Abstract:
BACKGROUND:Suprasellar pituitary adenomas (SPAs) are a special type of pituitary adenoma. Although dozens of SPA cases have been reported, the exact definition and the characteristics of SPA have not been exhaustively discussed before. METHODS:In a retrospective electronic medical records review, 13 patients with SPA were identified in our hospital between January 2010 and December 2019. A literature review was performed by searching the online database PubMed, and 39 cases conformed to the criteria based on the previous literature. Data regarding clinical symptoms, imaging manifestations, surgical information and follow-ups were analyzed. RESULTS:The mean age at diagnosis of 52 patients with SPA was 36.73 years, and most of the patients were female (61.5%). The most common hormone-secreting subtypes of SPA were nonfunctioning (36.5%) and ACTH-secreting (34.6%) SPA. Macroadenomas (68.9%) were more common than microadenomas (31.1%). The origins of the SPAs included the intrasellar pituitary gland (type I), the subdiaphragmatic (type IIa) and supradiaphragmatic (type IIb) part of the pituitary stalk, and the suprasellar peri-infundibular region (type III). The most common anatomic subtype of SPA was type III, and type IIb was also common. The most common presentations of SPA were visual symptoms, especially for type III SPA. In addition, 64.7% and 73.1% of type IIb and III SPAs, respectively, were suspected to be of suprasellar origin based on presurgical imaging examination. Patients with tumors of suspected suprasellar origin were more likely to receive transcranial surgery (TCS) initially than those with tumors of suspected intrasellar origin (70.6% vs. 22.2%, p = 0.0013). The intact rate for the pituitary stalk after surgery for type II SPA was lower than that for type I and III SPA (52.6% vs. 92.6%, p = 0.0036). More patients with type II SPA experienced postoperative central diabetes insipidus (CDI) than those with type I and III SPA (57.9% vs. 11.1%, p = 0.0011). There was no significant difference in the incidence of postoperative CDI between transsphenoidal surgery (TSS) and TCS (p = 0.1304). Nine patients in our hospital received extended endoscopic TSS; only one experienced tumor recurrence, and no severe complications occurred after surgery. CONCLUSIONS:SPAs could be defined as pituitary adenomas completely or partially located in the suprasellar region. There were both similarities and differences among the different anatomic subtypes of SPA. For patients who were suspected of having SPAs, visual field tests, pituitary hormone evaluation and MRI were necessary. Because imaging examination is not a reliable method, surgery is the only way to confirm the tumor origin. Extended endoscopic TSS might be a safe and efficient approach to remove these tumors, but more studies are needed to verify this conclusion. For type II SPA, the pituitary stalk should be carefully protected during surgery, and postoperative CDI should be monitored.
journal_name
Pituitaryjournal_title
Pituitaryauthors
Zhu J,Wang Z,Zhang Y,Liu J,Li X,Deng K,Lu L,Yao Ydoi
10.1007/s11102-020-01043-1subject
Has Abstractpub_date
2020-08-01 00:00:00pages
367-380issue
4eissn
1386-341Xissn
1573-7403pii
10.1007/s11102-020-01043-1journal_volume
23pub_type
杂志文章相关文献
Pituitary文献大全abstract::Growth hormone excess has been associated with hypercalciuria and nephrolithiasis. Hypercalcemia in acromegaly is rare and usually due to coexistent primary hyperparathyroidism. To report two cases of 1,25-dihydroxyvitamin D (1,25 (OH)(2) D)-dependent hypercalcemia in cromegaly. A 50 year-old female with 2 years histo...
journal_title:Pituitary
pub_type: 杂志文章,评审
doi:10.1007/s11102-010-0286-8
更新日期:2012-12-01 00:00:00
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
更新日期:2013-03-01 00:00:00
abstract:PURPOSE:The pituitary gland is an unusual site for metastatic spread, but as patients with metastatic malignancy are living longer, it may become more prevalent. Compression of important anatomy adjacent to the sella may produce disabling symptoms and endocrine derangement, leading to significant morbidity. METHODS:An...
journal_title:Pituitary
pub_type: 杂志文章,评审
doi:10.1007/s11102-018-0899-x
更新日期:2018-10-01 00:00:00
abstract::The role of pituitary radiotherapy (RT) in the management of clinically non-functioning pituitary tumors (NFTs) remains controversial. Observational studies suggest that RT is effective in preventing the regrowth of NFT remnants following initial surgical debulking. However, not all tumor remnants will regrow in the a...
journal_title:Pituitary
pub_type: 杂志文章,评审
doi:10.1023/b:pitu.0000004801.95086.e2
更新日期:2003-09-01 00:00:00
abstract::We evaluated the efficacy of Gamma knife stereotactic radiosurgery (GKSR) as an adjunctive management modality for patients with drug resistant or intolerant cavernous sinus invasive prolactinomas. Twenty-two patients with cavernous sinus invasive prolactinoma underwent GKSR between 1994 and 2009. Thirteen patients we...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-012-0376-x
更新日期:2013-03-01 00:00:00
abstract:PURPOSE:Recent guidelines suggest that a single prolactin measurement is adequate to confirm hyperprolactinaemia. This may lead to unnecessary investigation of artefactual hyperprolactinaemia. Prolactin measurement drawn from an indwelling cannula after rest removes stress as a confounding variable. The objective was t...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-014-0576-7
更新日期:2015-06-01 00:00:00
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
更新日期:2012-12-01 00:00:00
abstract:INTRODUCTION:The sphenoid bone has a superior depression called the sella turcica, Latin for "Turkish saddle," where the pituitary gland is found. The availability of modern radiological imaging techniques has replaced plain radiography of the sella turcica in the investigation of hypothalamo-pituitary abnormalities. H...
journal_title:Pituitary
pub_type: 历史文章,杂志文章,评审
doi:10.1007/s11102-014-0609-2
更新日期:2015-08-01 00:00:00
abstract:PURPOSE:Thyrotropin-secreting pituitary adenoma is a rare disorder and was recently classified as an aggressive tumor in the World Health Organization guidelines. The number of available studies on cosecreting thyrotropin/growth hormone pituitary adenoma is especially limited. METHODS:A single-center retrospective ana...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-020-01064-w
更新日期:2020-10-01 00:00:00
abstract::The availability of various first-line treatment modalities for acromegaly and evolving surgical techniques emphasize the need for accurately defined predictors of surgical outcome. We retrospectively analysed the outcome of 30 patients with acromegaly after initial endoscopic transsphenoidal surgery in two university...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-012-0395-7
更新日期:2013-06-01 00:00:00
abstract::Isolated familial somatotropinomas (IFS) rarely occurs in the absence of multiple endocrine neoplasia type I (MEN1) or the Carney complex. In the present study we report two Italian siblings affected by GH-secreting adenomas. There was no history of parental consanguinity. The sister presented at 18 years of age with ...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1023/a:1022193015993
更新日期:2002-01-01 00:00:00
abstract::Silent growth hormone adenomas (SGHA) are a rare entity of non-functioning pituitary neuroendocrine tumors. Diagnosis is invariably made post-operatively of a tumor immunopositive for GH (and Pit-1 in selected cases) but without clinical acromegaly. Mainly young females are affected, and tumors are often uncovered by ...
journal_title:Pituitary
pub_type: 杂志文章,评审
doi:10.1007/s11102-017-0858-y
更新日期:2018-04-01 00:00:00
abstract:PURPOSE:In a 10-week proof-of-concept study (LINC 1), the potent oral 11β-hydroxylase inhibitor osilodrostat (LCI699) normalized urinary free cortisol (UFC) in 11/12 patients with Cushing's disease. The current 22-week study (LINC 2; NCT01331239) further evaluated osilodrostat in patients with Cushing's disease. METHO...
journal_title:Pituitary
pub_type: 杂志文章,多中心研究
doi:10.1007/s11102-015-0692-z
更新日期:2016-04-01 00:00:00
abstract::In this report we emphasize the opportunity of considering the uncommon causes of chronic GH-excess in the initial diagnostic process, such as GHRH hypersecretion, especially in the presence of ambiguous pituitary neuroimaging. This topic may have an important clinical significance in order to plan the most cost-effec...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-008-0146-y
更新日期:2010-09-01 00:00:00
abstract::Pituitary radiotherapy (RT) is an effective second-line treatment for paediatric Cushing's disease (CD). We report long-term efficacy and anterior pituitary function in a cohort of paediatric CD patients treated with RT. Between 1988 and 2008, from our cohort of 48 paediatric CD patients, eight paediatric CD patients ...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-010-0231-x
更新日期:2010-12-01 00:00:00
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
更新日期:2014-08-01 00:00:00
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
更新日期:2015-02-01 00:00:00
abstract::To study the currently available data of recurrence rates of functioning and nonfunctioning pituitary adenomas following surgical cure and to analyze associated predisposing factors, which are not well established. A systematic literature search was conducted using Medline, Embase, Web of Science and the Cochran Libra...
journal_title:Pituitary
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s11102-011-0347-7
更新日期:2012-03-01 00:00:00
abstract::We report the results of long-term (6-year) treatment of Nelson's syndrome with the long-acting dopamine agonist, cabergoline, in a 55-year-old woman. The disease presented 26 years after bilateral adrenalectomy and radiation treatment for Cushing's disease, followed by glucocorticoid and mineralocorticoid replacement...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-006-9290-4
更新日期:2006-01-01 00:00:00
abstract:INTRODUCTION:Cushing's syndrome is associated with a number of clinical manifestations and co-morbidities which may not resolve even after long-term remission leading to excessive mortality. MATERIALS AND METHODS:This review summarizes the main manifestations of Cushing's syndrome (active or in remission) with particu...
journal_title:Pituitary
pub_type: 杂志文章,评审
doi:10.1007/s11102-014-0631-4
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:Lymphocytic hypophysitis (LH) is a rare chronic inflammatory disorder characterized by lymphocytic infiltration of the pituitary gland commonly affecting women during pregnancy or post-partum period. The pathogenesis remains uncertain, however an autoimmune process is frequently implicated. There is limited d...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-008-0119-1
更新日期:2009-01-01 00:00:00
abstract::Leptin is a key mediator in the maintenance of neuroendocrine homeostasis. The aim of this study was to determine the changes in serum leptin, tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), nitric oxide (NO) levels in patients with hyperprolactinemia. The study consists of 16 consecutive patients with ...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-008-0140-4
更新日期:2009-01-01 00:00:00
abstract::The management of invasive giant prolactinomas (IGP) has been an area of some controversy. The relative roles of transsphenoidal surgery, craniotomy, radiation therapy and dopamine agonist based medical therapy are gradually becoming clarified. We report the results of management of 30 patients with IGP. Surgery was t...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-005-5087-0
更新日期:2005-01-01 00:00:00
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
更新日期:2003-01-01 00:00:00
abstract::Patients with adult GH deficiency (AGHD) have a high cardiovascular risk and probably an alteration of the oxidative balance, although evidence is lacking. To evaluate the presence of endothelial dysfunction and oxidative stress in patients with AGHD. Biochemical parameters of oxidative stress and endothelial dysfunct...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-011-0374-4
更新日期:2012-12-01 00:00:00
abstract::The purpose of this study is to verify whether acute pre-treatment with alprazolam (ALP), a benzodiazepine that inhibits HPA secretion in normal subjects, could better characterize patients with subclinical Cushing's syndrome (SCS) than the 1-mg dexamethasone test (DST). In 22 patients with SCS, 10 with overt Cushing'...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-012-0433-5
更新日期:2013-09-01 00:00:00
abstract::In this case report we describe a 38 year-old-female with galactorrhea several months after the birth of an anencephalic child. She had hyperpolactemia and imaging of the pituitary gland revealed a midline defect and a nasopharyngeal mass compatible with a meningo-(hypophyso-) encephalocele and possibly an ectopic ter...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-011-0320-5
更新日期:2012-12-01 00:00:00
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
更新日期:2011-03-01 00:00:00
abstract::Acromegaly is caused by a somatotropinoma in the vast majority of the cases. These are monoclonal tumors that can occur sporadically or rarely in a familial setting. In the last few years, novel familial syndromes have been described and recent studies explored the landscape of somatic mutations in sporadic somatotrop...
journal_title:Pituitary
pub_type: 杂志文章,评审
doi:10.1007/s11102-017-0789-7
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Survival rates among childhood cancer survivors (CCSs) have significantly risen in the last 40 years due to substantial improvements in treatment protocols. However, this improvement has brought with it serious late effects that frequently involve the endocrine system. Of the endocrine disorders, GH deficien...
journal_title:Pituitary
pub_type: 杂志文章,评审
doi:10.1007/s11102-020-01052-0
更新日期:2020-08-01 00:00:00