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Chen Z, Sun X, Kang Y, Zhang J, Jia F, Liu X, Zhu H. A novel risk model based on the correlation between the expression of basement membrane genes and immune infiltration to predict the invasiveness of pituitary adenomas. Front Endocrinol (Lausanne) 2023; 13:1079777. [PMID: 36686480 PMCID: PMC9846255 DOI: 10.3389/fendo.2022.1079777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/14/2022] [Indexed: 01/05/2023] Open
Abstract
Objective Invasive pituitary adenomas (IPAs) are common tumors of the nervous system tumors for which invasive growth can lead to difficult total resection and a high recurrence rate. The basement membrane (BM) is a special type of extracellular matrix and plays an important role in the invasion of pituitary adenomas (PAs). The aim of this study was to develop a risk model for predicting the invasiveness of PAs by analyzing the correlation between the expression of BM genes and immune infiltration. Methods Four datasets, featuring samples IPAs and non-invasive pituitary adenomas (NIPAs), were obtained from the Gene Expression Omnibus database (GEO). R software was then used to identify differentially expressed genes (DEGs) and analyze their functional enrichment. Protein-protein interaction (PPI) network was used to screen BM genes, which were analyzed for immune infiltration; this led to the generation of a risk model based on the correlation between the expression of BM genes and immunity. A calibration curve and receiver operating characteristic (ROC) curve were used to evaluate and validate the model. Subsequently, the differential expression levels of BM genes between IPA and NIPA samples collected in surgery were verified by Quantitative Polymerase Chain Reaction (qPCR) and the prediction model was further evaluated. Finally, based on our analysis, we recommend potential drug targets for the treatment of IPAs. Results The merged dataset identified 248 DEGs that were mainly enriching in signal transduction, the extracellular matrix and channel activity. The PPI network identified 11 BM genes from the DEGs: SPARCL1, GPC3, LAMA1, SDC4, GPC4, ADAMTS8, LAMA2, LAMC3, SMOC1, LUM and THBS2. Based on the complex correlation between these 11 genes and immune infiltration, a risk model was established to predict PAs invasiveness. Calibration curve and ROC curve analysis (area under the curve [AUC]: 0.7886194) confirmed the good predictive ability of the model. The consistency between the qPCR results and the bioinformatics results confirmed the reliability of data mining. Conclusion Using a variety of bioinformatics methods, we developed a novel risk model to predict the probability of PAs invasion based on the correlation between 11 BM genes and immune infiltration. These findings may facilitate closer surveillance and early diagnosis to prevent or treat IPAs in patients and improve the clinical awareness of patients at high risk of IPAs.
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Affiliation(s)
- Zheng Chen
- Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Xin Sun
- Department of Immunology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yin Kang
- Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Jian Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Fang Jia
- Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Xiyao Liu
- Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Hongwei Zhu
- Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
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Lenders NF, Inder WJ, McCormack AI. Towards precision medicine for clinically non-functioning pituitary tumours. Clin Endocrinol (Oxf) 2021; 95:398-409. [PMID: 33774854 DOI: 10.1111/cen.14472] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/21/2021] [Accepted: 03/17/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Clinically non-functioning pituitary tumours (NFPT) are a heterogenous group of neoplasms with diverse outcomes. The purpose of this narrative review was to summarize available data on predictive factors, both in routine practice and research settings. DESIGN A literature review was conducted for papers published in peer-reviewed journals, investigating clinical, radiological, pathological and genetic predictive factors in NFPT. RESULTS Several clinical and radiological factors have been associated with NFPT recurrence and/or aggressiveness, including larger size and pre-/post-operative growth rates. Application of transcription factor immunohistochemistry has given rise to improved subtype identification, including 'higher-risk' subtypes, in routine clinical practice. Numerous other pathological and genetic biomarkers have demonstrated promise for prognostication in the research setting. CONCLUSION NFPT are a heterogenous group of tumours, characterized by diverse presentation, pathogenesis and outcomes. Ongoing refinements in understanding of tumour biology are likely to pave the way to improved integrative prognostication and precision medicine for NFPT.
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Affiliation(s)
- Nèle F Lenders
- Department of Endocrinology, St Vincent's Hospital, Sydney, New South Wales, Australia
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- St Vincent's Clinical School, Faculty of Medicine, UNSW, Sydney, New South Wales, Australia
| | - Warrick J Inder
- Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, the University of Queensland, Brisbane, Queensland, Australia
| | - Ann I McCormack
- Department of Endocrinology, St Vincent's Hospital, Sydney, New South Wales, Australia
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- St Vincent's Clinical School, Faculty of Medicine, UNSW, Sydney, New South Wales, Australia
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3
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Abstract
A subset of pituitary tumors present an aggressive behavior that remains difficult to predict, and in rare cases they metastasize. The current European Society for Endocrinology (ESE) guidelines for the management of aggressive pituitary tumors and carcinomas provide valuable guidance, but several issues remain unaddressed because of the scarcity of data in the literature. This article presents key clinical aspects regarding aggressive pituitary tumors and carcinomas, and also discusses some of the unanswered questions of the ESE guidelines, focusing on both diagnosis and treatment.
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Affiliation(s)
- Mirela Diana Ilie
- Endocrinology Department VI, "C.I.Parhon" National Institute of Endocrinology, 34-36 Aviatorilor Boulevard, Bucharest 011863, Romania. https://twitter.com/the_hormone_doc
| | - Emmanuel Jouanneau
- Neurosurgery Department, Reference Center for Rare Pituitary Diseases HYPO, "Groupement Hospitalier Est" Hospices Civils de Lyon, "Claude Bernard" Lyon 1 University, Hôpital Pierre Wertheimer, 59 Pinel Boulevard, Lyon, Bron 69677, France
| | - Gérald Raverot
- Endocrinology Department, Reference Center for Rare Pituitary Diseases HYPO, "Groupement Hospitalier Est" Hospices Civils de Lyon, "Claude Bernard" Lyon 1 University, Hôpital Louis Pradel, 59 Pinel Boulevard, Lyon, Bron 69677, France.
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Vicchio TM, Aliquò F, Ruggeri RM, Ragonese M, Giuffrida G, Cotta OR, Spagnolo F, Torre ML, Alibrandi A, Asmundo A, Angileri FF, Esposito F, Polito F, Oteri R, Aguennouz MH, Cannavò S, Ferraù F. MicroRNAs expression in pituitary tumors: differences related to functional status, pathological features, and clinical behavior. J Endocrinol Invest 2020; 43:947-958. [PMID: 31939196 DOI: 10.1007/s40618-019-01178-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 12/31/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND MicroRNAs (miRNAs) are small non-coding RNA molecules that regulate gene expression at post-transcriptional level, having a role in many biological processes, such as control of cell proliferation, cell cycle, and cell death. Altered miRNA expression has been reported in many neoplasms, including pituitary adenomas (PAs). PURPOSE In this study, we aimed to evaluate the expression of 20 miRNAs involved in pathways relevant to pituitary pathophysiology, in PAs and normal pituitary tissue and to correlate their expression profile with clinical and pathological features. METHODS Pituitary tumor samples were obtained during transphenoidal surgery from patients with non-functioning (NFPA, n = 12) and functioning (n = 11, 5 GH-, 3 ACTH-, 3 PRL-omas) PAs. The expression of selected miRNAs in PAs and in normal pituitary was analyzed by RT-qPCR. miRNAs expression was correlated with demographic, clinical, and neuroradiological data and with histopathological features including pituitary hormones immunostaining, Ki-67 proliferation index, and p53 immunohistochemistry evaluation. RESULTS All evaluated miRNAs except miR-711 were expressed in both normal and tumor pituitary tissue. Seventeen miRNAs were significantly down-regulated in pituitary tumors compared to normal pituitary. miRNAs were differentially expressed in functioning PAs or in NFPAs, as in the latter group miR-149-3p (p = 0.036), miR-130a-3p (p = 0.014), and miR-370-3p (p = 0.026) were significantly under expressed as compared to functioning tumors. Point-biserial correlation analysis demonstrated a negative correlation between miR-26b-5p and Ki-67 (p = 0.031) and between miR-30a-5p and 'atypical' morphological features (p = 0.038) or cavernous sinus invasion (p = 0.049), while 508-5p was inversely correlated with clinical aggressiveness (p = 0.043). CONCLUSIONS In this study, we found a significant down-regulation of 17 miRNAs in PAs vs normal pituitary, with differential expression profile related to functional status and tumor aggressiveness.
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Affiliation(s)
- T M Vicchio
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
| | - F Aliquò
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - R M Ruggeri
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - M Ragonese
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
| | - G Giuffrida
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - O R Cotta
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
| | - F Spagnolo
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
| | - M L Torre
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
| | - A Alibrandi
- Department of Economics, University of Messina, Messina, Italy
| | - A Asmundo
- Department of Biomedical Sciences, Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - F F Angileri
- Department of Biomedical Sciences, Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - F Esposito
- Department of Biomedical Sciences, Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - F Polito
- Department of Human Pathology of Adulthood and Childhood 'G. Barresi', University of Messina, UOC di Endocrinologia, Pad. H, 4° Piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy
| | - R Oteri
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - M H Aguennouz
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - S Cannavò
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
- Department of Human Pathology of Adulthood and Childhood 'G. Barresi', University of Messina, UOC di Endocrinologia, Pad. H, 4° Piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy
| | - F Ferraù
- Department of Human Pathology of Adulthood and Childhood 'G. Barresi', University of Messina, UOC di Endocrinologia, Pad. H, 4° Piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy.
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Serioli S, Doglietto F, Fiorindi A, Biroli A, Mattavelli D, Buffoli B, Ferrari M, Cornali C, Rodella L, Maroldi R, Gasparotti R, Nicolai P, Fontanella MM, Poliani PL. Pituitary Adenomas and Invasiveness from Anatomo-Surgical, Radiological, and Histological Perspectives: A Systematic Literature Review. Cancers (Basel) 2019; 11:E1936. [PMID: 31817110 PMCID: PMC6966643 DOI: 10.3390/cancers11121936] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/27/2019] [Accepted: 11/28/2019] [Indexed: 12/20/2022] Open
Abstract
Invasiveness in pituitary adenomas has been defined and investigated from multiple perspectives, with varying results when its predictive value is considered. A systematic literature review, following PRISMA guidelines, was performed, searching PubMed and Scopus databases with terms that included molecular markers, histological, radiological, anatomical and surgical data on invasiveness of pituitary adenomas. The results showed that differing views are still present for anatomical aspects of the sellar region that are relevant to the concept of invasiveness; radiological and histological diagnoses are still limited, but might improve in the future, especially if they are related to surgical findings, which have become more accurate thanks to the introduction of the endoscope. The aim is to achieve a correct distinction between truly invasive pituitary adenomas from those that, in contrast, present with extension in the parasellar area through natural pathways. At present, diagnosis of invasiveness should be based on a comprehensive analysis of radiological, intra-operative and histological findings.
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Affiliation(s)
- Simona Serioli
- Neurosurgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy; (S.S.); (A.F.); (A.B.); (C.C.); (M.M.F.)
| | - Francesco Doglietto
- Neurosurgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy; (S.S.); (A.F.); (A.B.); (C.C.); (M.M.F.)
- Neurosurgery, Spedali Civili Hospital, 25123 Brescia, Italy
| | - Alessandro Fiorindi
- Neurosurgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy; (S.S.); (A.F.); (A.B.); (C.C.); (M.M.F.)
| | - Antonio Biroli
- Neurosurgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy; (S.S.); (A.F.); (A.B.); (C.C.); (M.M.F.)
| | - Davide Mattavelli
- Otorhinolaryngology–Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy; (D.M.); (M.F.); (P.N.)
| | - Barbara Buffoli
- Section of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (B.B.); (L.R.)
| | - Marco Ferrari
- Otorhinolaryngology–Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy; (D.M.); (M.F.); (P.N.)
| | - Claudio Cornali
- Neurosurgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy; (S.S.); (A.F.); (A.B.); (C.C.); (M.M.F.)
- Neurosurgery, Spedali Civili Hospital, 25123 Brescia, Italy
| | - Luigi Rodella
- Section of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (B.B.); (L.R.)
| | - Roberto Maroldi
- Radiology, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy;
| | - Roberto Gasparotti
- Neuroradiology, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy;
| | - Piero Nicolai
- Otorhinolaryngology–Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy; (D.M.); (M.F.); (P.N.)
| | - Marco Maria Fontanella
- Neurosurgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy; (S.S.); (A.F.); (A.B.); (C.C.); (M.M.F.)
- Neurosurgery, Spedali Civili Hospital, 25123 Brescia, Italy
| | - Pietro Luigi Poliani
- Section of Pathology, Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
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6
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Ilie MD, Vasiljevic A, Raverot G, Bertolino P. The Microenvironment of Pituitary Tumors-Biological and Therapeutic Implications. Cancers (Basel) 2019; 11:cancers11101605. [PMID: 31640258 PMCID: PMC6826349 DOI: 10.3390/cancers11101605] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 02/07/2023] Open
Abstract
The tumor microenvironment (TME) includes resident and infiltrative non-tumor cells, as well as blood and lymph vessels, extracellular matrix molecules, and numerous soluble factors, such as cytokines and chemokines. While the TME is now considered to be a prognostic tool and a therapeutic target for many cancers, little is known about its composition in pituitary tumors. This review summarizes our current knowledge of the TME within pituitary tumors and the strong interest in TME as a therapeutic target. While we cover the importance of angiogenesis and immune infiltrating cells, we also address the role of the elusive folliculostellate cells, the emerging literature on pituitary tumor-associated fibroblasts, and the contribution of extracellular matrix components in these tumors. The cases of human pituitary tumors treated with TME-targeting therapies are reviewed and emerging concepts of vascular normalization and combined therapies are presented. Together, this snapshot overview of the current literature pinpoints not only the underestimated role of TME components in pituitary tumor biology, but also the major promise it may offer for both prognosis and targeted therapeutics.
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Affiliation(s)
- Mirela Diana Ilie
- Cancer Research Centre of Lyon (CRCL), INSERM U1052, CNRS UMR5286, Claude Bernard University, 69008 Lyon, France, (M.D.I.).
- "Claude Bernard" Lyon 1 University, University of Lyon, 69100 Villeurbanne, France.
- Endocrinology Department, "C.I.Parhon" National Institute of Endocrinology, 011863 Bucharest, Romania.
| | - Alexandre Vasiljevic
- Cancer Research Centre of Lyon (CRCL), INSERM U1052, CNRS UMR5286, Claude Bernard University, 69008 Lyon, France, (M.D.I.).
- "Claude Bernard" Lyon 1 University, University of Lyon, 69100 Villeurbanne, France.
- Pathology Department, "Groupement Hospitalier Est" Hospices Civils de Lyon, 69677 Bron, France.
| | - Gérald Raverot
- Cancer Research Centre of Lyon (CRCL), INSERM U1052, CNRS UMR5286, Claude Bernard University, 69008 Lyon, France, (M.D.I.).
- "Claude Bernard" Lyon 1 University, University of Lyon, 69100 Villeurbanne, France.
- Endocrinology Department, "Groupement Hospitalier Est" Hospices Civils de Lyon, 69677 Bron, France.
| | - Philippe Bertolino
- Cancer Research Centre of Lyon (CRCL), INSERM U1052, CNRS UMR5286, Claude Bernard University, 69008 Lyon, France, (M.D.I.).
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7
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Gonzalez A, Saindane AM, Neill SG, Oyesiku NM, Ioachimescu AG. The Intriguing Case of a Double Pituitary Adenoma. World Neurosurg 2019; 126:331-335. [PMID: 30898745 DOI: 10.1016/j.wneu.2019.02.242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 02/25/2019] [Accepted: 02/26/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND When distinct pituitary hypersecretory manifestations coexist, the differential diagnosis includes plurihormonal or double pituitary adenomas. We describe a rare case of hypercortisolemia and hyperprolactinemia caused by 2 noncontiguous adenomas that required 2 surgeries. CASE DESCRIPTION A 37-year-old woman presented with 6 months of weight gain, amenorrhea, joint pain, leg swelling, and skin changes. She received prednisone for possible systemic lupus erythematosus. Four months later, she presented with headaches and new-onset diabetes with glucose >1000 mg/dL. Work-up revealed a right-sided 1.1-cm pituitary adenoma and prolactin level of 152.9 ng/mL (normal: 3-27 ng/mL). She was advised to stop the prednisone, start bromocriptine, and see a pituitary specialist. Examination revealed centripetal obesity, supraclavicular and dorsocervical fat pads, violaceous wide striae, bilateral leg edema, and galactorrhea. Workup confirmed adrenocorticotrophic hormone-dependent Cushing syndrome, with a central-to-peripheral gradient on inferior petrosal sinus sampling bilaterally. Transsphenoidal adenenomectomy yielded an adenoma diffusely positive for prolactin. Postoperatively prolactin normalized, hypercortisolemia persisted, and magnetic resonance imaging findings raised suspicion for a 2-mm microadenoma. The patient underwent a second operation when an adrenocorticotrophic hormone-positive adenoma was identified. After 4 years, both hypersecretory syndromes remain in biochemical remission. CONCLUSIONS A complete clinical and biochemical evaluation is necessary in patients with pituitary adenomas. Repeat surgery may be necessary for noncontiguous double adenomas.
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Affiliation(s)
- Adriana Gonzalez
- Department of Medicine Division of Endocrinology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Amit M Saindane
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Stewart G Neill
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Nelson M Oyesiku
- Department of Neurological Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Adriana G Ioachimescu
- Department of Medicine Division of Endocrinology, Emory University School of Medicine, Atlanta, Georgia, USA; Department of Neurological Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
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8
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Clinical and Pathologic Characteristics Predicted the Postoperative Recurrence and Progression of Pituitary Adenoma: A Retrospective Study with 10 Years Follow-Up. World Neurosurg 2018; 118:e428-e435. [DOI: 10.1016/j.wneu.2018.06.210] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/23/2018] [Accepted: 06/26/2018] [Indexed: 12/15/2022]
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9
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Principe M, Chanal M, Karam V, Wierinckx A, Mikaélian I, Gadet R, Auger C, Raverot V, Jouanneau E, Vasiljevic A, Hennino A, Raverot G, Bertolino P. ALK7 expression in prolactinoma is associated with reduced prolactin and increased proliferation. Endocr Relat Cancer 2018; 25:795-806. [PMID: 30012586 DOI: 10.1530/erc-18-0082] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 05/16/2018] [Indexed: 12/29/2022]
Abstract
Prolactinoma represents the most frequent hormone-secreting pituitary tumours. These tumours appear in a benign form, but some of them can reach an invasive and aggressive stage through an unknown mechanism. Discovering markers to identify prolactinoma proliferative and invading character is therefore crucial to develop new diagnostic/prognostic strategies. Interestingly, members of the TGFβ-Activin/BMP signalling pathways have emerged as important actors of pituitary development and adult function, but their role in prolactinomas remains to be precisely determined. Here, using a heterotopic allograft model derived from a rat prolactinoma, we report that the Activins orphan type I receptor ALK7 is ectopically expressed in prolactinomas-cells. Through immunohistological approaches, we further confirm that normal prolactin-producing cells lack ALK7-expression. Using a series of human tumour samples, we show that ALK7 expression in prolactinomas cells is evolutionary conserved between rat and human. More interestingly, our results highlight that tumours showing a robust expression of ALK7 present an increased proliferation as address by Ki67 expression and retrospective analysis of clinical data from 38 patients, presenting ALK7 as an appealing marker of prolactinoma aggressiveness. Beside this observation, our work pinpoints that the expression of prolactin is highly heterogeneous in prolactinoma cells. We further confirm the contribution of ALK7 in these observations and the existence of highly immunoreactive prolactin cells lacking ALK7 expression. Taken together, our observations suggest that Activin signalling mediated through ALK7 could therefore contribute to the hormonal heterogeneity and increased proliferation of prolactinomas.
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Affiliation(s)
- M Principe
- Cancer Research Centre of Lyon (CRCL)INSERM U1052, CNRS UMR5286, Claude Bernard University, Lyon, France
| | - M Chanal
- Cancer Research Centre of Lyon (CRCL)INSERM U1052, CNRS UMR5286, Claude Bernard University, Lyon, France
| | - V Karam
- Cancer Research Centre of Lyon (CRCL)INSERM U1052, CNRS UMR5286, Claude Bernard University, Lyon, France
| | - A Wierinckx
- Cancer Research Centre of Lyon (CRCL)INSERM U1052, CNRS UMR5286, Claude Bernard University, Lyon, France
- ProfilXpertLyon, France
| | - I Mikaélian
- Cancer Research Centre of Lyon (CRCL)INSERM U1052, CNRS UMR5286, Claude Bernard University, Lyon, France
| | - R Gadet
- Cancer Research Centre of Lyon (CRCL)INSERM U1052, CNRS UMR5286, Claude Bernard University, Lyon, France
| | - C Auger
- Cancer Research Centre of Lyon (CRCL)INSERM U1052, CNRS UMR5286, Claude Bernard University, Lyon, France
| | - V Raverot
- Laboratoire d'HormonologieCentre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Lyon, France
| | - E Jouanneau
- Service de NeurochirurgieGroupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
- Faculté de Médecine Lyon EstUniversité Lyon 1, Lyon, France
| | - A Vasiljevic
- Faculté de Médecine Lyon EstUniversité Lyon 1, Lyon, France
- Department of PathologyGroupement Hospitalier EST, Hospices Civils de Lyon, University of Lyon, Lyon, France
| | - A Hennino
- Cancer Research Centre of Lyon (CRCL)INSERM U1052, CNRS UMR5286, Claude Bernard University, Lyon, France
| | - G Raverot
- Cancer Research Centre of Lyon (CRCL)INSERM U1052, CNRS UMR5286, Claude Bernard University, Lyon, France
- Department of PathologyGroupement Hospitalier EST, Hospices Civils de Lyon, University of Lyon, Lyon, France
- Department of EndocrinologyReference Center for Rare Pituitary Disease (HYPO), Groupement Hospitalier EST, Hospices Civils de Lyon, University of Lyon, Lyon, France
| | - P Bertolino
- Cancer Research Centre of Lyon (CRCL)INSERM U1052, CNRS UMR5286, Claude Bernard University, Lyon, France
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10
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Abstract
Surgery is the treatment of choice for nonfunctioning pituitary tumors (NFPTs). Postoperative tumor regrowth during follow-up is present in about half of the patients with invasive NFPTs with residual tumor but occurs also in 15% of patient without residue. Therapeutic strategies should consider this risk of recurrence and the potential side effects associated with therapeutic options. Identification of prognostic markers is mandatory to help clinicians to predict the risk of recurrence and to choose the best strategy between conservative follow-up, second surgery, postoperative adjuvant radiation therapy, and medical treatment (dopamine agonists, somatostatin analogs). Recent advances in pathological classification may be the first step for identification of NFPTs with a high risk of recurrence.
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Affiliation(s)
- Gerald Raverot
- Fédération d'Endocrinologie, Centre de Référence Maladies Rares Hypophysaires HYPO, Groupement Hospitalier Est, Hospices Civils de Lyon, Hôpital Louis Pradel-1er étage, 59 Bd Pinel, 69677, Bron Cedex, France.
- Faculté de Médecine Lyon Est, Université Lyon 1, 69372, Lyon, France.
- INSERM U1052, CNRS UMR5286, Cancer Research Centre of Lyon, 69372, Lyon, France.
| | - Alexandre Vasiljevic
- Faculté de Médecine Lyon Est, Université Lyon 1, 69372, Lyon, France
- INSERM U1052, CNRS UMR5286, Cancer Research Centre of Lyon, 69372, Lyon, France
- Centre de Pathologie et de Biologie Est, Groupement Hospitalier Est, Hospices Civils de Lyon, 69677, Bron, France
| | - Emmanuel Jouanneau
- Faculté de Médecine Lyon Est, Université Lyon 1, 69372, Lyon, France
- INSERM U1052, CNRS UMR5286, Cancer Research Centre of Lyon, 69372, Lyon, France
- Service de Neurochirurgie, Groupement Hospitalier Est, Hospices Civils de Lyon, 69677, Bron, France
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Early recognition of aggressive pituitary adenomas: a single-centre experience. Acta Neurochir (Wien) 2018; 160:49-55. [PMID: 29170844 DOI: 10.1007/s00701-017-3396-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 11/13/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pituitary adenomas are usually considered benign tumours, although some of them can exhibit an aggressive behaviour. Patients with clinically aggressive pituitary adenomas are frequently diagnosed with larger masses, and may present an earlier recurrence (or persistence) after surgery. Our aim was to characterise the clinical, histopathological and radiological features of patients with aggressive pituitary adenoma, in order to correlate their clinical behaviour with the response to treatment plan. METHOD We considered an aggressive pituitary adenoma on the basis of radiological features (size, local invasion), pathological reports (atypical adenoma: MIB-1 >3%, p53 immunoreactivity, increased mitotic activity) and clinical aspects (response to surgery, radiotherapy and medical treatment). RESULTS Among our cohort of 582 patients, we considered 102 subjects with aggressive pituitary adenomas (18%, 56 male and 46 female): 14 adrenocorticotrophic hormone (ACTH)-secreting, 18 growth hormone (GH)-secreting, 23 prolactin (PRL)-secreting and 47 non-secreting, with a median follow-up of 5 years. In the whole cohort, 75% of patients with aggressive pituitary adenomas presented invasion of surrounding structure, especially GH-secreting, PRL-secreting and non-secreting. Besides invasion, their remission rate after surgery, radiotherapy or medical treatment was similar, irrespective of hormonal secretion. Surgery was the most performed treatment (overall remission rate of 24%), especially in those patients with ACTH- or GH-secreting adenoma, and 22% of patients were submitted to radiotherapy, with a remission rate of 45% after a median of 3 years. Two consecutive years of medical treatment, in patients with secreting pituitary adenoma, achieved disease control in 41% of them. Considering pathological reports, 24% of cases were defined as atypical adenomas; radiological characteristics, responses to medical treatment and remission rates were similar among patients with typical and atypical adenoma. CONCLUSIONS We proposed a new and comprehensive definition of aggressive pituitary adenoma, based upon radiological, clinical and pathological features. In a selected cohort of patients, radiological invasion resulted in the most common marker to describe the aggressive behaviour of pituitary adenoma. Surgery, radiotherapy and medical treatment (the latter only in secreting adenoma) achieved disease control in half of the patients with aggressive adenoma, especially surgery in those with ACTH-oma and medical treatment in those with GH- and PRL-secreting adenoma. Nevertheless, radiological, clinical or atypical features did not affect the outcome.
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Raverot G, Burman P, McCormack A, Heaney A, Petersenn S, Popovic V, Trouillas J, Dekkers OM. European Society of Endocrinology Clinical Practice Guidelines for the management of aggressive pituitary tumours and carcinomas. Eur J Endocrinol 2018; 178:G1-G24. [PMID: 29046323 DOI: 10.1530/eje-17-0796] [Citation(s) in RCA: 332] [Impact Index Per Article: 55.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 10/12/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Pituitary tumours are common and easily treated by surgery or medical treatment in most cases. However, a small subset of pituitary tumours does not respond to standard medical treatment and presents with multiple local recurrences (aggressive pituitary tumours) and in rare occasion with metastases (pituitary carcinoma). The present European Society of Endocrinology (ESE) guideline aims to provide clinical guidance on diagnosis, treatment and follow-up in aggressive pituitary tumours and carcinomas. METHODS We decided upfront, while acknowledging that literature on aggressive pituitary tumours and carcinomas is scarce, to systematically review the literature according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. The review focused primarily on first- and second-line treatment in aggressive pituitary tumours and carcinomas. We included 14 single-arm cohort studies (total number of patients = 116) most on temozolomide treatment (n = 11 studies, total number of patients = 106). A positive treatment effect was seen in 47% (95% CI: 36-58%) of temozolomide treated. Data from the recently performed ESE survey on aggressive pituitary tumours and carcinomas (165 patients) were also used as backbone for the guideline. SELECTED RECOMMENDATION: (i) Patients with aggressive pituitary tumours should be managed by a multidisciplinary expert team. (ii) Histopathological analyses including pituitary hormones and proliferative markers are needed for correct tumour classification. (iii) Temozolomide monotherapy is the first-line chemotherapy for aggressive pituitary tumours and pituitary carcinomas after failure of standard therapies; treatment evaluation after 3 cycles allows identification of responder and non-responder patients. (iv) In patients responding to first-line temozolomide, we suggest continuing treatment for at least 6 months in total. Furthermore, the guideline offers recommendations for patients who recurred after temozolomide treatment, for those who did not respond to temozolomide and for patients with systemic metastasis.
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Affiliation(s)
- Gerald Raverot
- Fédération d'Endocrinologie, Centre de Référence des Maladies Rares Hypophysaires HYPO, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
- Faculté de Médecine Lyon Est, Université Lyon 1, Lyon, France
- INSERM U1052, CNRS UMR5286, Cancer Research Centre of Lyon, Lyon, France
| | - Pia Burman
- Department of Endocrinology, Skane University Hospital Malmö, University of Lund, Lund, Sweden
| | - Ann McCormack
- Garvan Institute, Sydney, Australia
- Department of Endocrinology, St Vincent's Hospital, University of New South Wales, Sydney, Australia
| | - Anthony Heaney
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | | | - Vera Popovic
- Medical Faculty, University Belgrade, Belgrade, Serbia
| | - Jacqueline Trouillas
- Faculté de Médecine Lyon Est, Université Lyon 1, Lyon, France
- Centre de Pathologie et de Biologie Est, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
| | - Olaf M Dekkers
- Departments of Internal Medicine (Section Endocrinology) & Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
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13
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Raverot G, Dantony E, Beauvy J, Vasiljevic A, Mikolasek S, Borson-Chazot F, Jouanneau E, Roy P, Trouillas J. Risk of Recurrence in Pituitary Neuroendocrine Tumors: A Prospective Study Using a Five-Tiered Classification. J Clin Endocrinol Metab 2017. [PMID: 28651368 DOI: 10.1210/jc.2017-00773] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Most pituitary neuroendocrine tumors (PitNETs) show benign behavior, but a substantial number are invasive, recur, or resist medical treatment. Based on a retrospective case-control study, we recently proposed a classification of PitNETs of prognostic relevance. This prospective study aims to test the value of this classification in an independent patient cohort. METHODS All patients who underwent PitNET surgery from 2007 to 2012 in one single center were included. Using a grading system based on invasion on magnetic resonance imaging, immunocytochemical profile, Ki-67, mitotic index, and p53 positivity, tumors were classified. Progression-free survival of the graded tumors was calculated by the Kaplan-Meier method and compared using the log-rank test. A multivariate analysis, using a Cox regression model, was also performed. RESULTS In total, 365 patients had grade 1a PitNETs (51.2%), followed by grade 2a (32.3%), 2b (8.8%), and 1b tumors (7.7%). Of 213 patients with a follow-up, 42% had recurrent (n = 52) or progressive disease (n = 37) at 3.5 years. Grade was a significant predictor of progression-free survival (P < 0.001). Multivariate analysis indicated grade (P < 0.001), age (P = 0.035), and tumor type (P = 0.028) as independent predictors of recurrence and/progression. This risk was 3.72-fold higher for a grade 2b tumor compared with grade 1a tumor. CONCLUSIONS Our data suggest that classification of PitNETs into five grades is of prognostic value to predict postoperative tumor behavior and identifies patients who have a high risk of early recurrence or progression. It therefore will allow clinicians to adapt their therapeutic strategies and stratify patients in future clinical trials.
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Affiliation(s)
- Gérald Raverot
- Fédération d'Endocrinologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron F-69677, France
- Faculté de Médecine Lyon Est, Université Lyon 1, Lyon F-69372, France
- INSERM U1052, CNRS UMR5286, Cancer Research Centre of Lyon, Lyon F-69372, France
| | - Emmanuelle Dantony
- Faculté de Médecine Lyon Est, Université Lyon 1, Lyon F-69372, France
- Service de Biostatistique, Hospices Civils de Lyon, Lyon F-69003, France
- CNRS, UMR 5558, Equipe Biostatistique Santé, Villeurbanne F-69622, France
| | - Julie Beauvy
- Fédération d'Endocrinologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron F-69677, France
- Faculté de Médecine Lyon Est, Université Lyon 1, Lyon F-69372, France
| | - Alexandre Vasiljevic
- Faculté de Médecine Lyon Est, Université Lyon 1, Lyon F-69372, France
- INSERM U1052, CNRS UMR5286, Cancer Research Centre of Lyon, Lyon F-69372, France
- Centre de Pathologie et de Biologie Est, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron F-69677, France
| | - Sara Mikolasek
- Fédération d'Endocrinologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron F-69677, France
| | - Françoise Borson-Chazot
- Fédération d'Endocrinologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron F-69677, France
- Faculté de Médecine Lyon Est, Université Lyon 1, Lyon F-69372, France
| | - Emmanuel Jouanneau
- Faculté de Médecine Lyon Est, Université Lyon 1, Lyon F-69372, France
- INSERM U1052, CNRS UMR5286, Cancer Research Centre of Lyon, Lyon F-69372, France
- Service de Neurochirurgie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron F-69677, France
| | - Pascal Roy
- Faculté de Médecine Lyon Est, Université Lyon 1, Lyon F-69372, France
- Service de Biostatistique, Hospices Civils de Lyon, Lyon F-69003, France
- CNRS, UMR 5558, Equipe Biostatistique Santé, Villeurbanne F-69622, France
| | - Jacqueline Trouillas
- Faculté de Médecine Lyon Est, Université Lyon 1, Lyon F-69372, France
- Centre de Pathologie et de Biologie Est, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron F-69677, France
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Mooney MA, Georges J, Yazdanabadi MI, Goehring KY, White WL, Little AS, Preul MC, Coons SW, Nakaji P, Eschbacher JM. Immediate ex-vivo diagnosis of pituitary adenomas using confocal reflectance microscopy: a proof-of-principle study. J Neurosurg 2017; 128:1072-1075. [PMID: 28548594 DOI: 10.3171/2016.11.jns161651] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the feasibility of using confocal reflectance microscopy (CRM) ex vivo to differentiate adenoma from normal pituitary gland in surgical biopsy specimens. CRM allows for rapid, label-free evaluation of biopsy specimens with cellular resolution while avoiding some limitations of frozen section analysis. METHODS Biopsy specimens from 11 patients with suspected pituitary adenomas were transported directly to the pathology department. Samples were immediately positioned and visualized with CRM using a confocal microscope located in the same area of the pathology department where frozen sections are prepared. An H & E-stained slide was subsequently prepared from imaged tissue. A neuropathologist compared the histopathological characteristics of the H & E-stained slide and the matched CRM images. A second neuropathologist reviewed images in a blinded fashion and assigned diagnoses of adenoma or normal gland. RESULTS For all specimens, CRM contrasted cellularity, tissue architecture, nuclear pleomorphism, vascularity, and stroma. Pituitary adenomas demonstrated sheets and large lobules of cells, similar to the matched H & E-stained slides. CRM images of normal tissue showed scattered small lobules of pituitary epithelial cells, consistent with matched H & E-stained images of normal gland. Blinded review by a neuropathologist confirmed the diagnosis in 15 (94%) of 16 images of adenoma versus normal gland. CONCLUSIONS CRM is a simple, reliable approach for rapidly evaluating pituitary adenoma specimens ex vivo. This technique can be used to accurately differentiate between pituitary adenoma and normal gland while preserving biopsy tissue for future permanent analysis, immunohistochemical studies, and molecular studies.
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Affiliation(s)
| | | | | | - Katherine Y Goehring
- 2Neuropathology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | | | | | | | - Stephen W Coons
- 2Neuropathology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | | | - Jennifer M Eschbacher
- 2Neuropathology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
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Syro LV, Rotondo F, Serna CA, Ortiz LD, Kovacs K. Pathology of GH-producing pituitary adenomas and GH cell hyperplasia of the pituitary. Pituitary 2017; 20:84-92. [PMID: 27586499 DOI: 10.1007/s11102-016-0748-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Histologic, immunohistochemical and electron microscopic studies have provided conclusive evidence that a marked diversity exists between tumors which secrete growth hormone (GH) in excess. GH cell hyperplasia can also be associated with acromegaly in patients with extrapituitary GH-releasing hormone secreting tumors or in familial pituitary tumor syndromes. MATERIALS AND METHODS A literature search was performed for information regarding pathology, GH-producing tumors and acromegaly. RESULTS This review summarizes the current knowledge on the morphology of GH-producing and silent GH adenomas, as well as GH hyperplasia of the pituitary. CONCLUSION The importance of morphologic classification and identification of different subgroups of patients with GH-producing adenomas and their impact on clinical management is discussed.
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Affiliation(s)
- Luis V Syro
- Department of Neurosurgery, Hospital Pablo Tobon Uribe and Clinica Medellin, Medellin, Colombia.
| | - Fabio Rotondo
- Department of Laboratory Medicine, Division of Pathology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Carlos A Serna
- Laboratorio de Patologia y Citologia Rodrigo Restrepo. Department of Pathology, Clinica Las Americas, Universidad CES, Medellin, Colombia
| | - Leon D Ortiz
- Division of Neuro-oncology, Instituto de Cancerologia, Clinica Las Americas, Medellin, Colombia
| | - Kalman Kovacs
- Department of Laboratory Medicine, Division of Pathology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
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Huang KT, Ludy S, Calligaris D, Dunn IF, Laws E, Santagata S, Agar NYR. Rapid Mass Spectrometry Imaging to Assess the Biochemical Profile of Pituitary Tissue for Potential Intraoperative Usage. Adv Cancer Res 2016; 134:257-282. [PMID: 28110653 DOI: 10.1016/bs.acr.2016.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Pituitary adenomas are relatively common intracranial neoplasms that are frequently treated with surgical resection. Rapid visualization of pituitary tissue remains a challenge as current techniques either produce little to no information on hormone-secreting function or are too slow to practically aid in intraoperative or even perioperative decision-making. Matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI MSI) represents a powerful method by which molecular maps of tissue samples can be created, yielding a two-dimensional representation of the expression patterns of small molecules and proteins from biologic samples. In this chapter, we review the use of MALDI MSI, its application to the characterization of the pituitary gland, and its potential applications for guiding the management of pituitary adenomas.
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Affiliation(s)
- K T Huang
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - S Ludy
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - D Calligaris
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - I F Dunn
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - E Laws
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - S Santagata
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, United States
| | - N Y R Agar
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, United States.
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Golden T, Siordia JA. Osteochondromyxoma: Review of a rare carney complex criterion. J Bone Oncol 2016; 5:194-197. [PMID: 28008382 PMCID: PMC5154699 DOI: 10.1016/j.jbo.2016.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 06/30/2016] [Accepted: 07/05/2016] [Indexed: 12/16/2022] Open
Abstract
Osteochondromyxoma is an extremely rare bone tumor associated with 1% of Carney complex patients and constitutes one of its 11 diagnostic criteria. This narrative review of osteochondromyxoma is based on a search of all references to the topic in PubMed, Web Of Science, SCOPUS, ScienceDirect, and JSTOR databases. Special attention was focused on case reports, leading to a review encompassing the case reports to date, as well as related animal model studies. This review covers the current understanding of osteochondromyxoma, highlighting its variability while providing consensus on the most common clinical presentation, pathological findings, and genetic features of this rare bone tumor.
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Affiliation(s)
- Todd Golden
- University of Arizona Medical Center, University of Arizona, 1501 N Campbell Ave., Tucson, AZ 85724, United States
- Corresponding author.
| | - Juan A. Siordia
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States
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