tumor Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Tian Tian
- Department of Pathology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xinyi Wu
- Department of Neurosurgery and Pituitary Tumor Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Dongsheng He
- Department of Neurosurgery and Pituitary Tumor Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yonghong Zhu
- Department of Histology and Embryology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Dawei Liu
- Department of Pathology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- *Correspondence: Dawei Liu, ; Haijun Wang,
| | - Haijun Wang
- Department of Neurosurgery and Pituitary Tumor Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- *Correspondence: Dawei Liu, ; Haijun Wang,
| |
Collapse
|
5
|
Giraldi EA, Neill SG, Mendoza P, Saindane A, Oyesiku NM, Ioachimescu AG. Functioning Crooke Cell Adenomas: Case Series and Literature Review. World Neurosurg 2021; 158:e754-e765. [PMID: 34800730 DOI: 10.1016/j.wneu.2021.11.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/11/2021] [Accepted: 11/12/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Crooke cell adenomas (CCA) are rare potentially aggressive pituitary adenomas. Data regarding prevalence and clinical course is sparse. METHODS Methods consisted of a retrospective review of 59 consecutive functioning corticotroph adenomas (FCA) operated between October 2017-November 2020, and a literature review of CCA publications since 1991. RESULTS The prevalence of CCA among FCA at our institution was 8.5% (5/59). In the 4 other surgical cases series, prevalence of CCA ranged between 0%-6.8%. Our patients, 4 women and 1 man, mean age 46±11 years, presented with hypercortisolism (3/5), vision loss (1/5) and incidentally (1/5). All patients had elevated ACTH (151±54 pg/ml) and urinary free cortisol (830±796.5 μg/day) levels. Radiologically, 3 tumors were macroadenomas and 2 had cavernous sinus invasion. All patients achieved biochemical remission at 3 months postoperatively. One patient with a giant pituitary adenoma underwent fractionated radiation for residual tumor. During follow-up (range: 3.1-31.0 months), no patients had evidence of radiological or biochemical recurrence. The literature review (3 case series) and 21 case reports identified 22 FCA with outcome data. Additional treatments included reoperation (50%), radiation (59%), bilateral adrenalectomy (23%) and Temozolomide (36%). CONCLUSION We report a higher CCA prevalence among functioning ACTH-adenomas after the implementation of 2017 WHO classification. In our series and the literature, most CCAs were macroadenomas with high ACTH levels. Postoperative outcomes were excellent in our series, while some cases from the literature were refractory to standard treatments. Larger clinical and molecular studies are needed to identify patients at risk.
Collapse
Affiliation(s)
- Erica A Giraldi
- Emory University School of Medicine, Department of Medicine, Division of Endocrinology, Metabolism and Lipids, 1365 Clifton Rd NE, Atlanta, GA 30322, USA; Emory University School of Medicine, Department of Neurosurgery, 1365 Clifton Rd NE, Atlanta, GA 30322, USA.
| | - Stewart G Neill
- Emory University School of Medicine, Department of Pathology and Laboratory Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322, USA
| | - Pia Mendoza
- Emory University School of Medicine, Department of Pathology and Laboratory Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322, USA
| | - Amit Saindane
- Emory University School of Medicine, Department of Radiology, 1364 Clifton Rd NE, Atlanta, GA 30322, USA
| | - Nelson M Oyesiku
- Emory University School of Medicine, Department of Medicine, Division of Endocrinology, Metabolism and Lipids, 1365 Clifton Rd NE, Atlanta, GA 30322, USA; Emory University School of Medicine, Department of Neurosurgery, 1365 Clifton Rd NE, Atlanta, GA 30322, USA
| | - Adriana G Ioachimescu
- Emory University School of Medicine, Department of Medicine, Division of Endocrinology, Metabolism and Lipids, 1365 Clifton Rd NE, Atlanta, GA 30322, USA; Emory University School of Medicine, Department of Neurosurgery, 1365 Clifton Rd NE, Atlanta, GA 30322, USA
| |
Collapse
|
6
|
Liu YQ, Gao BB, Dong B, Padikkalakandy Cheriyath SS, Song QW, Xu B, Wei Q, Xie LZ, Guo Y, Miao YW. Preoperative vascular heterogeneity and aggressiveness assessment of pituitary macroadenoma based on dynamic contrast-enhanced MRI texture analysis. Eur J Radiol 2020; 129:109125. [PMID: 32593076 DOI: 10.1016/j.ejrad.2020.109125] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/27/2020] [Accepted: 06/07/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE To assess the vascular heterogeneity and aggressiveness of pituitary macroadenomas (PM) using texture analysis based on Dynamic Contrast-Enhanced MRI (DCE-MRI). METHOD Fifty patients with pathologically confirmed PM, including 32 patients with aggressive PM (aggressive group) and 18 patients with non-aggressive PM (non-aggressive group), were included in this study. The preoperative DCE-MRI and clinical data were collected from all patients. The features based on Ktrans, Ve, and Kep were generated using Omni-Kinetics software. Independent-samples t-test and Mann-Whitney U test were used for comparison between two groups. Logistic regression analysis was used to determine the optimal model for distinguishing aggressive and non-aggressive PM. RESULTS Six features related to tumor morphology, 24 features in Ktrans, 20 features in Ve, and 3 features in Kep were significantly different between the aggressive and non-aggressive groups. Volume count, gray-level non-uniformity in Ktrans, voxel value sum in Ve and run-length non-uniformity in Kep (AUC = 0.816, 0.903, 0.785, 0.813) were considered the best feature for tumor diagnosis. After modeling, the diagnosis efficiency of mean model and total model was desirable (AUC = 0.859 and 0.957), and the diagnostic efficiency of morphological, Ktrans, Ve and Kep features model was improved (AUC = 0.845, 0.951, 0.847, 0.804). CONCLUSIONS Texture analysis based on DCE-MRI elucidates the vascular heterogeneity and aggressiveness of pituitary adenoma. The total model could be used as a new noninvasive method for predicting the aggressiveness of pituitary macroadenoma.
Collapse
Affiliation(s)
- YangYing Qiu Liu
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang, Dalian, 116000, China.
| | - Bing Bing Gao
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang, Dalian, 116000, China.
| | - Bin Dong
- Department of Neurosurgery, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang, Dalian, 116000, China.
| | | | - Qing Wei Song
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang, Dalian, 116000, China.
| | - Bin Xu
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang, Dalian, 116000, China.
| | - Qiang Wei
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang, Dalian, 116000, China.
| | - Li Zhi Xie
- GE Healthcare, MR Research China, Beijing, 100176, China.
| | - Yan Guo
- GE Healthcare, Life Science China, Shenyang, 110000, China.
| | - Yan Wei Miao
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang, Dalian, 116000, China.
| |
Collapse
|
7
|
Snyder MH, Shabo L, Lopes MB, Xu Z, Schlesinger D, Sheehan JP. Gamma Knife Radiosurgery in Patients with Crooke Cell Adenoma. World Neurosurg 2020; 138:e898-e904. [PMID: 32251826 DOI: 10.1016/j.wneu.2020.03.152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Crooke cell adenoma is a very rare subtype of pituitary neoplasm that is known to be clinically aggressive. These tumors can secrete adrenocorticotropic hormone or may be endocrinologically silent. We evaluated the effect of Gamma Knife radiosurgery (GKRS) on endocrine remission and tumor control. MATERIALS AND METHODS This study comprised 5 patients (2 men, 3 women; median age at GKRS, 55 years [range, 21-65 years]) with pathology-confirmed Crooke cell adenoma treated with GKRS at the Gamma Knife Center of the University of Virginia. The median time interval between transsphenoidal resection and GKRS was 5.8 months. The median margin dose was 25 Gy (range, 18-25 Gy). Median treated adenoma volume was 3.12 mL. Median follow-up was 107 months (range, 44-122 months). RESULTS Tumor control was achieved in all patients. Three patients achieved endocrine remission at the last follow-up. The median time interval to cortisol normalization when off of anti-hormone secreting medication was 12 months (range, 6-24 months). Newly developed or worsening endocrinopathy occurred in 3 patients at 6, 15, and 18 months, respectively. Cranial nerve III neuropathy developed in 1 patient. Two patients required bilateral adrenalectomy at 44 months and 50 months, respectively, following GKRS. CONCLUSIONS GKRS appears to be a safe and reasonably effective treatment option for Crooke cell adenoma. Multicenter studies with larger numbers of patients are needed to verify these findings.
Collapse
Affiliation(s)
- M Harrison Snyder
- Gamma Knife Center, Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Leah Shabo
- Gamma Knife Center, Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Maria-Beatriz Lopes
- Division of Neuropathology, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Zhiyuan Xu
- Gamma Knife Center, Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia, USA.
| | - David Schlesinger
- Gamma Knife Center, Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Jason P Sheehan
- Gamma Knife Center, Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia, USA
| |
Collapse
|
8
|
Cortez GM, Monteiro A, Agnoletto G, Bit-Ivan EN, Sauvageau E, Hanel RA. Aggressive Pituitary Tumor with Crooke's Cells and Invasion of the Posterior Fossa. World Neurosurg 2020; 138:530-534.e1. [PMID: 32145418 DOI: 10.1016/j.wneu.2020.02.137] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/21/2020] [Accepted: 02/22/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Pituitary adenomas are mostly benign in character and are managed via a transsphenoidal approach in most cases. Crooke's cell adenoma (CCA) is a particular variant accounting for less than 1% of the pituitary adenomas. They have a distinctive histopathologic pattern and behavior. CASE DESCRIPTION We present a case of a 56-year-old man with recurrent pituitary adenoma and complicated neurosurgical history. Imaging follow-up showed a suprasellar mass with progressive growth into the posterior fossa. Surgical management via retrosigmoid craniectomy was performed, and histopathology elucidated Crooke's cells. CONCLUSIONS CCA is recognized by its local aggressiveness and high recurrence rates. They tend to be locally invasive; however, posterior fossa invasion has not been reported to date. We aim to contribute to the arsenal of differential diagnosis of similar pituitary tumor cases.
Collapse
Affiliation(s)
- Gustavo M Cortez
- Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA; Jacksonville University, Jacksonville, Florida, USA
| | - Andre Monteiro
- Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA
| | - Guilherme Agnoletto
- Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA
| | - Esther N Bit-Ivan
- Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA
| | - Eric Sauvageau
- Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA
| | - Ricardo A Hanel
- Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA.
| |
Collapse
|
9
|
Manojlovic-Gacic E, Bollerslev J, Casar-Borota O. Invited Review: Pathology of pituitary neuroendocrine tumours: present status, modern diagnostic approach, controversies and future perspectives from a neuropathological and clinical standpoint. Neuropathol Appl Neurobiol 2019; 46:89-110. [PMID: 31112312 DOI: 10.1111/nan.12568] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 05/08/2019] [Indexed: 12/21/2022]
Abstract
Neuroendocrine tumours of the adenohypophysis have traditionally been designated as pituitary adenomas to underline their usually indolent growth and lack of metastatic potential. However, they may demonstrate a huge spectrum of growth patterns and endocrine disturbances, some of them significantly affecting health and quality of life. To predict tumour growth, risk of postoperative recurrence and response to medical therapy in patients with pituitary neuroendocrine tumours is challenging. A thorough histopathological and immunohistochemical diagnostic work-up is an obligatory part of a multidisciplinary effort to precisely define the tumour type and assess prognostic and predictive factors on an individual basis. In this review, we have summarized the current status in the pathology in pituitary neuroendocrine tumours based on the selection of references from the PubMed database. We have presented possible diagnostic approaches according to the current pituitary cell lineage-based classification. The importance of recognizing histological subtypes with potentially aggressive behaviour and identification of prognostic and predictive tissue biomarkers have been highlighted. Controversies related to particular subtypes of pituitary tumours and a still limited prognostic impact of the current classification indicate the need for further refinement. Multidisciplinary approach including clinical, pathological and molecular genetic characterization will be essential for improved personalized therapy and the search for novel therapeutic targets in patients with pituitary neuroendocrine tumours.
Collapse
Affiliation(s)
- E Manojlovic-Gacic
- Institute of Pathology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - J Bollerslev
- Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - O Casar-Borota
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.,Department of Clinical Pathology, Uppsala University Hospital, Uppsala, Sweden
| |
Collapse
|
10
|
Corlan AS, Cîmpean AM, Melnic E, Raica M, Sarb S. VEGF, VEGF165b and EG-VEGF expression is specifically related with hormone profile in pituitary adenomas. Eur J Histochem 2019; 63. [PMID: 30838843 PMCID: PMC6406074 DOI: 10.4081/ejh.2019.3010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 02/18/2019] [Indexed: 01/29/2023] Open
Abstract
Vascular endothelial growth factor (VEGF), its inhibitory splice variant, VEGF165b and Endocrine Gland derived VEGF (EG-VEGF) have a controversial role in pituitary gland. We aim to study VEGF, VEGF165b and EG-VEGF expression in pituitary adenomas. A significant correlation was found between growth hormone (GH) and VEGF secretion (P=0.024). For prolactinomas, VEGF and prolactin expression, had a P-value of 0.02 for Kendall coefficient and a P-value of 0.043 for the Spearman coefficient. VEGFmRNA amplification was detected in both tumor cells and folliculostellate cells. VEGF165b was positive in 16.66% of pituitary adenomas. EG-VEGF was significantly correlated with prolactin (P=0.025) and luteinizing hormone (P=0.028). Our data strongly support VEGF, VEGF165b and EG-VEGF as important players of pituitary adenomas tumorigenesis. Particular hormonal milieu heterogeneity, special vascular network with an unusual reactivity to tumor growth correlated with variability of VEGF, VEGF165b and EG-VEGF secretion may stratify pituitary adenomas in several molecular groups with a direct impact on therapy and prognosis.
Collapse
Affiliation(s)
- Ana Silvia Corlan
- Victor Babeș University of Medicine and Pharmacy, Department of Microscopic Morphology/Histology.
| | | | | | | | | |
Collapse
|
11
|
Todnem N, Ward A, Segar S, Rojiani AM, Rahimi SY. Clinically Silent Adrenocorticotropic Hormone-Positive Crooke Cell Adenoma: Case Report and Review of Literature. World Neurosurg 2018; 119:197-200. [PMID: 30077745 DOI: 10.1016/j.wneu.2018.07.233] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 07/25/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Pituitary adenomas are one of the most common tumors of adulthood; however, subtypes such as Crooke cell adenoma are relatively rare. CASE DESCRIPTION We present the case of a 55-year-old woman who presented with new-onset intermittent headache and dizziness. Clinical and laboratory investigations were not suggestive of corticotroph tumor. However, subsequent computed tomography and magnetic resonance imaging scans revealed the presence of a suprasellar pituitary adenoma displacing the optic chiasma superiorly, with hemorrhage and sellar expansion. The lesion was removed by transsphenoidal surgery and the biopsy confirmed the lesion to be a nonfunctioning pituitary macroadenoma. Further investigation revealed that the specimen demonstrated Crooke hyaline changes, with strong immunoreactivity for adrenocorticotropic hormone. However, initial workup and postoperative testing lacked evidence of Cushing disease. There was no sign of recurrence after 1-year follow-up. CONCLUSIONS Clinically silent Crooke cell adenomas are rare occurrences, and as such we report this case with investigation of past cases.
Collapse
Affiliation(s)
- Nathan Todnem
- Department of Neurosurgery, The Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Ayobami Ward
- Department of Neurosurgery, The Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Sharmila Segar
- Department of Neurosurgery, The Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Amyn M Rojiani
- Department of Pathology, The Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Scott Y Rahimi
- Department of Neurosurgery, The Medical College of Georgia at Augusta University, Augusta, Georgia, USA.
| |
Collapse
|
12
|
|
13
|
The 2017 World Health Organization classification of tumors of the pituitary gland: a summary. Acta Neuropathol 2017; 134:521-535. [PMID: 28821944 DOI: 10.1007/s00401-017-1769-8] [Citation(s) in RCA: 341] [Impact Index Per Article: 48.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 08/14/2017] [Accepted: 08/15/2017] [Indexed: 12/12/2022]
Abstract
The 4th edition of the World Health Organization (WHO) classification of endocrine tumors has been recently released. In this new edition, major changes are recommended in several areas of the classification of tumors of the anterior pituitary gland (adenophypophysis). The scope of the present manuscript is to summarize these recommended changes, emphasizing a few significant topics. These changes include the following: (1) a novel approach for classifying pituitary neuroendocrine tumors according to pituitary adenohypophyseal cell lineages; (2) changes to the histological grading of pituitary neuroendocrine tumors with the elimination of the term "atypical adenoma;" and (3) introduction of new entities like the pituitary blastoma and re-definition of old entities like the null-cell adenoma. This new classification is very practical and mostly based on immunohistochemistry for pituitary hormones, pituitary-specific transcription factors, and other immunohistochemical markers commonly used in pathology practice, not requiring routine ultrastructural analysis of the tumors. Evaluation of tumor proliferation potential, by mitotic count and Ki-67 labeling index, and tumor invasion is strongly recommended on individual case basis to identify clinically aggressive adenomas. In addition, the classification offers the treating clinical team information on tumor prognosis by identifying specific variants of adenomas associated with an elevated risk for recurrence. Changes in the classification of non-neuroendocrine tumors are also proposed, in particular those tumors arising in the posterior pituitary including pituicytoma, granular cell tumor of the posterior pituitary, and spindle cell oncocytoma. These changes endorse those previously published in the 2016 WHO classification of CNS tumors. Other tumors arising in the sellar region are also reviewed in detail including craniopharyngiomas, mesenchymal and stromal tumors, germ cell tumors, and hematopoietic tumors. It is hoped that the 2017 WHO classification of pituitary tumors will establish more biologically and clinically uniform groups of tumors, make it possible for practicing pathologists to better diagnose these tumors, and contribute to our understanding of clinical outcomes for patients harboring pituitary tumors.
Collapse
|
14
|
Garbicz F, Mehlich D, Rak B, Sajjad E, Maksymowicz M, Paskal W, Zieliński G, Włodarski PK. Increased expression of the microRNA 106b~25 cluster and its host gene MCM7 in corticotroph pituitary adenomas is associated with tumor invasion and Crooke's cell morphology. Pituitary 2017; 20:450-463. [PMID: 28432562 PMCID: PMC5508039 DOI: 10.1007/s11102-017-0805-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE MCM7 (minichromosome maintenance complex component 7), a DNA replication licensing factor, is a host gene for the oncogenic miR-106b~25 cluster. It has been recently revealed as a relevant prognostic biomarker in a variety of cancers, including pituitary adenomas. The purpose of this study was to assess whether miR-106b~25 and MCM7 levels correlate with tumor invasiveness in a cohort of ACTH-immunopositive adenomas. METHODS Tissue samples were obtained intraoperatively from 25 patients with pituitary adenoma. Tumor invasiveness was assessed according to the Knosp grading scale. MCM7, Ki-67 and TP53 levels were assessed by immunohistochemical staining, while the expression of miR-106b-5p, miR-93-5p, miR-93-3p and miR-25-3p were measured using quantitative real-time PCR performed on RNA isolated from FFPE tissues. RESULTS We have found a significant increase in MCM7 and Ki-67 labeling indices in invasive ACTHomas. Moreover, MCM7 was ubiquitously overexpressed in Crooke's cell adenomas. The expression of miR-93-5p was significantly elevated in invasive compared to noninvasive tumors. In addition, all four microRNAs from the miR-106b~25 cluster displayed marked upregulation in Crooke's cell adenomas. Remarkably, MCM7 and miR-106b-5p both strongly correlated with Knosp grade. A combination of MCM7 LI and miR-106b~25 cluster expression was able to accurately differentiate invasive from noninvasive tumors and had a significant discriminatory ability to predict postoperative tumor recurrence/progression. CONCLUSIONS miR-106b~25 and its host gene MCM7 are potential novel biomarkers for invasive ACTH-immunopositive pituitary adenomas. Additionally, they are both significantly upregulated in rare Crooke's cell adenomas and might therefore contribute to their aggressive phenotype.
Collapse
Affiliation(s)
- Filip Garbicz
- Laboratory of Centre for Preclinical Research, Department of Histology and Embryology, Medical University of Warsaw, Banacha 1B, 02-091, Warsaw, Poland
| | - Dawid Mehlich
- Laboratory of Centre for Preclinical Research, Department of Histology and Embryology, Medical University of Warsaw, Banacha 1B, 02-091, Warsaw, Poland
| | - Beata Rak
- Laboratory of Centre for Preclinical Research, Department of Histology and Embryology, Medical University of Warsaw, Banacha 1B, 02-091, Warsaw, Poland
- Postgraduate School of Molecular Medicine, Warsaw, Poland
- Department of Internal Diseases and Endocrinology, Public Central Teaching Hospital Medical University of Warsaw, Warsaw, Poland
| | - Emir Sajjad
- Laboratory of Centre for Preclinical Research, Department of Histology and Embryology, Medical University of Warsaw, Banacha 1B, 02-091, Warsaw, Poland
- Department of Neurosurgery, Military Institute of Medicine, Warsaw, Poland
| | - Maria Maksymowicz
- Department of Pathology and Laboratory Diagnostics, M. Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland
| | - Wiktor Paskal
- Laboratory of Centre for Preclinical Research, Department of Histology and Embryology, Medical University of Warsaw, Banacha 1B, 02-091, Warsaw, Poland
| | - Grzegorz Zieliński
- Department of Neurosurgery, Military Institute of Medicine, Warsaw, Poland
| | - Paweł K Włodarski
- Laboratory of Centre for Preclinical Research, Department of Histology and Embryology, Medical University of Warsaw, Banacha 1B, 02-091, Warsaw, Poland.
| |
Collapse
|
15
|
Di Ieva A, Davidson JM, Syro LV, Rotondo F, Montoya JF, Horvath E, Cusimano MD, Kovacs K. Crooke's cell tumors of the pituitary. Neurosurgery 2015; 76:616-22. [PMID: 25635886 DOI: 10.1227/neu.0000000000000657] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Crooke's cell adenomas are a rare type of pituitary neoplasm. They produce adrenocorticotropic hormone causing Cushing's disease or may be endocrinologically silent. These tumors are usually invasive, may exhibit aggressive clinical behavior, and often recur with a low success of cure after reoperation and/or radiotherapy. Due to their rarity, they present great difficulties in assessing prognosis, treatment, and clinical management. Neurosurgeons and physicians dealing with pituitary adenomas diagnosed as Crooke's cell adenomas have to be aware of their potential clinical aggressiveness to plan strict follow-up of patients and eventual multimodality treatment. We review here the published cases of Crooke's cell tumors, as well as the clinical and histopathological characteristics of these unusual neoplasms.
Collapse
Affiliation(s)
- Antonio Di Ieva
- ‡Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; §Department of Neurosurgery, Hospital Pablo Tobon Uribe and Clinica Medellin, Medellin, Colombia; ¶Division of Pathology, Department of Laboratory Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; ‖Division of Endocrinology, Hospital Pablo Tobon Uribe and Universidad de Antioquia, Medellin, Colombia
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Human Kallikrein 10 Expression in Surgically Removed Human Pituitary Corticotroph Adenomas. Appl Immunohistochem Mol Morphol 2015; 23:433-7. [DOI: 10.1097/pai.0000000000000108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
17
|
Liu JK, Patel J, Eloy JA. The role of temozolomide in the treatment of aggressive pituitary tumors. J Clin Neurosci 2015; 22:923-9. [PMID: 25772801 DOI: 10.1016/j.jocn.2014.12.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 12/24/2014] [Indexed: 01/09/2023]
Abstract
Pituitary tumors are amongst the most common intracranial neoplasms and are generally benign. However, some pituitary tumors exhibit clinically aggressive behavior that is characterized by tumor recurrence and continued progression despite repeated treatments with conventional surgical, radiation and medical therapies. More recently, temozolomide, a second generation oral alkylating agent, has shown therapeutic promise for aggressive pituitary adenomas and carcinomas with favorable clinical and radiographic responses. Temozolomide causes DNA damage by methylation of the O(6) position of guanine, which results in potent cytotoxic DNA adducts and consequently, tumor cell apoptosis. The degree of MGMT expression appears to be inversely related to therapeutic responsiveness to temozolomide with a significant number of temozolomide-sensitive pituitary tumors exhibiting low MGMT expression. The presence of high MGMT expression appears to mitigate the effectiveness of temozolomide and this has been used as a marker in several studies to predict the efficacy of temozolomide. Recent evidence also suggests that mutations in mismatch repair proteins such as MSH6 could render pituitary tumors resistant to temozolomide. In this article, the authors review the development of temozolomide, its biochemistry and interaction with O(6)-methylguanine-DNA methyltransferase (MGMT), its role in adjuvant treatment of aggressive pituitary neoplasms, and future works that could influence the efficacy of temozolomide therapy.
Collapse
Affiliation(s)
- James K Liu
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Department of Neurological Surgery, Rutgers University, New Jersey Medical School, Suite 8100, 90 Bergen Street, Newark, NJ 07103, USA; Department of Neurological Surgery, Rutgers University, New Jersey Medical School, Newark, NJ, USA; Department of Otolaryngology-Head and Neck Surgery, Rutgers University, New Jersey Medical School, Newark, NJ, USA.
| | - Jimmy Patel
- Department of Neurological Surgery, Rutgers University, New Jersey Medical School, Newark, NJ, USA
| | - Jean Anderson Eloy
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Department of Neurological Surgery, Rutgers University, New Jersey Medical School, Suite 8100, 90 Bergen Street, Newark, NJ 07103, USA; Department of Neurological Surgery, Rutgers University, New Jersey Medical School, Newark, NJ, USA; Department of Otolaryngology-Head and Neck Surgery, Rutgers University, New Jersey Medical School, Newark, NJ, USA
| |
Collapse
|
18
|
Ceccato F, Lombardi G, Manara R, Emanuelli E, Denaro L, Milanese L, Gardiman MP, Bertorelle R, Scanarini M, D’Avella D, Occhi G, Boscaro M, Zagonel V, Scaroni C. Temozolomide and pasireotide treatment for aggressive pituitary adenoma: expertise at a tertiary care center. J Neurooncol 2015; 122:189-96. [DOI: 10.1007/s11060-014-1702-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 12/19/2014] [Indexed: 10/24/2022]
|
19
|
Bruno OD, Juárez-Allen L, Christiansen SB, Manavela M, Danilowicz K, Vigovich C, Gómez RM. Temozolomide Therapy for Aggressive Pituitary Tumors: Results in a Small Series of Patients from Argentina. Int J Endocrinol 2015; 2015:587893. [PMID: 26106414 PMCID: PMC4461777 DOI: 10.1155/2015/587893] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 05/06/2015] [Accepted: 05/06/2015] [Indexed: 02/01/2023] Open
Abstract
We evaluated results of temozolomide (TMZ) therapy in six patients, aged 34-78 years, presenting aggressive pituitary tumors. In all the patients tested O(6)-methylguanine-DNA methyltransferase (MGMT) immunoexpression in surgical specimens was absent. Patients received temozolomide 140-320 mg/day for 5 days monthly for at least 3 months. In two patients minimum time for evaluation could not be reached because of death in a 76-year-old man with a malignant prolactinoma and of severe neutro-thrombopenia in a 47-year-old woman with nonfunctioning pituitary adenoma. In two patients (a 34-year-old acromegalic woman and a 39-year-old woman with Nelson's syndrome) no response was observed after 4 and 6 months, respectively, and the treatment was stopped. Conversely, two 52- and 42-year-old women with Cushing's disease had long-term total clinical and radiological remissions which persisted after stopping temozolomide. We conclude that TMZ therapy may be of variable efficacy depending on-until now-incompletely understood factors. Cooperative work on a greater number of cases of aggressive pituitary tumors should be crucial to establish the indications, doses, and duration of temozolomide administration.
Collapse
Affiliation(s)
- Oscar D. Bruno
- Foundation of Endocrinology, 1425 Buenos Aires, Argentina
- *Oscar D. Bruno:
| | | | | | - Marcos Manavela
- Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, 1120 Buenos Aires, Argentina
| | - Karina Danilowicz
- Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, 1120 Buenos Aires, Argentina
| | - Carlos Vigovich
- Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, 1120 Buenos Aires, Argentina
| | - Reynaldo M. Gómez
- Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, 1120 Buenos Aires, Argentina
| |
Collapse
|
20
|
Syro LV, Builes CE, Di Ieva A, Sav A, Rotondo F, Kovacs K. Improving differential diagnosis of pituitary adenomas. Expert Rev Endocrinol Metab 2014; 9:377-386. [PMID: 30763997 DOI: 10.1586/17446651.2014.922412] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Pituitary adenomas are common tumors arising in adenohypophysial cells or their precursors. For improving control of the disease an early diagnosis is important. Initially considered sporadic tumors, some of them are associated with familial syndromes and their recognition and classification is also required. Morphologically, pituitary adenomas represent a heterogeneous group of tumors with several subtypes and different clinical behavior thus a precise pathological diagnosis is crucial. The simple diagnosis of pituitary adenoma is not satisfactory and the correct classification of histological subtypes may predict aggressiveness in the majority of cases. Although considered not malignant, some of them are clinically aggressive and their recognition remains a challenge. In this paper we present the recent advances in the event of improving early recognition and differential diagnosis of pituitary tumors.
Collapse
Affiliation(s)
- Luis V Syro
- a Department of Neurosurgery, Hospital Pablo Tobon Uribe and Clinica Medellin, Calle 54 # 46-27, Cons 501, Medellin, Colombia
| | - Carlos E Builes
- b Department of Endocrinology, Hospital Pablo Tobon Uribe, Medellin, Colombia
| | - Antonio Di Ieva
- c Department of Surgery, Division of Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Aydin Sav
- d Department of Pathology, Acibadem University, School of Medicine, Atasehir, Istanbul, Turkey
| | - Fabio Rotondo
- e Laboratory Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Kalman Kovacs
- e Laboratory Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
21
|
Management of aggressive pituitary adenomas and pituitary carcinomas. J Neurooncol 2014; 117:459-68. [DOI: 10.1007/s11060-014-1413-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 02/21/2014] [Indexed: 10/25/2022]
|
22
|
Matsuno A, Murakami M, Hoya K, Yamada SM, Miyamoto S, Yamada S, Son JH, Nishido H, Ide F, Nagashima H, Sugaya M, Hirohata T, Mizutani A, Okinaga H, Ishii Y, Tahara S, Teramoto A, Osamura RY. Molecular status of pituitary carcinoma and atypical adenoma that contributes the effectiveness of temozolomide. Med Mol Morphol 2013; 47:1-7. [PMID: 23955641 DOI: 10.1007/s00795-013-0050-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 07/02/2013] [Indexed: 01/16/2023]
Abstract
There have been several reports of temozolomide (TMZ) treatment of pituitary carcinomas and atypical adenomas. O(6)-methyl-guanine-DNA methyltransferase is not the sole molecule determining the sensitivity to TMZ in pituitary carcinomas and atypical adenomas. The Japan Society of Hypothalamic and Pituitary Tumors study suggests that MSH6, one of mismatch repair pathway enzyme, fulfills a contributory role to the efficacy of TMZ treatment for pituitary carcinomas and atypical adenomas. The preserved MSH6 function might be essential for the responsiveness to TMZ treatment in pituitary carcinomas and atypical adenomas.
Collapse
Affiliation(s)
- Akira Matsuno
- Department of Neurosurgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba, 299-0111, Japan,
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|