Abstract:
BACKGROUND:Macroadenomas represent 50% of pituitary tumours and are often (30%) nonfunctioning. Their immunophenotype suggests differentiation toward a specific pituitary cell line. A substantial proportion of tumours with particularly aggressive behaviour are so called 'silent subtype 3 adenoma'. Its diagnosis requires ultrastructural confirmation. Although once included among silent corticotroph adenomas, this aggressive, morphologically distinctive tumour is now recognized as a major form of plurihormonal adenoma and, in fact, some patients might present with clinical hormonal excess. The cytogenesis and pathobiology of silent subtype 3 adenomas is unsettled. OBJECTIVE:We undertook a systematic clinicopathologic examination of the Mayo Clinic experience with this poorly understood tumour. DESIGN:This retrospective, single institution study found 27 confirmed examples of silent subtype 3 adenoma, a frequency of 0.9% of adenomas. Despite histologic and immunophenotypic variation, their ultrastructural features were diagnostic and the sole basis for case inclusion. RESULTS:The study group was comprised of 16 men (59%) and 11 women (41%); two patients (7%) had definitive diagnosis of multiple endocrine neoplasia type 1 (MEN1). Three tumours (11%) were discovered incidentally. Nine patients each (38%) presented with headaches or visual field loss. Endocrine hyperfunction was noted in eight cases (30%), including GH excess in five (19%) and clinically significant PRL elevation in three (11%). Hypogonadism was noted in 17 cases (63%) and growth arrest in one (4%). All tumours were macroadenomas; 16 (60%) showed radiographic evidence of invasion. Most tumours were plurihormonal, featuring immunoreactivity for PRL (17), GH (15), TSH (16) or ACTH (3); only one lesion was immunonegative. Although a gross total resection was achieved in 19 cases (70%), re-operation for recurrence(s) was required in seven of these (37%). Follow-up (mean, 69 months) showed a high (59%) rate of persistent or recurrent of tumour. Overall, 14 patients (54%) underwent radiotherapy after surgical treatment: three patients (12%) for substantial residual tumour, eight (31%) as adjuvant therapy and three (12%) for tumour regrowth. CONCLUSION:Silent subtype 3 adenoma, a plurihormonal tumour, is rare and aggressive in nature. This adenoma must be considered in the differential of often clinically nonfunctioning but plurihormonal adenomas featuring variable cytologic atypia. Electron microscopy is required for confirmation of the diagnosis. The cytogenesis of silent subtype 3 adenoma remains unsettled.
journal_name
Clin Endocrinol (Oxf)journal_title
Clinical endocrinologyauthors
Erickson D,Scheithauer B,Atkinson J,Horvath E,Kovacs K,Lloyd RV,Young WF Jrdoi
10.1111/j.1365-2265.2008.03514.xsubject
Has Abstractpub_date
2009-07-01 00:00:00pages
92-9issue
1eissn
0300-0664issn
1365-2265pii
CEN3514journal_volume
71pub_type
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1989.tb00437.x
更新日期:1989-04-01 00:00:00
abstract::Nutrition and growth during infancy are an emerging issue because of their potential link to metabolic health disorders in later life. Moreover, prolonged breast-feeding appears to be associated with a lower risk of obesity than formula feeding. Human milk is a source of various hormones and growth factors, namely adi...
journal_title:Clinical endocrinology
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2265.2009.03585.x
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abstract::We have employed a syngeneic system utilizing thyroid cell monolayers initiated following thyroid surgery co-cultured with autologous T cells to demonstrate T cell autosensitization in patients with Graves' disease. Antigen-induced blastogenesis was monitored using 24 h [3H]thymidine uptake. Control experiments with 5...
journal_title:Clinical endocrinology
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doi:10.1111/j.1365-2265.1985.tb01077.x
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abstract:BACKGROUND:We performed a randomized, double-blind, prospective, 16-week clinical trial to evaluate the efficacy and safety of risedronate with and without cholecalciferol on 25-hydroxyvitamin D [25(OH)D] levels and bone markers in Korean patients with osteoporosis. METHODS:We randomly assigned 164 adults with osteopo...
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pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1365-2265.2011.04041.x
更新日期:2011-06-01 00:00:00
abstract::Two main types of RET/PTC oncogene, named RET/PTC-1 and 3, occur in papillary thyroid carcinomas especially in those from Belarus children after the Chernobyl nuclear accident. Several variants of RET/PTC-3 have also been found, having different break points with respect to the classical RET/PTC-3. To our knowledge, n...
journal_title:Clinical endocrinology
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doi:10.1046/j.1365-2265.2000.01046.x
更新日期:2000-07-01 00:00:00
abstract::Six girls and one boy with precocious puberty were treated with a superactive LHRH analogue (D-TRP6-LHRH) for periods ranging from 1 year to 2 years and 3 months. In the first phase of the treatment it was administered in combination with cyproterone acetate (CyA) to counteract an early stimulatory effect until inhibi...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1984.tb03433.x
更新日期:1984-04-01 00:00:00
abstract::A 16-year-old female patient with an adrenal tumour was studied. Clinically she had progressive hirsutism, showed high urinary 17-oxosteroid excretion with normal plasma cortisol. Plasma C19-steroids, both unconjugated (including testosterone) and sulphate-conjugated, were greatly elevated. On surgical exploration an ...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1978.tb02773.x
更新日期:1978-04-01 00:00:00
abstract:OBJECTIVE:The aim was to investigate whether, in the absence of gonads, GH could bring forward the age of neuroendocrine activation resulting in onset of puberty. DESIGN:In girls with Turner's syndrome, we evaluated the effects of GH therapy on developmental changes in FSH serum concentrations used as an indicator of ...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1993.tb01755.x
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abstract:BACKGROUND AND OBJECTIVE:Excess endogenous thyroxine causes bone loss, but the effects of exogenous thyroxine are disputed. We report on bone mass and metabolism in women taking L-thyroxine therapy. DESIGN:Cross-sectional and longitudinal studies. PATIENTS:Cross-sectional study: 40 healthy premenopausal women with au...
journal_title:Clinical endocrinology
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doi:10.1111/j.1365-2265.1994.tb02789.x
更新日期:1994-12-01 00:00:00
abstract:OBJECTIVE:We have recently demonstrated multiple aberrations in the GH-IGF axis in the sera of children with untreated insulin-dependent diabetes mellitus (IDDM) which were restored after insulin replacement. However, the net result of these alterations in the IGF system on the concentrations of free/biologically avail...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1046/j.1365-2265.1996.7760786.x
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doi:10.1111/j.1365-2265.2005.02383.x
更新日期:2005-11-01 00:00:00
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journal_title:Clinical endocrinology
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doi:10.1111/cen.13799
更新日期:2018-10-01 00:00:00
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doi:10.1046/j.1365-2265.2000.00934.x
更新日期:2000-02-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1985.tb00225.x
更新日期:1985-09-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1046/j.1365-2265.1997.1630976.x
更新日期:1997-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/j.1365-2265.1989.tb00452.x
更新日期:1989-07-01 00:00:00
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journal_title:Clinical endocrinology
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journal_title:Clinical endocrinology
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doi:10.1111/j.1365-2265.1977.tb02005.x
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更新日期:2015-09-01 00:00:00
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journal_title:Clinical endocrinology
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doi:10.1111/j.1365-2265.1987.tb00813.x
更新日期:1987-05-01 00:00:00
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journal_title:Clinical endocrinology
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doi:10.1111/cen.14149
更新日期:2020-04-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1990.tb00916.x
更新日期:1990-06-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1990.tb00888.x
更新日期:1990-04-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/cen.12517
更新日期:2014-12-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章,评审
doi:10.1111/cen.14368
更新日期:2020-11-29 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1994.tb02513.x
更新日期:1994-06-01 00:00:00
abstract::Only five cases of growth hormone secreting pituitary carcinoma have been documented. We present a 49-year-old West Indian male with grossly elevated plasma growth hormone (760-10,400 mU/l), and a large aggressive pituitary tumour that continued to grow despite repeated pituitary surgery, radiotherapy and medical ther...
journal_title:Clinical endocrinology
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2265.1992.tb02306.x
更新日期:1992-08-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1993.tb00993.x
更新日期:1993-02-01 00:00:00