Abstract:
:Giant prolactinomas are rare tumours, representing only 2-3% of all prolactin (PRL)-secreting tumours and raising special diagnostic and therapeutic challenges. Based on several considerations developed in this review, their definition should be restricted to pituitary adenomas with a diameter of 40 mm or more, significant extrasellar extension, very high PRL concentrations (usually above 1000 μg/l) and no concomitant GH or ACTH secretion. Giant prolactinomas are much more frequent in young to middle-aged men than in women, with a male to female ratio of about 9:1. Endocrine symptoms are often present but overlooked for a long period of time, and diagnosis is eventually made when neurologic complications arise from massive extension into the surrounding structures, leading to cranial nerve palsies, hydrocephalus, temporal epilepsy or exophthalmos. PRL concentrations are usually in the range of 1000-100,000 μg/l, but may be underestimated by the so-called 'high-dose hook effect'. As in every prolactinoma, dopamine agonists are the first-line treatment allowing rapid alleviation of neurologic symptoms in the majority of the cases, a significant reduction in tumour size in three-fourths of the patients and PRL normalization in 60-70%. These extensive tumours are usually not completely resectable and neurosurgery has significant morbidity and mortality. It should therefore be restricted to acute complications such as apoplexy or leakage of cerebrospinal fluid (often induced by medical treatment) or to patients with insufficient tumoural response or progression. Irradiation and temozolomide are useful adjuvant therapies in a subset of patients with aggressive/invasive tumours, which are not controlled despite combined medical and surgical treatments. Because of these various challenges, we advocate a multidisciplinary management of these giant tumours in expert centres.
journal_name
Eur J Endocrinoljournal_title
European journal of endocrinologyauthors
Maiter D,Delgrange Edoi
10.1530/EJE-14-0013subject
Has Abstractpub_date
2014-06-01 00:00:00pages
R213-27issue
6eissn
0804-4643issn
1479-683Xpii
EJE-14-0013journal_volume
170pub_type
杂志文章,评审abstract:OBJECTIVE:Short stature caused by point mutations or deletions of the short stature homeobox (SHOX) gene (SHOX haploinsufficiency (SHI)) is a registered indication for GH treatment. Patients with a SHOX enhancer deletion (SED) have a similar phenotype, but their response to GH is unknown. It is uncertain if duplication...
journal_title:European journal of endocrinology
pub_type: 杂志文章,多中心研究
doi:10.1530/EJE-15-0451
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:Platinum-based chemotherapy (PBC) is the most effective cytotoxic treatment for advanced adrenocortical carcinoma (ACC). Excision repair cross complementing group 1 (ERCC1) plays a critical role in the repair of platinum-induced DNA damage. Two studies investigating the role of ERCC1 immunostaining as a predi...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-17-0788
更新日期:2018-02-01 00:00:00
abstract::Thyrotropin (TSH)-secreting adenomas (TSHomas) are the rarest form of pituitary adenomas, and most endocrinologists will see few cases in a lifetime, if any. In most cases, the diagnostic approach is complicated and cases may be referred after being presented as a syndrome of inappropriate TSH secretion or as a pituit...
journal_title:European journal of endocrinology
pub_type: 杂志文章,评审
doi:10.1530/EJE-16-1029
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:We conducted a prospective phase II clinical trial to determine the efficacy of sorafenib in patients with advanced radio-iodine refractory differentiated thyroid cancer. In this article, the long-term results are presented. PATIENTS AND METHODS:Thirty-one patients with progressive metastatic or locally adva...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-12-0405
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE AND DESIGN:Based on our clinical experience with combined gene therapy of glioblastoma, we developed a retroviral vector expressing two therapeutic genes (i.e. thymidine kinase of herpes simplex virus, HSV-TK, and interleukin-2, IL-2) and evaluated its efficiency in vitro and in vivo. METHODS:Expression of t...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1480073
更新日期:2003-01-01 00:00:00
abstract::In 2006, two major society-sponsored guidelines and one major consensus statement for thyroid diagnosis and management were published by: the American Association of Clinical Endocrinologists/Associazione Medici Endocrinologi (AACE/AME); the American Thyroid Association (ATA); and the European Thyroid Association (ETA...
journal_title:European journal of endocrinology
pub_type: 杂志文章,评审
doi:10.1530/EJE-08-0135
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVES:To examine whether glucagon-like peptide-1 (GLP-1), which has been suggested as a new therapeutic agent in type 2 diabetes, affects circulating islet amyloid polypeptide (IAPP), a B-cell peptide of potential importance for diabetes pathophysiology. DESIGN:GLP-1 was administered in a buccal tablet (400 micro...
journal_title:European journal of endocrinology
pub_type: 临床试验,杂志文章
doi:10.1530/eje.0.1370643
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Primary hyperparathyroidism (PHPT) is associated with increased cardiovascular mortality and morbidity. Little is known about hemostatic features of patients with PHPT. To our knowledge, plasma tissue factor pathway inhibitor (TFPI) and thrombin-activatable fibrinolysis inhibitor (TAFI) levels...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-09-0069
更新日期:2009-05-01 00:00:00
abstract:CONTEXT:CDKN1B encodes the cyclin-dependent kinase inhibitor p27Kip1 and is mutated in multiple endocrine neoplasia-like syndromes. CDKN1B also harbors single nucleotide polymorphisms; the T/G transversion at nucleotide 326 (the V109G variant) has been reported to be protective in breast, hereditary prostate, and pancr...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-10-0929
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Phytosterolaemia (sitosterolaemia) is a rare autosomal recessive condition caused by mutations on the ABCG5 and ABCG8 gut transporter proteins. This leads to accumulation of plant-derived cholesterol-like molecules in blood and tissues. CASE:We describe a family of Bangladesh origin, where three siblings (t...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-07-0222
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVE:Limited data exist concerning the presence of polycystic ovary syndrome (PCOS) in premenopausal women with nonalcoholic fatty liver disease (NAFLD). We aimed to investigate the prevalence of PCOS in overweight and obese premenopausal women with NAFLD. DESIGN:Prospective, observational, and cross-sectional st...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-15-0567
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:We have studied the effect of tryptophan on cellular [(125)I]tri-iodothyronine (T3) uptake by mouse thymocytes. MATERIALS AND METHODS:Mouse thymocytes (20 x 10(6 )cells/ml) were suspended in Krebs-Ringer solution buffered by Tris-HCl and incubation (23 degrees C at pH7.45+/-0.6), in the presence or absence o...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1430119
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:Recent observational studies have established progression and recurrence rates of pituitary adenomas. However, it is still unknown how individual pituitary adenomas grow over years and whether growth kinetics follow a distinct growth model. The objective of this study was to define a growth model for non-func...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-07-0502
更新日期:2008-03-01 00:00:00
abstract::There is increasing evidence that ovarian steroids inhibit vascular responsiveness to the neurohypophysial hormone vasopressin. The present study examined the recovery of the arterial blood pressure following a single (2 ml/100 g body weight) haemorrhage in ovariectomized (OVX) Brattleboro rats with hereditary hypotha...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1360330
更新日期:1997-03-01 00:00:00
abstract:OBJECTIVE:To assess the influence of craniopharyngioma or consequent surgery on melatonin secretion, and the association with fatigue, sleepiness, sleep pattern and sleep quality. DESIGN:Cross-sectional study. METHODS:A total of 15 craniopharyngioma patients were individually matched to healthy controls. In this stud...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-13-1025
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:While anti-pituitary antibodies (APAs) were detected in some patients with Sheehan's syndrome (SS) suggesting an autoimmune pituitary involvement in the development of their hypopituitarism, hypothalamic cell anti-hypothalamus antibodies (AHAs) have not been investigated so far. DESIGN:The aim of this study ...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-07-0647
更新日期:2008-02-01 00:00:00
abstract::Four groups(N = 3 per group) of juvenile rhesus monkeys (Macaca mulatta, 14-20 months old) received either vehicle or highly purified human follicle-stimulating hormone (FSH; 10 IU kg-1 day-1), human chorionic gonadotropin (hCG; 250 IU every alternate day) or both hormones for a period of 4 weeks. Testicular volume an...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1330235
更新日期:1995-08-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-17-0111
更新日期:2017-07-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.1.02047
更新日期:2005-12-01 00:00:00
abstract::Human growth hormone (GH) exists in a variety of isoforms. In the pituitary, the most abundant isoform is 22-kD GH (22 K GH), while other isoforms (non-22 K GH) are present in variable amounts. In human plasma, the GH heterogeneity contributes to the wide variability in GH levels measured by different immunoassays. Th...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1350573
更新日期:1996-11-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章,评审
doi:10.1530/EJE-15-0957
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:The risk of radiation-induced benign and malignant thyroid nodules is well known. OBJECTIVE:The aim of this study was to determine the occurrence of thyroid nodules and carcinomas after fractionated total body irradiation (TBI) preceding hematopoietic stem cell transplantation (HSCT) for malignant hematolog...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-12-0073
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:Adrenocortical tumors may originate from the zona glomerulosa, zona fasciculata, or zona reticularis and be associated with syndromes due to overproduction of mineralocorticoids, glucocorticoids, or androgens respectively. We report an unusual case of recurrent adrenocortical carcinoma (ACC), which seems to c...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.1.02011
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVE:Pretibial myxedema (PM) is a manifestation of Graves' disease (GD). Currently, its diagnosis depends on physicians' observation and biopsy. No satisfactory, objective, and non-invasive tool is available to record and investigate lesions. Digital infrared thermal imaging (DITI) detects surface temperature, and...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-10-1095
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:Glucocorticoid-induced osteoporosis is the most frequent cause of secondary osteoporosis. Nevertheless, limited data are available on bone status in patients with endogenous cortisol excess. This study is aimed at investigating the role of sex steroids and severity of hypercortisolism on bone mineral density ...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-07-0137
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE:To compare clinical and humoral parameters before and after surgery in patients with incidental adrenocortical adenomas. DESIGN:Six patients with subclinical Cushing's syndrome and nine with non-functioning adenomas were investigated before and 12 Months after removal of the mass. METHODS:Anthropometric (bo...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/eje.0.1480213
更新日期:2003-02-01 00:00:00
abstract::Objective To explore whether gestational prolactin and breast increase are markers of metabolic health in pregnancy and on long-term, in PCOS. Design Follow-up study. Women with PCOS, according to the Rotterdam criteria (n = 239), former participants of the randomized controlled trial (RCT) PregMet were invited, 131 p...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-19-0002
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:To examine the genes for AMP-activated protein kinase (AMPK) subunits alpha2 (PRKAA2) and gamma3 (PRKAG3) as candidates for polycystic ovary syndrome (PCOS) and its component traits. DESIGN AND METHODS:A total of 287 white PCOS women were recruited from the reproductive endocrinology clinic at the University...
journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-09-0245
更新日期:2009-09-01 00:00:00
abstract:CONTEXT:The TIMES2 (testosterone replacement in hypogonadal men with either metabolic syndrome or type 2 diabetes) study reported beneficial effects of testosterone replacement therapy (TRT) on insulin resistance and other variables in men with diabetes or metabolic syndrome. The androgen receptor CAG repeat polymorphi...
journal_title:European journal of endocrinology
pub_type: 杂志文章,随机对照试验
doi:10.1530/EJE-13-0703
更新日期:2013-12-21 00:00:00
abstract:OBJECTIVE:Both animal and human studies have associated the endocannabinoid system with obesity and markers of metabolic dysfunction. Blockade of the cannabinoid receptor 1 (CB1) caused weight loss and reduction in waist size in both obese and type II diabetics. Recent studies on common variants of the CB1 receptor gen...
journal_title:European journal of endocrinology
pub_type: 杂志文章,随机对照试验
doi:10.1530/EJE-10-0192
更新日期:2010-09-01 00:00:00