Management of aggressive pituitary adenomas: current treatment strategies.

Abstract:

:Aggressive pituitary adenomas are notoriously difficult to manage due to their size, invasiveness, speed of growth and high frequency of recurrence. Except for prolactinomas, surgery (usually transsphenoidal but sometimes transcranial) is the first-line option, but re-growth of aggressive tumors is almost inevitable and monitoring and repeat surgery is required to control symptoms. In prolactinomas, dopamine agonists are the first-line treatment and they normalize prolactin levels in most patients even with macroprolactinomas. Somatostatin analogues offer another pharmacotherapy for pituitary adenomas either for primary therapy, pre-operatively to reduce the tumor volume and make it more amenable to surgical removal, or post-surgery to control re-expansion. When surgery and pharmacotherapy fail, radiotherapy is a useful third-line strategy that reduces recurrence, while extreme pituitary adenomas with metastases may potentially be managed with chemotherapy (although more data are needed). A combination of these therapies will be required for aggressive pituitary adenomas and careful follow-up is essential.

journal_name

Pituitary

journal_title

Pituitary

authors

Buchfelder M

doi

10.1007/s11102-008-0153-z

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

256-60

issue

3

eissn

1386-341X

issn

1573-7403

journal_volume

12

pub_type

杂志文章,评审
  • Ancient views on the hypothalamic-pituitary-thyroid axis: an historical and epistemological perspective.

    abstract::The modern views on the anatomical and physiological interactions between the hypothalamus, pituitary and thyroid gland have emerged only in the last fifty years, although their historical roots may be found in a number of ancient and still not widely known ideas and observations. The regulation of energy body stores ...

    journal_title:Pituitary

    pub_type: 历史文章,杂志文章

    doi:10.1023/a:1009953723963

    authors: Toni R

    更新日期:2000-10-01 00:00:00

  • Dopamine resistance of prolactinomas.

    abstract::Resistance to dopamine agonists can be defined with respect to failure to normalize PRL levels and failure to decrease tumor size by > or = 50%. Using these definitions, failure to normalize PRL levels is seen in 24% of those treated with bromocriptine, 13% of those treated with pergolide and 11% of those treated with...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1023/a:1026225625897

    authors: Molitch ME

    更新日期:2003-01-01 00:00:00

  • Can tissue biomarkers reliably predict the biological behavior of craniopharyngiomas? A comprehensive overview.

    abstract:BACKGROUND:The growing interest in the molecular and genetic alterations of craniopharyngiomas (CPs) is embodied in recent studies revealing insights into the CP tumorigenesis and identifying novel molecular pathways amenable of targeted therapies. The actual impact of this new information, however, remains inconclusiv...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1007/s11102-018-0890-6

    authors: Prieto R,Pascual JM

    更新日期:2018-08-01 00:00:00

  • Characterization of the ability of a, second-generation SST-DA chimeric molecule, TBR-065, to suppress GH secretion from human GH-secreting adenoma cells.

    abstract:CONTEXT:Somatostatin (SST) and dopamine (DA) inhibit growth hormone (GH) secretion and proliferation of GH-secreting pituitary adenomas (GHomas) through binding to SSTR2 and D2R receptors. Chimeric SST-DA compounds (Dopastatins) display increased potency in inhibiting GH secretion, as compared with individual SST or DA...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-020-01113-4

    authors: Cuny T,Graillon T,Defilles C,Datta R,Zhang S,Figarella-Branger D,Dufour H,Mougel G,Brue T,Landsman T,Halem HA,Culler MD,Barlier A,Saveanu A

    更新日期:2021-01-12 00:00:00

  • Medical management of pituitary adenomas: structural and ultrastructural changes.

    abstract::The morphology of the various pituitary cell types is highly dynamic and allows recognition of many cellular functions. Most pituitary cells show morphologic changes that reflect stimulation or inhibition by hormones. Drugs have also been shown to alter the morphology of several pituitary tumor types, allowing a measu...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1023/a:1022320732718

    authors: Asa SL,Ezzat S

    更新日期:2002-01-01 00:00:00

  • Acromegaly in the setting of Tatton-Brown-Rahman Syndrome.

    abstract:PURPOSE:Tatton-Brown-Rahman syndrome (TBRS) is a newly defined genetic entity characterized by overgrowth and intellectual disability, resulting from germline mutations in the gene encoding DNA methyltransferase 3 alpha (DNMT3A). Affected individuals with benign and malignant tumors have been reported; to our knowledge...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-019-01019-w

    authors: Hage C,Sabini E,Alsharhan H,Fahrner JA,Beckers A,Daly A,Salvatori R

    更新日期:2020-04-01 00:00:00

  • Childhood craniopharyngioma.

    abstract::Craniopharyngiomas (CP) are partly cystic embryogenic malformations of the sellar and parasellar region. With an overall incidence of 0.5-2.0 new cases/million population/year, approximately 30-50 % of all cases represent childhood CP. Typical manifestations at diagnosis are headache, visual impairment, polyuria/polyd...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1007/s11102-012-0401-0

    authors: Müller HL

    更新日期:2013-03-01 00:00:00

  • Gene expression profiling in human null cell pituitary adenoma tissue.

    abstract::It is estimated that up to one in five individuals develops pituitary gland tumors, despite the common occurrence of these tumors, the pathogenetic mechanisms underlying their development mainly remain unknown. We studied the gene expression in null cell adenomas compared with normal pituitary by expressed sequence ta...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-007-0008-z

    authors: Hu J,Song H,Wang X,Shen Y,Chen F,Liu Y,Li S,Wang Y,Shou X,Zhang Y,Hu R

    更新日期:2007-01-01 00:00:00

  • Drugs and prolactin.

    abstract::Medications commonly cause hyperprolactinemia and their use must be differentiated from pathologic causes. The most common medications to cause hyperprolactinemia are the antipsychotic agents, although some of the newer atypical antipsychotics do not do so. Other medications causing hyperprolactinemia include antidepr...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1007/s11102-008-0106-6

    authors: Molitch ME

    更新日期:2008-01-01 00:00:00

  • Prevalence of hematological abnormalities in patients with Sheehan's syndrome: response to replacement of glucocorticoids and thyroxine.

    abstract::Anemia and other hematological abnormalities are common in patients with Sheehan's syndrome. The response of these abnormalities to replacement of thyroxine and glucocorticoids is not clear. The aim of the present study was to document the profile of hematological abnormalities and response to treatment in patients wi...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-010-0255-2

    authors: Laway BA,Mir SA,Bashir MI,Bhat JR,Samoon J,Zargar AH

    更新日期:2011-03-01 00:00:00

  • Medical combination therapies in Cushing's disease.

    abstract:INTRODUCTION:There has been growing interest on medical therapy for the management of Cushing's disease (CD), particularly in cases of persistent or recurrent hypercortisolism. Ketoconazole, an inhibitor of adrenal steroidogenesis, is the most widely used drug, whereas cabergoline and pasireotide are the most promising...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-015-0641-x

    authors: Vilar L,Naves LA,Machado MC,Bronstein MD

    更新日期:2015-04-01 00:00:00

  • Management of cystic prolactinomas: a review.

    abstract:INTRODUCTION:Cystic prolactinoma is a variant of prolactin-secreting pituitary adenoma. The strategies for the management of cystic prolactinoma have not been addressed thoroughly in clinical guidelines. METHODS:A literature search was performed using Pubmed to review the current approaches to the treatment of cystic ...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1007/s11102-018-0888-0

    authors: Nakhleh A,Shehadeh N,Hochberg I,Zloczower M,Zolotov S,Taher R,Daoud Naccache D

    更新日期:2018-08-01 00:00:00

  • The trans-sphenoidal resection of pituitary adenomas in elderly patients and surgical risk.

    abstract::In western countries, the process of "ageing of the population" is increasingly forcing clinical medicine to find answers for pathologies affecting the elder segments of our community. In this respect, pituitary adenomas often raise difficult questions on surgical indications, since little is known about postoperative...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-012-0390-z

    authors: Locatelli M,Bertani G,Carrabba G,Rampini P,Zavanone M,Caroli M,Sala E,Ferrante E,Gaini SM,Spada A,Mantovani G,Lania A

    更新日期:2013-06-01 00:00:00

  • Effect of gsp oncogene on somatostatin receptor subtype 1 and 2 mRNA levels in GHRH-responsive GH3 cells.

    abstract::Growth hormone releasing hormone (GHRH) signals via G protein-coupled receptors (GHRH-R) to enhance intracellular Galphas/adenylyl cyclase/cAMP signaling, which in turn has positive effects on GH synthesis and release, as well as proliferation of the GH-producing cells of the anterior pituitary gland. Some GH-producin...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-005-5245-4

    authors: Kim E,Sohn S,Lee M,Park C,Jung J,Park S

    更新日期:2005-01-01 00:00:00

  • Towards a better quality of life (QoL) for patients with pituitary diseases: results from a focus group study exploring QoL.

    abstract:PURPOSE:Patients treated for pituitary adenomas generally report a reduced quality of life (QoL). At present, the patient's perspective of QoL has not been fully addressed and this, and further insight in potential determinants of QoL in pituitary diseases is required to design strategies to improve QoL. We aimed to de...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-014-0561-1

    authors: Andela CD,Niemeijer ND,Scharloo M,Tiemensma J,Kanagasabapathy S,Pereira AM,Kamminga NG,Kaptein AA,Biermasz NR

    更新日期:2015-02-01 00:00:00

  • Hepatolithiasis (intrahepatic stone) during octreotide therapy for acromegaly: a case report.

    abstract::We report a case of hepatolithiasis (intrahepatic stone) complicated by gram-negative sepsis in a 37 year old male with acromegaly being treated with octreotide. As a child, he had suffered a traumatic injury to his liver requiring the surgical repair of a laceration. This is the first reported case of hepatolithiasis...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1023/a:1012880113759

    authors: Sheehan MT,Nippoldt TB

    更新日期:2000-12-01 00:00:00

  • Histopathological classification of non-functioning pituitary neuroendocrine tumors.

    abstract::Non-functioning pituitary neuroendocrine tumors do not cause endocrine symptoms related to hypersecretion of adenohypophyseal hormones and are clinically characterized by symptoms due to growing sellar tumor mass. Histopathological classification of this tumor group has always been challenging due to their heterogenei...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1007/s11102-017-0855-1

    authors: Manojlovic-Gacic E,Engström BE,Casar-Borota O

    更新日期:2018-04-01 00:00:00

  • Chiasmapexy for secondary empty sella syndrome: diagnostic and therapeutic considerations.

    abstract:PURPOSE:Secondary empty sella syndrome (SESS) following pituitary surgery remains a diagnostic and therapeutic challenge. The aim of this study was to specify the diagnostic criteria, surgical indications and results of chiasmapexy in the SESS. METHODS:Three cases from two experienced neurosurgical centers were collec...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1007/s11102-020-01104-5

    authors: Graillon T,Passeri T,Boucekine M,Meyer M,Abritti R,Bernat AL,Labidi M,Dufour H,Froelich S

    更新日期:2020-11-02 00:00:00

  • Acromegaly due to an ectopic pituitary adenoma in the clivus: case report and review of literature.

    abstract::Pituitary adenomas rarely originate outside the sella turcica. Ectopic locations include the suprasellar region, sphenoid sinus, cavernous sinus and clivus. We describe a 50-year-old female who presented with clinical signs and biochemical evidence of acromegaly. Pituitary MRI demonstrated a 2 mm hypointense lesion on...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1007/s11102-011-0345-9

    authors: Appel JG,Bergsneider M,Vinters H,Salamon N,Wang MB,Heaney AP

    更新日期:2012-12-01 00:00:00

  • Autoimmune lymphocytic hypophysitis in association with autoimmune eye disease and sequential treatment with infliximab and rituximab.

    abstract:INTRODUCTION:Autoimmune lymphocytic hypophysitis associates predominantly with other autoimmune endocrinopathies and is most commonly treated with glucocorticoids and/or decompressive pituitary surgery. Here we report a new association and treatment modality for lymphocytic hypophysitis. METHODS:A 52-year-old woman pr...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-014-0592-7

    authors: Xu C,Ricciuti A,Caturegli P,Keene CD,Kargi AY

    更新日期:2015-08-01 00:00:00

  • Updates on the role of adrenal steroidogenesis inhibitors in Cushing's syndrome: a focus on novel therapies.

    abstract:PURPOSE:Endogenous Cushing's syndrome (CS) is a rare disease that results from exposure to high levels of cortisol; Cushing's disease (CD) is the most frequent form of CS. Patients with CS suffer from a variety of comorbidities that increase the risk of mortality. Surgical resection of the disease-causing lesion is gen...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1007/s11102-016-0742-1

    authors: Fleseriu M,Castinetti F

    更新日期:2016-12-01 00:00:00

  • Hypopituitarism in five PROP1 mutation siblings: long-lasting natural course and the effects of growth hormone replacement introduction in middle adulthood.

    abstract::Twenty years after the first description of combined hypopituitarism (CPHD) caused by PROP1 mutations, the phenotype of affected subjects is still challenging for clinicians. These patients suffer from pituitary hormone deficits ranging from IGHD to panhypopituitarism. ACTH deficiency usually develops later in life. P...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-020-01049-9

    authors: Doknic M,Gasic V,Stojanovic M,Pavlovic S,Marinkovic S,Miljic D,Pekic S,Manojlovic-Gacic E,Damjanovic D,Soldatovic I,Petakov M

    更新日期:2020-08-01 00:00:00

  • Molecular pathogenesis of human prolactinomas identified by gene expression profiling, RT-qPCR, and proteomic analyses.

    abstract::The molecular pathogenesis of prolactinomas has resisted elucidation; with the exception of a RAS mutation in a single aggressive prolactinoma, no mutational changes have been identified. In prolactinomas, a further obstacle has been the paucity of surgical specimens suitable for molecular analysis since prolactionoma...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-007-0082-2

    authors: Evans CO,Moreno CS,Zhan X,McCabe MT,Vertino PM,Desiderio DM,Oyesiku NM

    更新日期:2008-01-01 00:00:00

  • Pathology of prolactinomas: any predictive value?

    abstract::Lactotroph adenomas, also called prolactinomas and prolactin-secreting adenomas, constitute nearly 80% of functioning pituitary tumors and about 30-50% of all adenomas in the clinical practice. Lactotroph adenomas occur in the general population at a prevalence of 45/100,000, are more common in women, but also involve...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1007/s11102-019-00997-1

    authors: Lopes MBS

    更新日期:2020-02-01 00:00:00

  • Subclinical Cushing's syndrome.

    abstract::Clinically inapparent adrenal masses, or adrenal incidentalomas, are discovered inadvertently in the course of workup or treatment of unrelated disorders. Cortical adenoma is the most frequent type of adrenal incidentaloma accounting for approximately 50% of cases in surgical series and even greater shares in medical ...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1007/s11102-005-4024-6

    authors: Terzolo M,Reimondo G,Bovio S,Angeli A

    更新日期:2004-01-01 00:00:00

  • Cabergoline decreases somatotroph adenoma size: a case report.

    abstract::Dopamine agonists have been shown to reduce growth hormone secretion in some patients with acromegaly, but their effect on adenoma size has not been well appreciated. We describe a 69 year-old woman with acromegaly caused by a somatotroph macroadenoma who received primary treatment with the dopamine agonist cabergolin...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-005-5353-1

    authors: Rickels MR,Snyder PJ

    更新日期:2004-01-01 00:00:00

  • Apoplexy in non functioning pituitary adenoma after one dose of leuprolide as treatment for prostate cancer.

    abstract::We report the case of a 60 year old male who complained of headache and blurry vision--that progressed to left ophthalmoplegia and ptosis--after receiving a dose of leuprolide for Prostate cancer therapy. Imaging showed a hemorrhagic sellar mass. The patient underwent transsphenoidal debulking, and the tissue obtained...

    journal_title:Pituitary

    pub_type: 杂志文章,评审

    doi:10.1007/s11102-009-0202-2

    authors: Guerra Y,Lacuesta E,Marquez F,Raksin PB,Utset M,Fogelfeld L

    更新日期:2010-01-01 00:00:00

  • Clinical features of sellar and suprasellar meningiomas.

    abstract::Meningiomas account for about 1% of sellar masses. Although they can mimic pituitary adenomas, they are more vascularized and invasive. To gain insights that would enhance our ability to establish a pre-surgical diagnosis of meningioma, we performed a retrospective study of these tumors. Query of the surgical patholog...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1007/s11102-013-0507-z

    authors: Kwancharoen R,Blitz AM,Tavares F,Caturegli P,Gallia GL,Salvatori R

    更新日期:2014-08-01 00:00:00

  • Proliferation markers in different types of clinically non-secreting pituitary adenomas.

    abstract::160 clinically non-secreting pituitary adenomas were examined in regard to their expression of the markers PCNA, bcl2, Ki 67 in the mib-1 modification and p53 which are still under investigation for their relevance to cell proliferation. The series contained 60 null cell adenomas, 60 oncocytomas and 40 gonadotroph ade...

    journal_title:Pituitary

    pub_type: 杂志文章

    doi:10.1023/a:1009933820856

    authors: Schreiber S,Saeger W,Lüdecke DK

    更新日期:1999-05-01 00:00:00

  • Oral estroprogestin: an alternative low cost therapy for women with postoperative persistent acromegaly?

    abstract::Oral estrogens reduce GH-induced IGF-1 production and preliminary studies have shown that adjuvant estroprogestin (EP) therapy with octreotide LAR may control disease activity in some female patients who are partially responsive to octreotide LAR. Our aim was to verify if EP alone or in combination with octreotide LAR...

    journal_title:Pituitary

    pub_type: 临床试验,杂志文章

    doi:10.1007/s11102-010-0236-5

    authors: Vallette S,Serri O

    更新日期:2010-12-01 00:00:00