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1.
Trop Doct ; 50(3): 240-242, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32106779

RESUMO

Pituitary hyperplasia as a result of autoimmune thyroiditis has been rarely reported in children. We report a prepubertal girl with Hashimoto's thyroiditis who was inadvertently diagnosed to have a pituitary macroadenoma based on neuroimaging.


Assuntos
Adenoma/etiologia , Doença de Hashimoto/complicações , Neoplasias Hipofisárias/etiologia , Adenoma/diagnóstico por imagem , Adenoma/patologia , Criança , Feminino , Humanos , Neuroimagem , Neoplasias Hipofisárias/diagnóstico por imagem , Neoplasias Hipofisárias/patologia
2.
Medicine (Baltimore) ; 99(8): e19222, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32080117

RESUMO

RATIONALE: Primary hypothyroidism is characterized by loss of thyroxine feedback inhibition and overproduction of thyrotropin-releasing hormone, which might result in reactive pituitary hyperplasia. However, pituitary adenoma secondary to primary hypothyroidism is extremely rare and usually underdiagnosed, and the pathogenic mechanism remains unclear. Herein, we reported two cases with pituitary adenoma secondary to primary hypothyroidism. PATIENT CONCERNS: Case 1: A 35-year-old man presented to the local clinic with a 2-year history of fatigue, puffiness in the bilateral lower extremities and facial region, and coarseness of facial features. Additionally, his relatives also supplemented that he suffered from hypomnesis and hypophrenia.Case 2: A 56-year-old, postmenopausal woman presented to the local clinic with fatigue, dry skin, and sluggishness. DIAGNOSES: The pathological diagnosis of two patients was plurihormonal pituitary adenoma. INTERVENTIONS: A microscopical tumorectomy was performed when the two patients were admitted to our hospital. Thyroid hormone replacement therapy (thyroxine 50 µg/day) was prescribed after microsurgery. OUTCOMES: After 32 months (Case 1) or 43 months (Case 2) follow-up respectively, there was no recurrence, and the symptoms were completely relieved. LESSONS: Pituitary hyperplasia caused by primary hypothyroidism responds well to thyroid hormone replacement therapy. It is worth noting that repeated detection of serum T3, T4, and thyroid-stimulating hormone (TSH) should be performed 3 months after replacement therapy. If the results showed that TSH level decreased partly, while thyroid function did not improve significantly, long-term increased secretion of pituitary TSH adenoma should be considered. And microsurgical resection via a transsphenoidal approach could be ordered. If the optic nerve or optic chiasm were pressed by the adenoma, microsurgery should be performed to relieve the pressure immediately. And then, thyroxine tablet substitute therapy should be performed after surgery.


Assuntos
Adenoma/etiologia , Hipotireoidismo/complicações , Neoplasias Hipofisárias/etiologia , Adenoma/cirurgia , Adulto , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias Hipofisárias/cirurgia , Tireotropina/sangue , Tiroxina/sangue
3.
World Neurosurg ; 136: 28-31, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31904435

RESUMO

BACKGROUND: The majority of patients with acute lymphoblastic leukaemia develop disease relapse in the central nervous system in the absence of central nervous system-directed prophylactic therapy. In the past, prophylactic cranial irradiation was commonly used in the form of whole-brain radiotherapy in patients with acute lymphoblastic leukemia to prevent the development of intracranial diseases. However, in addition to the inherent risk of toxicity, this type of therapy has several delayed side effects including the development of secondary intracranial tumors. CASE DESCRIPTION: We report a rare case of a patient with concurrent pituicytoma, meningioma, and cavernomas 44 years after prophylactic cranial irradiation for childhood acute lymphoblastic leukemia. The patient presented with visual disturbance, headache, and features of hypopituitarism. Endoscopic transsphenoidal resection of the pituicytoma and meningioma was performed. Subsequent regrowth of the residual meningioma necessitated further surgery and adjuvant treatment with radiotherapy. CONCLUSIONS: This case report highlights the unusual case of a patient with 3 concurrent intracranial lesions of distinct pathologies after prophylactic cranial irradiation therapy for childhood acute lymphoblastic leukemia.


Assuntos
Neoplasias Meníngeas/etiologia , Meningioma/etiologia , Neoplasias Induzidas por Radiação/etiologia , Neoplasias Hipofisárias/etiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/radioterapia , Adulto , Feminino , Humanos
4.
J Clin Endocrinol Metab ; 105(3)2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31701145

RESUMO

PURPOSE: To determine the prevalence of insulin-like growth factor-1 (IGF-1) normalization with long-term multimodality therapy in a pituitary center and to assess changes over time. METHODS: Patients with acromegaly (N = 409), with ≥1 year of data after surgery and at least 2 subsequent clinic visits were included in long-term analysis (N = 266). Biochemical data, clinical characteristics, and therapeutic interventions were reviewed retrospectively. RESULTS: At diagnosis, mean [standard deviation] age was 43.4 [14.3] years, body mass index was 28.5 (24.9-32.1) kg/m2 (median, interquartile range), serum IGF-1 index (IGF-1 level/upper limit of normal) was 2.3 [1.7-3.1], and 80.5% had macroadenomas. Patients with transsphenoidal surgery after 2006 were older [46.6 ± 14.3 vs 40.0 ± 13.4 years; P < 0.001]. Age and tumor size correlated inversely. Overall (N = 266), 93.2% achieved a normal IGF-1 level during 9.9 [5.0-15.0] years with multimodality therapy. The interval to first normal IGF-1 level following failed surgical remission was shorter after 2006: 14.0 (95% confidence interval, 10.0-20.0) versus 27.5 (22.0-36.0) months (P = 0.002). Radiation therapy and second surgery were rarer after 2006: 28 (22%) versus 62 (47.0%); P < 0.001 and 12 (9.4%) versus 28 (21.2%); P = 0.010, respectively. Age at diagnosis increased over time periods, possibly reflecting increased detection of acromegaly in older patients with milder disease. Male gender, older age, smaller tumor and lower IGF-1 index at diagnosis predicted long-term sustained IGF-1 control after surgery without adjuvant therapies. CONCLUSION: The vast majority of patients with acromegaly can be biochemically controlled with multimodality therapy in the current era. Radiotherapy and repeat pituitary surgery became less frequently utilized over time. Long-term postoperative IGF-1 control without use of adjuvant therapies has improved.


Assuntos
Acromegalia/terapia , Adenoma/terapia , Terapia Combinada/métodos , Fator de Crescimento Insulin-Like I/metabolismo , Neoplasias Hipofisárias/terapia , Acromegalia/sangue , Acromegalia/complicações , Adenoma/etiologia , Adulto , Índice de Massa Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Hipofisárias/etiologia , Período Pós-Operatório , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
5.
J Neuropathol Exp Neurol ; 79(1): 62-66, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31769844

RESUMO

Transgender individuals may receive long-term hormonal treatment as part of their sexual transition; limited literature has suggested that they consequently may be predisposed to development of prolactinomas. We questioned whether we had encountered such cases. Pathology databases were searched for the years 2000-2019 for tissue specimens from transgender individuals; Sixty surgical specimens from 58 individuals and 8 cytology specimens were identified. Two of these 60 were pituitary adenomas, neither of which were lactotroph adenomas (prolactinomas).The first occurred in a 71-year-old transgender male-to-female who had undergone high-dose hormone therapy, followed by orchiectomy 30 years prior. Chronic hypertension, dizziness, and vertigo prompted an endocrine workup which revealed elevated IGF-1 and prolactin; The pituitary mass proved to be a mixed somatotroph/lactotroph adenoma. The second occurred in a 53-year-old transgender male-to-female who was being evaluated by an endocrinologist prior to initiating hormone therapy for transition when a slightly elevated prolactin level was discovered. This pituitary macroadenoma proved to be a gonadotroph adenoma. The most common surgical specimens were 33 bilateral mastectomies, 13 hysterectomies, and 4 orchiectomies, almost all for gender transition purposes rather than medical conditions. Pathologists may wish to be aware of the occurrence of pituitary adenomas in transgender individuals, although the incidence is quite low.


Assuntos
Adenoma/etiologia , Hormônios/efeitos adversos , Neoplasias Hipofisárias/etiologia , Procedimentos de Readequação Sexual/efeitos adversos , Pessoas Transgênero , Adenoma/cirurgia , Idoso , Bases de Dados Factuais , Feminino , Hormônios/uso terapêutico , Humanos , Hipofisectomia , Masculino , Pessoa de Meia-Idade , Orquiectomia , Neoplasias Hipofisárias/cirurgia , Prolactinoma/etiologia
6.
J Exp Clin Cancer Res ; 38(1): 404, 2019 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-31519191

RESUMO

BACKGROUND: Metabolic reprogramming is an important characteristic of tumors. In the progression of pituitary adenomas (PA), abnormal glucose metabolism has been confirmed by us before. However, whether cholesterol metabolism is involved in the process of PA remains unclear. This study aimed to investigate whether abnormal cholesterol metabolism could affect the progression of PA. METHODS: We analyzed the expression of sterol carrier protein 2 (SCP2) in 40 surgical PA samples. In vitro experiments and xenograft models were used to assess the effects of SCP2 and cholesterol on proliferation of PA. The incidence of hypercholesterolemia between 140 PA patients and 100 heathy controls were compared. RESULTS: We found an upregulation of SCP2 in PA samples, especially in tumors with high proliferation index. Forced expression of SCP2 promoted PA cell lines proliferation in vitro. Furthermore, SCP2 regulated cholesterol trafficking from cytoplasm to membrane in GH3 cells, and extracellularly treating GH3 cells and primary PA cells with methyl-ß-cyclodextrin/cholesterol complex to mimic membrane cholesterol concentration enhanced cell proliferation, which suggested a proliferative effect of cholesterol. Mechanistically, cholesterol induced activation of PKA/SUFU/GLI1 signaling via smoothened receptor, which was well-known as Hedgehog signaling, resulting in inhibiting apoptosis and promoting cell cycle. Accordingly, activation of Hedgehog signaling was also confirmed in primary PA cells and surgical PA samples. In vivo, SCP2 overexpression and high cholesterol diet could promote tumor growth. Intriguingly, the incidence of hypercholesterolemia was significantly higher in PA patients than healthy controls. CONCLUSIONS: Our data indicated that dysregulated cholesterol metabolism could promote PA growth by activating Hedgehog signaling, supporting a potential tumorigenic role of cholesterol metabolism in PA progression.


Assuntos
Proteínas de Transporte/metabolismo , Colesterol/metabolismo , Proteínas Hedgehog/metabolismo , Neoplasias Hipofisárias/metabolismo , Transdução de Sinais , Adulto , Idoso , Animais , Transporte Biológico , Biomarcadores , Proteínas de Transporte/genética , Linhagem Celular Tumoral , Proliferação de Células , Modelos Animais de Doenças , Feminino , Xenoenxertos , Humanos , Hipercolesterolemia/etiologia , Hipercolesterolemia/metabolismo , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Neoplasias Hipofisárias/etiologia , Neoplasias Hipofisárias/patologia , Ratos
7.
Int J Mol Sci ; 20(16)2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31412614

RESUMO

Endogenous somatostatin shows anti-secretory effects in both physiological and pathological settings, as well as inhibitory activity on cell growth. Since somatostatin is not suitable for clinical practice, researchers developed synthetic somatostatin receptor ligands (SRLs) to overcome this limitation. Currently, SRLs represent pivotal tools in the treatment algorithm of neuroendocrine tumors (NETs). Octreotide and lanreotide are the first-generation SRLs developed and show a preferential binding affinity to somatostatin receptor (SST) subtype 2, while pasireotide, which is a second-generation SRL, has high affinity for multiple SSTs (SST5 > SST2 > SST3 > SST1). A number of studies demonstrated that first-generation and second-generation SRLs show distinct functional properties, besides the mere receptor affinity. Therefore, the aim of the present review is to critically review the current evidence on the biological effects of SRLs in pituitary adenomas and neuroendocrine tumors, by mainly focusing on the differences between first-generation and second-generation ligands.


Assuntos
Antineoplásicos/farmacologia , Antineoplásicos/uso terapêutico , Tumores Neuroendócrinos/tratamento farmacológico , Tumores Neuroendócrinos/metabolismo , Receptores de Somatostatina/metabolismo , Animais , Estudos Clínicos como Assunto , Avaliação Pré-Clínica de Medicamentos , Humanos , Ligantes , Tumores Neuroendócrinos/etiologia , Tumores Neuroendócrinos/patologia , Neoplasias Hipofisárias/tratamento farmacológico , Neoplasias Hipofisárias/etiologia , Neoplasias Hipofisárias/metabolismo , Neoplasias Hipofisárias/patologia , Ligação Proteica , Multimerização Proteica , Receptores de Somatostatina/química , Transdução de Sinais , Resultado do Tratamento
8.
Hinyokika Kiyo ; 65(5): 171-174, 2019 May.
Artigo em Japonês | MEDLINE | ID: mdl-31247696

RESUMO

Gonadotropin-releasing hormone (GnRH) agonists play an important role in androgen deprivation therapy (ADT) employed for locally advanced prostate cancer. A 76-year-old man presented with elevated levels of prostate-specific antigen (PSA, 8.33 ng/ml). Subsequently he was diagnosed with cT3bN0M0 prostate cancer, Gleason score 4+5. Before he was referred to our clinic, he had been administered bicalutamide (80 mg/day) daily by the referring physician, followed by subcutaneous injection of goserelin (3. 6 mg) 15 days later. The second dose of another GnRH agonist (leuprolide, 22.5 mg) was administered at his first visit to our clinic, 11 days after goserelin injection, at the discretion of the attending physician (26th day after bicalutamide administration). Bicalutamide administration was concomitantly maintained throughout the period. The patient presented with severe headache the next morning, and imaging studies detected a prominent pituitary adenoma. A trans-sphenoidal surgery was conducted for symptomatic relief. Histopathological analysis revealed a gonadotroph (follicle-stimulating hormone-secreting) pituitary adenoma. Although speculative, repeated injection of GnRH agonist was concluded to be the most likely cause of acute symptomatic gonadotroph pituitary adenoma. The irregular use of medication can cause undesirable and unanticipated adverse events. Awareness is the key to the prevention of such conditions.


Assuntos
Antagonistas de Androgênios , Gonadotrofos , Hormônio Liberador de Gonadotropina , Cefaleia , Neoplasias Hipofisárias , Neoplasias da Próstata , Idoso , Antagonistas de Androgênios/uso terapêutico , Hormônio Liberador de Gonadotropina/agonistas , Cefaleia/etiologia , Humanos , Masculino , Neoplasias Hipofisárias/complicações , Neoplasias Hipofisárias/etiologia , Neoplasias da Próstata/tratamento farmacológico
9.
Metab Brain Dis ; 34(3): 841-846, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30607824

RESUMO

Due to absence of clinical manifestations of hormonal hyper secretion, the treatment of Nonfunctioning pituitary adenoma (NFPA) was always delayed. PTTG1 was reported to be overexpressed in most of pituitary tumors, however, the polymorphism of PTTG1 rs1895320, rs2910200 and rs6882742 with NFPA were still not fully elucidated in NFPA. Thus, a hospital based case control study which included 79 patients and 142 healthy control participants were conducted. DNA was extracted from peripheral blood samples and genotyped by Mass Array methods. In addition, a meta-analysis of rs2910200 was also employed to further testify the conclusion. Significant difference were observed between patients and healthy controls under rs2910200 locus between allelic genotype (p = 0.0219). However, no other significant difference was observed in rs1895329 and rs6882742. In addition, a logistic regression analysis showed that the dominant model of rs2910200 were closely correlated with the NFPA susceptibility (OR = 1.951, 95% CI:1.075-3.542, p = 0.028). While no significant difference was observed in the rs1895320 and rs6882742 under dominant model, recessive model and additive model The meta-analysis results showed that the dominant model and heterozygote model can significantly increase the risk of PA (p = 0.007, OR = 1.57, 95% CI:1.14-2.18; p = 0.009, OR = 1.57, 95% CI:1.12-2.19). Whereas no significant difference were observed under the homozygous model and recessive model. In conclusion, the polymorphism of PTTG1 rs2910200 dominant model and T allelic might increase the risk of NFPA.


Assuntos
Neoplasias Hipofisárias/etiologia , Neoplasias Hipofisárias/genética , Polimorfismo de Nucleotídeo Único/genética , Securina/genética , Alelos , Grupo com Ancestrais do Continente Asiático/genética , Estudos de Casos e Controles , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade
10.
Medicine (Baltimore) ; 97(42): e12879, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30335007

RESUMO

RATIONALE: Nonalcoholic fatty liver disease (NAFLD), among the commonest chronic liver disorders in children and adolescents, is considered a reflection of the current obesity epidemic in children and adults. This liver disease has been linked with various metabolic disorders, but not with prolactinoma (PRLoma). PATIENT CONCERNS: A 13-year-old Japanese girl manifested obesity, serum transaminase and γ-glutamyltransferase elevations, and amenorrhea. Abdominal ultrasonography showed fatty liver. Her serum prolactin concentration was elevated, and cranial magnetic resonance imaging showed a pituitary mass consistent with macroadenoma. DIAGNOSES: NAFLD and PRLoma. INTERVENTIONS AND OUTCOMES: After the patient's NAFLD failed to respond to diet and exercise, cabergoline treatment of the PRLoma decreased body weight, serum transaminase and γ-glutamyltransferase elevations, and ultrasonographic fatty liver grade as the tumor became smaller. LESSONS: Physicians should consider the possibility of PRLoma when diet and exercise fail to improve fatty liver disease in a patient with endocrine symptoms such as amenorrhea.


Assuntos
Hepatopatia Gordurosa não Alcoólica/complicações , Neoplasias Hipofisárias/etiologia , Prolactinoma/etiologia , Adolescente , Feminino , Humanos
12.
Taiwan J Obstet Gynecol ; 56(6): 719-724, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29241908

RESUMO

The role of macroprolactinemia in women with hyperprolactinemia is currently controversial and can lead to clinical dilemmas, depending upon the origin of macroprolactin, the presence of hyperprolactinemic symptoms and monomeric prolactin (PRL) levels. Macroprolactinemia is mostly considered an extrapituitary phenomenon of mild and asymptomatic hyperprolactinemia associated with normal concentrations of monomeric PRL and a predominance of macroprolactin confined to the vascular system, which is biologically inactive. Patients can therefore be reassured that macroprolactinemia should be considered a benign clinical condition, resistant to antiprolactinemic drugs, and that no diagnostic investigations or prolonged follow-up should be necessary. However, a significant proportion of macroprolactinemic patients appears to suffer from hyperprolactinemia-related symptoms and radiological pituitary findings commonly associated with true hyperprolactinemia. The symptoms of hyperprolactinemia are correlated to the levels of monomeric PRL excess, which may be explained as coincidental, by dissociation of macroprolactin, or by physiological, pharmacological and pathological causes. The excess of monomeric PRL levels in such cases is of primarily importance and the diagnosis of macroprolactinemia is misleading or inadequate. However, macroprolactinemia of pituitary origin associated with radiological findings of pituitary adenomas may rarely occur with similar hyperprolactinemic manifestations, exclusively due to bioactivity of macroprolactin. Therefore, in such cases with hyperprolactinemic signs and pituitary findings, macroprolactinemia should be considered a pathological biochemical condition of hyperprolactinemia. Accordingly, individualized diagnostic investigations with the introduction of dopamine agonists, or other treatment with prolonged follow-up, should be mandatory. The review analyses the laboratory and clinical significance of macroprolactinemia in hyperprolactinemic women suggesting clinically useful diagnostic and treatment strategies.


Assuntos
Hiperprolactinemia/sangue , Prolactina/sangue , Adenoma/diagnóstico , Adenoma/etiologia , Adulto , Feminino , Humanos , Hiperprolactinemia/complicações , Hiperprolactinemia/diagnóstico , Pessoa de Meia-Idade , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/etiologia , Avaliação de Sintomas
13.
Endocrinol Diabetes Nutr ; 64(7): 384-395, 2017.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28745610

RESUMO

Clinically non-functioning pituitary adenomas (NFPAs) are among the most common tumors in the sellar region. These lesions do not cause a hormonal hypersecretion syndrome, and are therefore found incidentally (particularly microadenomas) or diagnosed based on compressive symptoms such as headache and visual field defects, as well as clinical signs of pituitary hormone deficiencies. Immunohistochemically, more than 45% of these adenomas stain for gonadotropins or their subunits and are therefore called gonadotropinomas, while 30% of them show no immunostaining for any hormone and are known as null cell adenomas. The diagnostic approach to NFPAs should include visual field examination, an assessment of the integrity of all anterior pituitary hormone systems, and magnetic resonance imaging of the sellar region to define tumor size and extension. The treatment of choice is transsphenoidal resection of the adenoma, which in many instances cannot be completely accomplished. The recurrence rate after surgery may be up to 30%. Persistent or recurrent adenomas are usually treated with radiation therapy. In a small proportion of these cases, drug treatment with dopamine agonists and, to a lesser extent, somatostatin analogs may achieve reduction or at least stabilization of the tumor.


Assuntos
Adenoma , Neoplasias Hipofisárias , Adenoma/diagnóstico por imagem , Adenoma/etiologia , Adenoma/patologia , Adenoma/terapia , Antineoplásicos/uso terapêutico , Transformação Celular Neoplásica , Terapia Combinada , Irradiação Craniana , Agonistas de Dopamina/uso terapêutico , Gonadotropinas Hipofisárias/metabolismo , Humanos , Hipofisectomia/efeitos adversos , Hipopituitarismo/etiologia , Achados Incidentais , Recidiva Local de Neoplasia/terapia , Neuroimagem , Apoplexia Hipofisária/etiologia , Neoplasias Hipofisárias/diagnóstico por imagem , Neoplasias Hipofisárias/etiologia , Neoplasias Hipofisárias/patologia , Neoplasias Hipofisárias/terapia , Prevalência , Somatostatina/análogos & derivados , Somatostatina/uso terapêutico , Transtornos da Visão/etiologia , Campos Visuais
14.
Acta Oncol ; 56(10): 1302-1309, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28548875

RESUMO

BACKGROUND: In 2016, the International Agency for Research on Cancer (IARC) has announced that avoiding body fatness (i.e. overweight and obesity) contributes to prevent meningioma occurrence, but considered the available evidence for glioma inadequate. The association of body fatness with other CNS tumor subgroups is largely unknown. OBJECTIVES: To assess whether body fatness or body height are associated with risk for meningioma, glioma, pituitary adenoma (PA) or nerve sheath tumor (NST) in a large population-based Norwegian cohort. METHODS: In this prospective cohort study of 1.8 million Norwegian residents, weight and height were measured at baseline and incident intracranial tumors were subsequently identified by linkage to the Cancer Registry of Norway. Cox regression analyses were performed to estimate risk for each tumor subgroup in relation to anthropometric measures, stratified by sex and in different age groups. RESULTS: During 54 million person-years of follow-up 3335 meningiomas, 4382 gliomas, 1071 PAs and 759 NSTs were diagnosed. Obesity (BMI ≥30 kg/m2) was not associated with risk for meningioma or glioma, but was significantly associated with risk for PA (HR 1.43; 95% CI 1.09-1.88) compared with the reference group (BMI 20-24.9 kg/m2). For intracranial NSTs, obesity was associated with reduced tumor risk (HR 0.68; 95% CI 0.46-0.99). Body height was associated with increased risk for all four tumor subgroups. CONCLUSIONS: This study does not confirm overweight or obesity as risk factors for meningioma. Additionally, overweight and obesity can be quite confidently excluded as risk factors for glioma. However, this study indicates that body fatness increases the risk for PA, while it reduces the risk for NST.


Assuntos
Adenoma/etiologia , Estatura , Glioma/etiologia , Meningioma/etiologia , Neoplasias da Bainha Neural/etiologia , Obesidade/complicações , Sobrepeso/complicações , Neoplasias Hipofisárias/etiologia , Estudos de Coortes , Humanos , Estudos Prospectivos , Fatores de Risco
15.
World J Surg ; 41(8): 2026-2032, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28321559

RESUMO

BACKGROUND: Recent clinical practice guidelines recommend that routine screening of MEN1 mutation carriers should start at the age of 5 years. The occurrence of clinically relevant MEN1 organ manifestations in children (≤18 years) was evaluated. METHODS: Two prospective collected databases of MEN1 patients (n = 166) who underwent annual screening were retrospectively analyzed for organ manifestations in MEN1 patients ≤18 years. The follow-up was based on the most recent screening examination until December 2015. RESULTS: Twenty [11 females, 9 males, (12%)] of 166 MEN1 patients were diagnosed with at least one organ manifestation at age ≤18 years. The most frequent manifestation was mild asymptomatic pHPT (n = 9, 45%, age range 8-18 years). Eight (40%) young patients had pNENs (three non-functioning pNENs, five insulinomas, age range 9-18 years). All five insulinomas were diagnosed based on hypoglycemic symptoms. The other organ manifestations were asymptomatic pituitary adenomas in six patients (30%, age range 15-18 years) and a bronchial carcinoid in one 15-year-old patient. Only six (30%) patients ≤18 years had clinically relevant organ manifestations. CONCLUSION: Symptomatic or severe manifestations in MEN1 patients rarely occur below the age of 16 years. With regard to psychological burden and cost-effectiveness, routine screening of asymptomatic MEN1 patients should be postponed at least until the age of 16 years.


Assuntos
Neoplasia Endócrina Múltipla Tipo 1/diagnóstico , Adolescente , Criança , Feminino , Humanos , Insulinoma/etiologia , Masculino , Neoplasia Endócrina Múltipla Tipo 1/complicações , Neoplasias Pancreáticas/etiologia , Neoplasias Hipofisárias/etiologia , Estudos Prospectivos , Estudos Retrospectivos
16.
J Clin Neurosci ; 41: 78-80, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28279554

RESUMO

Co-existence of thyrotropin/growth hormone-secreting pituitary adenoma with differentiated thyroid carcinoma is exceedingly rare, with less than 15 cases having been reported. Its clinical presentation and treatment strategy are challenging. We report a case of pituitary macroadenoma, with clinical syndromes of acromegaly and hyperthyroidism, and a thyroid nodule, with cytologically confirmed to be a papillary thyroid carcinoma. Clinical implications, focusing on the strategy for proper management, and possible pathogenesis were discussed.


Assuntos
Carcinoma Papilar/complicações , Adenoma Hipofisário Secretor de Hormônio do Crescimento/complicações , Hipertireoidismo/complicações , Neoplasias Hipofisárias/complicações , Neoplasias da Glândula Tireoide/complicações , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/etiologia , Feminino , Adenoma Hipofisário Secretor de Hormônio do Crescimento/diagnóstico , Adenoma Hipofisário Secretor de Hormônio do Crescimento/etiologia , Humanos , Hipertireoidismo/diagnóstico , Hipertireoidismo/etiologia , Pessoa de Meia-Idade , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/etiologia , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/etiologia , Tireotropina/sangue
17.
Endocr Relat Cancer ; 24(3): C1-C4, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28122798

RESUMO

Acromegaly has traditionally been regarded as a monomorphous disorder resulting from a benign pituitary adenoma. Increasing evidence, however, is highlighting that this disorder is associated with a spectrum of morphologically distinct pituitary tumors with variable clinical, biochemical and radiologic features and differing therapeutic outcomes that are attributed to different genetic and epigenetic changes. These data underscore the need for developing a more refined clinicopathological risk stratification system and implementing personalized targeted therapeutic approaches.


Assuntos
Acromegalia/etiologia , Neoplasias Hipofisárias/complicações , Acromegalia/diagnóstico , Acromegalia/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Hipófise/patologia , Neoplasias Hipofisárias/classificação , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/etiologia
18.
J Pediatr Endocrinol Metab ; 30(2): 231-235, 2017 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-28099131

RESUMO

BACKGROUND: Turner syndrome (TS) is the most common sex chromosome abnormality in females, typically associated with primary amenorrhea and premature ovarian failure due to gonadal dysgenesis. The association of TS with hypopituitarism is an uncommon finding. The objective of the study was to describe an adolescent with TS with hypergonadotropic hypogonadism and subsequent hypogonadotropic hypogonadism. CASE PRESENTATION: A 16-year-old female with primary amenorrhea was diagnosed with TS based on karyotype 45,XO. Other laboratory values included FSH 45.52 IU/L, LH 17.4 IU/L, undetectable estradiol, and prolactin 1.08 nmol/L. Two months later and before treatment, she presented with severe headache and a new left cranial nerve VI palsy. Brain MRI showed a 2.7-cm hemorrhagic pituitary macroadenoma expanding the sella. Laboratory evaluation showed FSH 5.9 IU/L, LH 0.9 IU/L, prolactin 0.09 nmol/L, and GH 1.03 ng/mL. She underwent transphenoidal hypophysectomy, and pathology revealed pituitary adenoma with immunohistochemical staining positive for growth hormone and prolactin. She subsequently developed multiple pituitary hormone deficiencies. Review of the literature identified eight case reports of women with TS who developed pituitary adenomas. CONCLUSIONS: This case illustrates an uncommon co-occurrence of TS and pituitary macroadenoma. Sequential gonadotropin measurements demonstrate the evolution of hypergonadotropic hypogonadism into hypogonadotropic hypogonadism due to hemorrhagic pituitary macroadenoma.


Assuntos
Adenoma/etiologia , Hipogonadismo/complicações , Hipogonadismo/etiologia , Neoplasias Hipofisárias/etiologia , Síndrome de Turner/complicações , Adenoma/patologia , Adolescente , Biomarcadores/sangue , Feminino , Gonadotropinas/sangue , Humanos , Hipogonadismo/sangue , Hipogonadismo/patologia , Neoplasias Hipofisárias/sangue , Neoplasias Hipofisárias/patologia , Prognóstico
20.
Asia Pac J Clin Oncol ; 13(2): e181-e184, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25869477

RESUMO

The introduction of anti-HER2 therapy with trastuzumab has seen an increase in frequency of central nervous system metastasis as the site of first recurrence. Here, we present a rare case of a 63-year-old woman who presented with an isolated breast carcinoma pituitary metastasis 5 years following treatment for a high-risk breast cancer. This report underscores the changing nature of HER2-positive disease in the post-trastuzumab era.


Assuntos
Neoplasias da Mama/complicações , Neoplasias do Sistema Nervoso Central/etiologia , Metástase Neoplásica/patologia , Neoplasias Hipofisárias/etiologia , Anticorpos Monoclonais Humanizados/uso terapêutico , Neoplasias do Sistema Nervoso Central/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Hipofisárias/patologia , Receptor ErbB-2
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