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Anguezomo G, El Mghari G, El Ansari N. [Multiple endocrine neoplasia type 1: about a case]. Pan Afr Med J 2019; 33:238. [PMID: 31692695 PMCID: PMC6814935 DOI: 10.11604/pamj.2019.33.238.18053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 02/22/2019] [Indexed: 11/11/2022] Open
Abstract
La néoplasie endocrinienne multiple type1 (NEM1) est une maladie rare, définie par l'atteinte tumorale, chez le même sujet, d'au moins deux glandes endocrines affectant l'antéhypophyse, les parathyroïdes et le tissu endocrine duodéno-pancréatique. Cette pathologie héréditaire autosomique dominante est liée à la mutation du gène NEM1 codant pour la ménine et situé sur le chromosome 11q13. Il existe, toutefois, des formes sporadiques dans 8 à 14% des cas. La lésion endocrinienne initiale peut être unique dans environ 75%. Cependant, chacune des principales atteintes peut être inaugurale. Le cas rapporté ici est révélé par un adénome hypophysaire somatoprolactinique ayant un caractère agressif, ne répondant pas au traitement conventionnel. La découverte d'une hyperparathyroïdie primaire ainsi qu'une tumeur neuroendocrine du pancréas (pNET) sept ans plus tard en font toute la particularité. L'attitude thérapeutique est discutée au sein d'une équipe pluridisciplinaire spécialisée dans le domaine de la pathologie endocrine.
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Affiliation(s)
- Gladys Anguezomo
- Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, CHU Mohamed VI Marrakech, Maroc.,Faculté de Médecine et de Pharmacie de Marrakech, Université Cadi Ayyad, Marrakech, Maroc
| | - Ghizlane El Mghari
- Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, CHU Mohamed VI Marrakech, Maroc.,Faculté de Médecine et de Pharmacie de Marrakech, Université Cadi Ayyad, Marrakech, Maroc
| | - Nawal El Ansari
- Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, CHU Mohamed VI Marrakech, Maroc.,Faculté de Médecine et de Pharmacie de Marrakech, Université Cadi Ayyad, Marrakech, Maroc
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Dai C, Feng M, Liu X, Ma S, Sun B, Bao X, Yao Y, Deng K, Wang Y, Xing B, Lian W, Zhong D, Ma W, Wang R. Refractory pituitary adenoma: a novel classification for pituitary tumors. Oncotarget 2018; 7:83657-83668. [PMID: 27845901 PMCID: PMC5347795 DOI: 10.18632/oncotarget.13274] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 10/03/2016] [Indexed: 11/25/2022] Open
Abstract
Pituitary adenomas are classified as typical or atypical, invasive or noninvasive, and aggressive or nonaggressive based on pathological features, radiological findings, and clinical behavior. Only pituitary tumors with cerebrospinal and/or systemic metastasis are considered malignant carcinomas. However, some pituitary adenomas with high Ki-67 indexes exhibit aggressive behaviors, such as rapid growth, early and frequent recurrence, and resistance to conventional treatment, even in the absence of metastasis. Novel terminology is needed to define these tumors. Here, we propose the use of the term “refractory pituitary adenoma” to define malignant pituitary tumors exhibiting 1) a high Ki-67 index and rapid growth, 2) early and high frequency of recurrence, 3) resistance to conventional treatments and/or salvage treatment with temozolomide (TMZ), 4) poor prognosis, 5) and a lack of cerebrospinal or systemic metastases. To illustrate the utility of this refractory pituitary adenoma classification and the difficulty in managing disease in these patients, we examined twelve clinical cases. Correctly identifying refractory pituitary adenomas is crucial for improving patient prognoses. Early identification might encourage the early use of aggressive therapeutic strategies to prevent or delay recurrence.
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Affiliation(s)
- Congxin Dai
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Ming Feng
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xiaohai Liu
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Sihai Ma
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Bowen Sun
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xinjie Bao
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yong Yao
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Kan Deng
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yu Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Bing Xing
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Wei Lian
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Dingrong Zhong
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Wenbin Ma
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Renzhi Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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