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Chehade G, El Hajj N, Aittaleb M, Alkailani MI, Bejaoui Y, Mahdi A, Aldaalis AAH, Verbiest M, Lelotte J, Ruiz-Reig N, Durá I, Raftopoulos C, Tajeddine N, Tissir F. DIAPH3 predicts survival of patients with MGMT-methylated glioblastoma. Front Oncol 2024; 14:1359652. [PMID: 38454929 PMCID: PMC10917989 DOI: 10.3389/fonc.2024.1359652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/07/2024] [Indexed: 03/09/2024] Open
Abstract
Background Glioblastoma is one of the most aggressive primary brain tumors, with a poor outcome despite multimodal treatment. Methylation of the MGMT promoter, which predicts the response to temozolomide, is a well-established prognostic marker for glioblastoma. However, a difference in survival can still be detected within the MGMT methylated group, with some patients exhibiting a shorter survival than others, emphasizing the need for additional predictive factors. Methods We analyzed DIAPH3 expression in glioblastoma samples from the cancer genome atlas (TCGA). We also retrospectively analyzed one hundred seventeen histological glioblastomas from patients operated on at Saint-Luc University Hospital between May 2013 and August 2019. We analyzed the DIAPH3 expression, explored the relationship between mRNA levels and Patient's survival after the surgical resection. Finally, we assessed the methylation pattern of the DIAPH3 promoter using a targeted deep bisulfite sequencing approach. Results We found that 36% and 1% of the TCGA glioblastoma samples exhibit copy number alterations and mutations in DIAPH3, respectively. We scrutinized the expression of DIAPH3 at single cell level and detected an overlap with MKI67 expression in glioblastoma proliferating cells, including neural progenitor-like, oligodendrocyte progenitor-like and astrocyte-like states. We quantitatively analyzed DIAPH3 expression in our cohort and uncovered a positive correlation between DIAPH3 mRNA level and patient's survival. The effect of DIAPH3 was prominent in MGMT-methylated glioblastoma. Finally, we report that the expression of DIAPH3 is at least partially regulated by the methylation of three CpG sites in the promoter region. Conclusion We propose that combining the DIAPH3 expression with MGMT methylation could offer a better prediction of survival and more adapted postsurgical treatment for patients with MGMT-methylated glioblastoma.
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Affiliation(s)
- Georges Chehade
- Université Catholique de Louvain, Institute of Neuroscience, Cellular and Molecular Division, Brussels, Belgium
| | - Nady El Hajj
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Mohamed Aittaleb
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Maisa I. Alkailani
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Yosra Bejaoui
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Asma Mahdi
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Arwa A. H. Aldaalis
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Michael Verbiest
- Laboratory of Population Genomics, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Julie Lelotte
- Department of Neuropathology, Saint-Luc University Hospital, Brussels, Belgium
| | - Nuria Ruiz-Reig
- Université Catholique de Louvain, Institute of Neuroscience, Cellular and Molecular Division, Brussels, Belgium
| | - Irene Durá
- Université Catholique de Louvain, Institute of Neuroscience, Cellular and Molecular Division, Brussels, Belgium
| | | | - Nicolas Tajeddine
- Université Catholique de Louvain, Institute of Neuroscience, Cellular and Molecular Division, Brussels, Belgium
| | - Fadel Tissir
- Université Catholique de Louvain, Institute of Neuroscience, Cellular and Molecular Division, Brussels, Belgium
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
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Chehade G, Lawson TM, Lelotte J, Daoud L, Di Perri D, Whenham N, Duprez T, Tajeddine N, Tissir F, Raftopoulos C. Long-term survival in patients with IDH-wildtype glioblastoma: clinical and molecular characteristics. Acta Neurochir (Wien) 2023; 165:1075-1085. [PMID: 36920664 DOI: 10.1007/s00701-023-05544-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/01/2023] [Indexed: 03/16/2023]
Abstract
BACKG ROUND Glioblastoma is an aggressive tumor that has a dismal prognosis even with multimodal treatment. However, some patients survive longer than expected. The objective of this study was to revisit patients diagnosed with glioblastoma according to the 2021 WHO classification and analyze clinical and molecular characteristics associated with long-term survival (LTS). METHODS We retrospectively analyzed 120 IDH-wildtype glioblastomas operated on at our institution between 2013 and 2018. We divided them into LTS patients, surviving more than 3 years, and non-LTS patients, and then compared their features. Additionally, we performed DNA methylation-based brain tumor classification in LTS patients. RESULTS Sixteen patients were long-term survivors. Age < 70 years, MGMT promoter methylation, extent of resection ≥ 95%, and administration of radiochemotherapy were associated with LTS (P = 0.005, P < 0.001, P = 0.048, and P = 0.008, respectively). In addition, when these factors were combined, the probability of LTS was 74% (95% CI: 62--84). The methylome analysis confirmed the diagnosis of glioblastoma in the majority of the tested LTS patients. Regarding subtypes, 29% of cases were mesenchymal (MES), 43% were RTK1, and 29% were RTK2. Interestingly, RTK1 and RTK2 cases tended to have longer overall survival than MES cases (P = 0.057). Moreover, the only tested LTS patient with an unmethylated MGMT promoter had an "adult-type diffuse high-grade glioma, IDH-wildtype, subtype E" rather than a glioblastoma. This tumor was characterized by multinucleated giant cells and a somatic mutation in POLE. CONCLUSIONS We suggest that glioblastoma patients with a combination of favorable prognostic factors can achieve LTS in 74% of cases. In addition, methylome analysis is important to ascertain the type of glioma in LTS patients, especially when the MGMT promoter is unmethylated.
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Affiliation(s)
- Georges Chehade
- Department of Neurosurgery, Saint-Luc University Hospital, Université Catholique de Louvain, 10 Hippocrate Av, 1St Floor, Woluwe-Saint-Lambert, 1200, Brussels, Belgium.,Developmental Neurobiology, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Tévi Morel Lawson
- Department of Neurosurgery, Saint-Luc University Hospital, Université Catholique de Louvain, 10 Hippocrate Av, 1St Floor, Woluwe-Saint-Lambert, 1200, Brussels, Belgium
| | - Julie Lelotte
- Department of Neuropathology, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium.,Department of Neuropathology, Institut de Pathologie et de Génétique, Charleroi, Belgium
| | - Lina Daoud
- Department of Neuropathology, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium
| | - Dario Di Perri
- Department of Radiotherapy, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium
| | - Nicolas Whenham
- Department of Oncology, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium
| | - Thierry Duprez
- Department of Radiology, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium
| | - Nicolas Tajeddine
- Cell Physiology, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Fadel Tissir
- Developmental Neurobiology, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium.,College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Christian Raftopoulos
- Department of Neurosurgery, Saint-Luc University Hospital, Université Catholique de Louvain, 10 Hippocrate Av, 1St Floor, Woluwe-Saint-Lambert, 1200, Brussels, Belgium.
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Pinto Pereira J, Lelotte J, Ghaye B, Laterre PF, Hantson P. Pulmonary tumor thrombotic microangiopathy in a patient with a metastatic urothelial carcinoma. Urol Case Rep 2021; 38:101668. [PMID: 33889498 PMCID: PMC8050002 DOI: 10.1016/j.eucr.2021.101668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 03/23/2021] [Accepted: 03/25/2021] [Indexed: 11/28/2022] Open
Abstract
A 78-year-old woman was admitted for acute dyspnoea. One year before, she had been treated with cisplatin and gemcitabine for a high grade urothelial carcinoma. Immunotherapy was discussed 9 months later due the progression of bone metastases but could not be administered before this episode of respiratory distress. There was a major discrepancy between the findings of a limited pulmonary embolism at thoracic tomodensitometry and the severity of a recently developed pulmonary hypertension at echocardiography. The patient presented cardiac arrest on day 6 and post-mortem findings were consistent with diffuse pulmonary tumor thrombotic microangiopathy, a rare complication of urothelial carcinoma.
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Affiliation(s)
- Joao Pinto Pereira
- Department of Intensive Care, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Julie Lelotte
- Department of Pathology, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Benoit Ghaye
- Department of Radiology, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Pierre-François Laterre
- Department of Intensive Care, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Philippe Hantson
- Department of Intensive Care, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
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4
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Schmit G, Lelotte J, Vanhaebost J, Horsmans Y, Van Bockstal M, Baldin P. The Liver in COVID-19-Related Death: Protagonist or Innocent Bystander? Pathobiology 2020; 88:88-94. [PMID: 33108789 PMCID: PMC7705929 DOI: 10.1159/000512008] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 10/05/2020] [Indexed: 01/14/2023] Open
Abstract
Introduction The coronavirus disease 2019 (COVID-19) infection, caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), involves several organs through participation of angiotensin-conversion enzyme 2 (ACE2) receptors. The presence of ACE2 receptors in the liver renders this organ a potential target for the novel coronavirus. Methods We performed 14 complete autopsies of patients infected with SARS-CoV-2. In each case we stained liver tissue sections with haematoxylin/eosin, Masson blue trichrome stain, periodic acid-Schiff (PAS), Perls, and performed cytokeratin-7 (CK7) immunochemistry. Results Macroscopically, livers were pale and yellowish in 8 of 14 (57%) patients, and had a nutmeg appearance in the other 6 cases (42%). Histologically, centrolobular necrosis was observed in 12 cases (86%), and was associated with discreet to moderate lobular or portal inflammation. Steatosis was seen in 8 cases (57%), but fibrosis was rare. Cholestasis and discrete bile duct proliferation was observed in 5 cases (36%). Discussion/Conclusion The main histological changes can be explained by the hypoxic status as a result of severe hypoxemic pneumonia leading to death. Drug toxicity may also play a role in certain cases. Other histological changes may be explained by previous hepatic conditions or underlying hepatic diseases. We concluded that COVID-19 infection was not associated with a specific histopathological pattern of the liver.
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Affiliation(s)
- Grégory Schmit
- Center of Forensic Medicine, Department of Pathology, Cliniques Universitaires Saint-Luc, Brussels, Belgium, .,Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium,
| | - Julie Lelotte
- Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium.,Department of Pathology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Jessica Vanhaebost
- Center of Forensic Medicine, Department of Pathology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.,Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium
| | - Yves Horsmans
- Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium.,Department of Hepato-Gastro-Enterology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Mieke Van Bockstal
- Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium.,Department of Pathology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Pamela Baldin
- Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium.,Department of Pathology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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Lebrun L, Meléndez B, Blanchard O, De Nève N, Van Campenhout C, Lelotte J, Balériaux D, Riva M, Brotchi J, Bruneau M, De Witte O, Decaestecker C, D’Haene N, Salmon I. Clinical, radiological and molecular characterization of intramedullary astrocytomas. Acta Neuropathol Commun 2020; 8:128. [PMID: 32771057 PMCID: PMC7414698 DOI: 10.1186/s40478-020-00962-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/08/2020] [Indexed: 01/12/2023] Open
Abstract
Intramedullary astrocytomas (IMAs) are rare tumors, and few studies specific to the molecular alterations of IMAs have been performed. Recently, KIAA1549-BRAF fusions and the H3F3A p.K27M mutation have been described in low-grade (LG) and high-grade (HG) IMAs, respectively. In the present study, we collected clinico-radiological data and performed targeted next-generation sequencing for 61 IMAs (26 grade I pilocytic, 17 grade II diffuse, 3 LG, 3 grade III and 12 grade IV) to identify KIAA1549-BRAF fusions and mutations in 33 genes commonly implicated in gliomas and the 1p/19q regions. One hundred seventeen brain astrocytomas were analyzed for comparison. While we did not observe a difference in clinico-radiological features between LG and HG IMAs, we observed significantly different overall survival (OS) and event-free survival (EFS). Multivariate analysis showed that the tumor grade was associated with better OS while EFS was strongly impacted by tumor grade and surgery, with higher rates of disease progression in cases in which only biopsy could be performed. For LG IMAs, EFS was only impacted by surgery and not by grade. The most common mutations found in IMAs involved TP53, H3F3A p.K27M and ATRX. As in the brain, grade I pilocytic IMAs frequently harbored KIAA1549-BRAF fusions but with different fusion types. Non-canonical IDH mutations were observed in only 2 grade II diffuse IMAs. No EGFR or TERT promoter alterations were found in IDH wild-type grade II diffuse IMAs. These latter tumors seem to have a good prognosis, and only 2 cases underwent anaplastic evolution. All of the HG IMAs presented at least one molecular alteration, with the most frequent one being the H3F3A p.K27M mutation. The H3F3A p.K27M mutation showed significant associations with OS and EFS after multivariate analysis. This study emphasizes that IMAs have distinct clinico-radiological, natural evolution and molecular landscapes from brain astrocytomas.
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6
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Hantson P, Hubert C, Dieu A, Castanares-Zapatero D, Lelotte J, Laterre PF. Refractory shock during the anesthetic and surgical management of an intrahepatic tumor arising from the adrenal cortex: A case report. Int J Surg Case Rep 2020; 73:109-111. [PMID: 32673783 PMCID: PMC7363625 DOI: 10.1016/j.ijscr.2020.06.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/18/2020] [Accepted: 06/25/2020] [Indexed: 11/28/2022] Open
Abstract
With adrenocortical carcinoma, tumoral secretion is present in 25 to 75% of the cases. In the absence of excessive hormonal production, the diagnosis is often delayed. Isolated liver metastatic lesion may develop after several years of follow-up. Resection of a large intrahepatic malignant lesion may be complicated by a secondary capillary leak syndrome.
Introduction Adrenocortical carcinoma is a rare type of malignant adrenal tumor with a possibility of delayed metastases. Diagnosis may be delayed with a non-secreting tumor or metastasis, and even in this case, surgical management may be complicate. Presentation of case A 55-year-old man underwent elective surgery for the resection of a large intra-hepatic mass from an undetermined type according to a recent liver biopsy. He had a previous history of a non-secreting adrenal tumor that was operated ten years before. Pre-operatively, he was poorly symptomatic, with a normal arterial blood pressure. Anesthesia induction was uneventful, but at the time of tumor resection and removal, he developed extreme vasoplegia and shock with anuric renal failure, lactic acidosis, four-limb and abdominal compartment syndrome. The patient died on day 9 from delayed septic complications. According to the pathological findings, the tumor was a non-secreting adrenocortical carcinoma. Discussion Adrenocortical carcinoma (ACC) is rare condition with diverse clinical manifestations due to excessive hormonal production when the tumor is secreting and mimicking pheochromocytoma. Our patient underwent the resection a large intrahepatic non-secreting metastasis more than ten years after the initial lesion. Peri-operative and post-operative management was complicated by a refractory shock with the characteristics of a secondary systemic capillary leak syndrome. The role of endothelial lesions may be discussed. Conclusion Surgery of metastatic adrenocortical carcinoma may be complicated by severe hemodynamic complications, even in the absence of hormonal secretion.
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Affiliation(s)
- Philippe Hantson
- Department of Intensive Care, Cliniques St-Luc, Université catholique de Louvain, 1200 Brussels, Belgium; Louvain Centre for Toxicology and Applied Pharmacology (LTAP), Université catholique de Louvain, 1200 Brussels, Belgium.
| | - Catherine Hubert
- Department of Abdominal Surgery and Transplantation, Unit of Hepato-biliary and Pancreatic Surgery, Cliniques St-Luc, Université catholique de Louvain, 1200 Brussels, Belgium
| | - Audrey Dieu
- Department of Anesthesiology, Cliniques St-Luc, Université catholique de Louvain, 1200 Brussels, Belgium
| | - Diego Castanares-Zapatero
- Department of Intensive Care, Cliniques St-Luc, Université catholique de Louvain, 1200 Brussels, Belgium
| | - Julie Lelotte
- Department of Pathology, Cliniques St-Luc, Université catholique de Louvain, 1200 Brussels, Belgium
| | - Pierre-François Laterre
- Department of Intensive Care, Cliniques St-Luc, Université catholique de Louvain, 1200 Brussels, Belgium
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Lelotte J, Duprez T, Raftopoulos C, Michotte A. Polymorphous low-grade neuroepithelial tumor of the young: case report of a newly described histopathological entity. Acta Neurol Belg 2020; 120:729-732. [PMID: 31754999 DOI: 10.1007/s13760-019-01241-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 11/06/2019] [Indexed: 10/25/2022]
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Hoffmann D, Dvorakova T, Stroobant V, Bouzin C, Daumerie A, Solvay M, Klaessens S, Letellier MC, Renauld JC, van Baren N, Lelotte J, Marbaix E, Van den Eynde BJ. Tryptophan 2,3-Dioxygenase Expression Identified in Human Hepatocellular Carcinoma Cells and in Intratumoral Pericytes of Most Cancers. Cancer Immunol Res 2019; 8:19-31. [DOI: 10.1158/2326-6066.cir-19-0040] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 06/27/2019] [Accepted: 11/15/2019] [Indexed: 11/16/2022]
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9
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Joris V, Ribeiro Vaz JG, Lelotte J, Duprez T, Raftopoulos C. Large Epileptogenic Type IIIb Dysplasia: A Radiological and Anatomopathological Challenge. World Neurosurg 2019; 129:330-333. [DOI: 10.1016/j.wneu.2019.06.106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/12/2019] [Accepted: 06/13/2019] [Indexed: 01/12/2023]
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Costa E, Lawson TM, Lelotte J, Fomekong E, Vaz RG, Renard L, Whenham N, Raftopoulos C. Long-term survival after glioblastoma resection: hope despite poor prognosis factors. J Neurosurg Sci 2019; 63:251-257. [DOI: 10.23736/s0390-5616.18.04180-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Furnica RM, Lelotte J, Duprez T, Maiter D, Alexopoulou O. Recurrent pituitary abscess: case report and review of the literature. Endocrinol Diabetes Metab Case Rep 2018; 2018:EDM-17-0162. [PMID: 29497537 PMCID: PMC5825836 DOI: 10.1530/edm-17-0162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 02/02/2018] [Indexed: 12/28/2022] Open
Abstract
A 26-year-old woman presented with severe postpartum headaches. Magnetic resonance imaging (MRI) revealed a symmetric, heterogeneous enlargement of the pituitary gland. Three months later, she developed central diabetes insipidus. A diagnosis of postpartum hypophysitis was suspected and corticosteroids were prescribed. Six months later, the pituitary mass showed further enlargement and characteristics of a necrotic abscess with a peripheral shell and infiltration of the hypothalamus. Transsphenoidal surgery was performed, disclosing a pus-filled cavity which was drained. No bacterial growth was observed, except a single positive blood culture for Staphylococcus aureus, considered at that time as a potential contaminant. A short antibiotic course was, however, administered together with hormonal substitution for panhypopituitarism. Four months after her discharge, severe headaches recurred. Pituitary MRI was suggestive of a persistent inflammatory mass of the sellar region. She underwent a new transsphenoidal resection of a residual abscess. At that time, the sellar aspiration fluid was positive for Staphylococcus aureus and she was treated with antibiotics for 6 weeks, after which she had complete resolution of her infection. The possibility of a pituitary abscess, although rare, should be kept in mind during evaluation for a necrotic inflammatory pituitary mass with severe headaches and hormonal deficiencies.
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Affiliation(s)
- Raluca Maria Furnica
- Departments of Endocrinology, Pathology, and NeuroradiologyUniversité catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Julie Lelotte
- Departments of Pathology, and NeuroradiologyUniversité catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Thierry Duprez
- Departments of NeuroradiologyUniversité catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Dominique Maiter
- Departments of Endocrinology, Pathology, and NeuroradiologyUniversité catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Orsalia Alexopoulou
- Departments of Endocrinology, Pathology, and NeuroradiologyUniversité catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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Lelotte J, Mourin A, Fomekong E, Michotte A, Raftopoulos C, Maiter D. Both invasiveness and proliferation criteria predict recurrence of non-functioning pituitary macroadenomas after surgery: a retrospective analysis of a monocentric cohort of 120 patients. Eur J Endocrinol 2018; 178:237-246. [PMID: 29259039 DOI: 10.1530/eje-17-0965] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 12/19/2017] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Additional robust criteria to predict early postoperative recurrence of non-functioning pituitary macroadenomas (NFMAs) are needed. Recently, a new classification of pituitary tumors has been proposed, which is based on both radiological and histological criteria and allows the grading into 5 groups of different potential aggressiveness. The aim of this study was to use this classification to further characterize predictive factors of recurrence in an independent series of NFMA. CASES AND METHODS 120 patients operated for a NFMA were analyzed retrospectively. For each of them, the invasion of the cavernous and/or sphenoidal sinuses by the tumor was studied on the preoperative MRI and the proliferative character was based on precise histological and immunohistological examination. RESULTS 26% (n = 31) of the adenomas were proliferative and 57% (n = 68) were invasive. The invasive lesions were larger (P < 0.001) and their removal was complete in only 82% of the cases. The distribution of NFMAs was as follows: 32% grade 1a, 11% (proliferative) grade 1b, 42% (invasive) grade 2a and 15% (proliferative and invasive) grade 2b. Their probability of recurrence at 5 years was 20, 39, 44 and 66%, respectively. A young age, the atypical character and the presence of postoperative residual tumor were all independent risk factors of recurrence (P < 0.025). DISCUSSION The new clinicopathological classification proves to be very useful in predicting the risk of recurrence of non-functioning pituitary macroadenomas after a first surgery. In particular, grade 2b lesions showed an overall likelihood of recurrence that was 8.6 times greater than those of grade 1a.
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Affiliation(s)
| | | | - Edward Fomekong
- Department of Neurosurgery, University Hospital Saint-LucBrussels, Belgium
| | - Alex Michotte
- Department of NeurologyUZ Brussels, Brussels, Belgium
| | | | - Dominique Maiter
- Department of Endocrinology, University Hospital Saint-LucBrussels, Belgium
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13
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Yildiz H, Ould-Nana I, Lelotte J, Duprez T, Vandercam B, Lambert M, Lefebvre C. A strange oculomotor palsy with eosinophilia. Acta Clin Belg 2016; 71:327-330. [PMID: 27075809 DOI: 10.1080/17843286.2015.1110896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A 75-year-old man was admitted to the Department of internal medicine because of a 2-month history of neurological deterioration. During the previous year, he complained of recurrent sinusitis, asthma, arthralgias, myalgias and asthenia. Later on, an oculomotor palsy, weakness and disturbance of the sensibility of the right upper limb appeared. Blood sample showed 6510 eosinophils per microlitre. The cerebral magnetic resonance demonstrated bilateral frontal and left parietal subcortical lesions from which the most voluminous presented large haemorrhagic areas. A cerebral biopsy showed small vessel's vasculitis, fibrinoid necrosis and extravascular eosinophilic encroachment. A diagnosis of oculomotor palsy secondary to eosinophilic granulomatosis with polyangeitis was then made, which was successfully treated with corticosteroids and cyclophosphamide.
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Mavrogenis G, Lelotte J, Jouret-Mourin A, Azzouzi K. Terminal ileum hemosiderosis secondary to prolonged oral iron ingestion. Ann Gastroenterol 2015; 28:288. [PMID: 25831064 PMCID: PMC4367223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Accepted: 10/13/2014] [Indexed: 11/03/2022] Open
Affiliation(s)
- Georgios Mavrogenis
- Department of Hepatogastroenterology (Georgios Mavrogenis, Kassem Azzouzi), Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium,
Correspondence to: Georgios Mavrogenis, Department of Hepatogastroenterology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200, Brussels, Belgium, Tel.: +32 474 458025, Fax: +32 027 648927, e-mail:
| | - Julie Lelotte
- Department of Pathology (Julie Lelotte, Anne Jouret-Mourin), Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Anne Jouret-Mourin
- Department of Pathology (Julie Lelotte, Anne Jouret-Mourin), Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Kassem Azzouzi
- Department of Hepatogastroenterology (Georgios Mavrogenis, Kassem Azzouzi), Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
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