Pre-operative serum inflammation-based scores in patients with pituitary adenomas
AbstractObjectiveFull blood count (FBC) and serum inflammation-based scores reflect systemic inflammation and predict outcomes in cancer, but little is known in pituitary adenomas (PAs). We aimed to characterise FBC and inflammation-based scores in PA patients and investigate their usefulness in predicting challenging disease course.MethodsWe studied 424 PA patients first operated at our centre with available pre-operative biochemical data. Patients with infection, malignancies, autoimmune or haematological conditions were excluded. Inflammation-based scores studied: Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lympho...
Source: Pituitary - November 24, 2020 Category: Endocrinology Source Type: research

Prior testosterone replacement therapy may impact spermatogenic response to combined gonadotropin therapy in severe congenital hypogonadotropic hypogonadism
ConclusionPrior-TRT may interfere with spermatogenic response to CGT in CHH patients, especially in those with a severe phenotype. (Source: Pituitary)
Source: Pituitary - November 23, 2020 Category: Endocrinology Source Type: research

Levoketoconazole improves clinical signs and symptoms and patient-reported outcomes in patients with Cushing ’s syndrome
AbstractPurposeThe efficacy of levoketoconazole in treating hypercortisolism was demonstrated in an open-label phase 3 study (SONICS) of adults with endogenous Cushing ’s syndrome (CS) and baseline mean urinary free cortisol (mUFC) ≥  1.5× ULN. Clinical signs and symptoms and patient-reported outcomes from the SONICS trial were evaluated in the current manuscript.MethodsPatients titrated to an individualized therapeutic dose entered a 6-month maintenance phase. Secondary endpoints included investigator-graded clinical signs and symptoms of CS during the maintenance phase, and patient-reported q...
Source: Pituitary - November 20, 2020 Category: Endocrinology Source Type: research

Integrated multi-omics profiling of nonfunctioning pituitary adenomas
ConclusionThis study presents comprehensive multi-omics views of CNV, DNA methylation, and gene expression in 8 NFPAs. Pathway analysis and network maps of key genes provide clues to elucidate the molecular basis of hpNFPA. (Source: Pituitary)
Source: Pituitary - November 18, 2020 Category: Endocrinology Source Type: research

Risk factors for tumor recurrence and progression of spindle cell oncocytoma of the pituitary gland: a systematic review and pooled analysis
ConclusionOur study demonstrated the characteristic clinicopathological features of SCOs with a high recurrence/progression rate and outlined the predictor for tumor relapse. Failure to achieve gross total resection is the only risk factor for tumor recurrence/progression. (Source: Pituitary)
Source: Pituitary - November 18, 2020 Category: Endocrinology Source Type: research

Management of sellar and parasellar tumors becoming symptomatic during pregnancy: a practical algorithm based on multi-center experience and systematic literature review
ConclusionsSPTs becoming symptomatic in pregnancy deserve careful monitoring and multidisciplinary management. Overall, wait-and-see approach is suggested, reserving surgery to patients with rapidly progressive/life-threatening situations, significant risk of permanent neurological impairment or malignant lesions. (Source: Pituitary)
Source: Pituitary - November 17, 2020 Category: Endocrinology Source Type: research

Cephalocaudal tumor diameter is a predictor of diabetes insipidus after endoscopic transsphenoidal surgery for non-functioning pituitary adenoma
AbstractPurposeDiabetes insipidus (DI) develops commonly after endoscopic transsphenoidal surgery (ETS). We retrospectively investigated the incidence, onset, duration and predictors of DI after ETS in patients with non-functioning pituitary adenoma (NFPA).MethodsA total of 168 patients who underwent ETS to remove NFPAs were included. Various perioperative data on demographics, comorbidities, previous treatments, perioperative hormone deficiencies, tumor characteristics, surgery, anesthesia, intraoperative fluid balance, perioperative laboratory findings, postoperative complications, readmission and hospital length of stay...
Source: Pituitary - November 16, 2020 Category: Endocrinology Source Type: research

Congenital hypopituitarism in two brothers with a duplication of the ‘acrogigantism gene’ GPR101 : clinical findings and review of the literature
ConclusionIn our patients with hypopituitarism we found a 6  Mb duplication which includesGPR101, a gene associated with X- linked gigantism, andSOX3, a gene involved in early pituitary organogenesis that is associated with variable degrees of hypopituitarism. Our findings show that in duplications containing bothGPR101 andSOX3, the growth hormone deficiency phenotype is dominant. This suggests that, ifGPR101 is duplicated, it might not be expressed phenotypically when early patterning of the embryonic pituitary is affected due toSOX3 duplication. These results, together with the review of the literature, shed a new l...
Source: Pituitary - November 13, 2020 Category: Endocrinology Source Type: research

Meeting abstracts from the 2020 International Meeting on GH/IGF: actions in the shadow of COVID19
(Source: Pituitary)
Source: Pituitary - November 11, 2020 Category: Endocrinology Source Type: research

Biliary adverse events in acromegaly during somatostatin receptor ligands: predictors of onset and response to ursodeoxycholic acid treatment
AbstractPurposeSomatostatin receptor ligands (SRL) are the first-line medical treatment for acromegaly. Gallbladder alterations are one of most important SRL side effect, but according to some authors growth hormone hypersecretion itself is a risk factor for gallstones. This single center, longitudinal retrospective study evaluated the incidence and the predictors of biliary adverse events (BAE) in acromegaly during SRL therapy and their response to ursodeoxycholic acid (UDCA).Methods91 acromegaly patients with indication to SRL were enrolled. Evaluations of acromegaly activity (GH, IGF-I, IGF-I/ULN) and metabolic profile ...
Source: Pituitary - November 9, 2020 Category: Endocrinology Source Type: research

Genetics, clinical features and outcomes of non-syndromic pituitary gigantism: experience of a single center from Sao Paulo, Brazil
ConclusionWe characterize the clinical and molecular findings and long-term outcome of the largest single-center PG cohort described so far. (Source: Pituitary)
Source: Pituitary - November 6, 2020 Category: Endocrinology Source Type: research

Chiasmapexy for secondary empty sella syndrome: diagnostic and therapeutic considerations
ConclusionT2-weighted or CISS/FIESTA sequence MRI is mandatory to visualize adhesions, ON kinking and neurovascular conflict. TS approach is the most commonly used approach. The literature review could not conclude on the need for an intra or extradural approach suggesting case by case adapted strategy. Intrasellar packing with non-absorbable material such as bone should be considered. Severity of the visual loss clearly decreases the visual outcome suggesting early chiasmapexy. In case of severe and long standing symptoms before surgery, benefits and surgical risks should be carefully balanced. (Source: Pituitary)
Source: Pituitary - November 2, 2020 Category: Endocrinology Source Type: research

International meeting on GH/IGF actions in the shadow of COVID19
(Source: Pituitary)
Source: Pituitary - October 31, 2020 Category: Endocrinology Source Type: research

Prognostic value of nadir GH levels for long-term biochemical remission or recurrence in surgically treated acromegaly
AbstractContextOutcome of acromegaly surgery is assessed by IGF-1 and glucose-suppressed GH, but whether the latter provides additional clinically relevant information when IGF-1 is normal is unclear. The role of GH suppression testing after surgery requires clarification.MethodsWe studied 97 acromegaly patients with normal IGF-1 after surgery by measuring GH after oral glucose longitudinally, initially at ≥ 3 months after surgery and repeated one or more times ≥ 1 year later. Nadir GH was categorized as normal or abnormal relative to the 97.5th percentile of nadir GH in 100 healthy subjects, ...
Source: Pituitary - October 30, 2020 Category: Endocrinology Source Type: research

Vasculometabolic effects in patients with congenital growth hormone deficiency with and without GH replacement therapy during adulthood
ConclusionsNo differences in vascular properties were observed in congenital GHD adult patients with or without GHRT despite patients without GHRT had an unfavorable body composition. GHRT currently remains an individualized decision in adults with GHD and these findings bring new insight into the treatment and follow-up of these patients. (Source: Pituitary)
Source: Pituitary - October 24, 2020 Category: Endocrinology Source Type: research

HOMA-IR in acromegaly: a systematic review and meta-analysis
ConclusionHOMA-IR in treatment-na ïve ACRO patients is higher than in the reference population, even in patients without diabetes. This finding, confirms that insulin resistance is an early event in ACRO. Our results also suggest that HOMA-IR is not an adequate tool for assessing insulin resistance in those patients treated with SS As. (Source: Pituitary)
Source: Pituitary - October 21, 2020 Category: Endocrinology Source Type: research

A Pituitary Society update to acromegaly management guidelines
AbstractGuidelines and consensus statements ensure that physicians managing acromegaly patients have access to current information on evidence-based treatments to optimize outcomes. Given significant novel recent advances in understanding acromegaly natural history and individualized therapies, the Pituitary Society invited acromegaly experts to critically review the current literature in the context of Endocrine Society guidelines and Acromegaly Consensus Group statements. This update focuses on how recent key advances affect treatment decision-making and outcomes, and also highlights the likely role of recently FDA-appro...
Source: Pituitary - October 20, 2020 Category: Endocrinology Source Type: research

Clinical, biological, radiological, and pathological comparison of sparsely and densely granulated somatotroph adenomas: a single center experience from a cohort of 131 patients with acromegaly
AbstractPurposeGrowth hormone-producing pituitary adenomas are divided into two clinically relevant histologic subtypes, densely (DG-A) and sparsely (SG-A) granulated. Histologic subtype was evaluated in a large cohort of patients with acromegaly, separating DG-A and SG-A, and correlated with clinicopathological characteristics.MethodsPatients with acromegaly undergoing surgery as initial therapy between 1995 and 2015 were identified. Histologic subtype was determined by keratin expression pattern with CAM5.2 and correlated with clinical and imaging parameters, somatostatin receptor subtype 2 (SST2) expression, post-surgic...
Source: Pituitary - October 19, 2020 Category: Endocrinology Source Type: research

The effect of somatostatin analogs and acromegaly on the upper gastrointestinal system
ConclusionThe study showed that octreotide LAR treatment could be a risk factor in addition to known factors for the development of gastritis in patients with acromegaly. (Source: Pituitary)
Source: Pituitary - October 19, 2020 Category: Endocrinology Source Type: research

Corticotroph tumor progression during long-term therapy with osilodrostat  in a patient with persistent Cushing’s disease
ConclusionThis case highlights the importance of monitoring ACTH and corticotroph tumor size in patients with persistent CD, either under effective treatment with steroidogenesis inhibitors or after bilateral adrenalectomy. (Source: Pituitary)
Source: Pituitary - October 19, 2020 Category: Endocrinology Source Type: research

Increased risk of preneoplastic colonic lesions and colorectal carcinoma in acromegaly: multicenter case –control study
ConclusionsOur findings show an increased risk of preneoplastic colonic lesions and colorectal carcinoma in patients with chronic and sustained GH excess compared to a control group. This supports the recommendation to perform screening colonoscopy at diagnosis of acromegaly. (Source: Pituitary)
Source: Pituitary - October 15, 2020 Category: Endocrinology Source Type: research

Chiasmal herniation following treatment of pituitary macroadenoma
ConclusionHerniation does not appear to have clinical relevance with respect to VF outcome. The newly designed CHS is the first scoring system to quantify the severity of herniation and, in the absence of alternatives, may be useful to describe MRI findings to serve future added value in larger sized outcome studies. (Source: Pituitary)
Source: Pituitary - October 15, 2020 Category: Endocrinology Source Type: research

Establishing a papillary craniopharyngioma cell line by SV40LT-mediated immortalization
ConclusionWe successfully developed PCP cell lines by SV40LT-mediated immortalization. These cell lines represent a powerful tool for fundamental and therapeutical studies on craniopharyngioma. (Source: Pituitary)
Source: Pituitary - October 12, 2020 Category: Endocrinology Source Type: research

Healthcare utilization and costs among prolactinoma patients: a cross-sectional study and analysis of determinants
ConclusionHealthcare utilization and costs of prolactinoma patients are related to patient-reported HRQoL, bother by disease and needs for support. Therefore, addressing patients ’ HRQoL and needs is a way forward to improve efficiency of care and patients’ health status. (Source: Pituitary)
Source: Pituitary - October 5, 2020 Category: Endocrinology Source Type: research

Machine learning in predicting early remission in patients after surgical treatment of acromegaly: a multicenter study
This study aims to train and validate machine learning prediction models for early endocrine remission of acromegalic patients.MethodsThe training cohort included 833 patients with growth hormone (GH) secreting pituitary adenoma from 2010 to 2018. We trained a partial model (only using pre-operative variables) and a full model (using all variables) to predict off-medication endocrine remission at six-month follow-up after surgery using multiple algorithms. The models were validated in 99 prospectively collected patients from a second campus and 52 patients from a third institution.ResultsC-statistic and the accuracy of the...
Source: Pituitary - October 5, 2020 Category: Endocrinology Source Type: research

AIP variant causing familial prolactinoma
AbstractPathogenic variants in the aryl hydrocarbon  receptor-interacting protein (AIP) gene are increasingly recognised as a cause of familial isolated pituitary adenoma.AIP-associated tumours are most commonly growth hormone (GH) producing. In our cohort of 175AIP mutation positive patients representing 93 kindreds, 139 (79%) have GH excess, 19 have prolactinoma (17 familial and 2 sporadic cases) and out of the 17 clinically non-functioning tumours 4 were subsequently operated and found to be GH or GH& prolactin immunopositive adenoma. Here we report a family with anAIP variant, in which multiple family members ...
Source: Pituitary - October 2, 2020 Category: Endocrinology Source Type: research

Co-expression of intermediate filaments glial fibrillary acidic protein and cytokeratin in pituitary adenoma
AbstractPurposeTo analyze the co-expression of the intermediate filaments GFAP and cytokeratin in 326 pituitary adenomas with regard to the distribution pattern, the subtype of the adenoma and clinical prognostic data.MethodsTissue from 326 pituitary adenomas and 13 normal anterior pituitaries collected in the Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, between 2006 and 2009 was investigated by immunohistochemistry, immunofluorescence and electron microscopy.ResultsCo-expression of intermediate filaments GFAP and cytokeratin was associated with hormone expression in 62/278 cases (22%), but onl...
Source: Pituitary - September 30, 2020 Category: Endocrinology Source Type: research

Postoperative diabetes insipidus: how to define and grade this complication?
ConclusionsTo improve reliability and comparability we propose the following definition for postoperative DI: polyuria (urine production  >  300 ml/hour for 3 h) accompanied by a urine specific gravity (USG)   300 mosmol/kg, or serum sodium >  145 mmol/L. To prevent unnecessary treatment with desmopressin, we present an algorithm for the diagnosis and treatment of postoperative DI. (Source: Pituitary)
Source: Pituitary - September 28, 2020 Category: Endocrinology Source Type: research

Incidence, mortality, and cardiovascular diseases in pituitary adenoma in Korea: a nationwide population-based study
ConclusionSouth Korea had a relatively high incidence of NFPA. The incidence of stroke was highest for ACTH  + TSH and NFPA, which was directly related to mortality during long-term follow-up. Patients with these types of PA should receive stroke prevention measures to reduce their risk of mortality. (Source: Pituitary)
Source: Pituitary - September 18, 2020 Category: Endocrinology Source Type: research

Pituitary adenomas in older adults ( ≥ 65 years): 90-day outcomes and readmissions: a 10-year endoscopic endonasal surgical experience
ConclusionThis study suggests that elderly patients carefully selected for endoscopic adenoma removal can have excellent short-term outcomes including high resection rates, low complication rates and short length of stay. Our experience supports a multidisciplinary approach and the concept of pituitary centers of excellence. Based on our observations, approximately 25% of elderly patients with pituitary adenomas referred for possible surgery can be monitored closely without surgery. (Source: Pituitary)
Source: Pituitary - September 15, 2020 Category: Endocrinology Source Type: research

The sellar barrier on preoperative imaging predicts intraoperative cerebrospinal fluid leak: a prospective multicenter cohort study
AbstractBackgroundThe type of sellar barrier observed between a pituitary tumor and cerebrospinal fluid (CSF) on preoperative magnetic resonance imaging (MRI) may predict intraoperative CSF leak during endonasal pituitary surgery. This is the first multicentric prospective cohort trial to study the sellar barrier concept and CSF leak rate during endoscopic pituitary surgery.MethodsThis multi-center, international study enrolled patients operated for pituitary adenomas via fully endoscopic endonasal surgery over a period of 4 months. The independent variable was the subtype of sellar barrier observed on preoperative MRI (st...
Source: Pituitary - September 11, 2020 Category: Endocrinology Source Type: research

Pituitary apoplexy associated with acute COVID-19 infection and pregnancy
ConclusionHere we demonstrate the first known case of successful elective induction of vaginal delivery and transsphenoidal intervention in a near full term gravid patient presenting with pituitary apoplexy and acute SARS-CoV-2 infection. Further reports may help determine if there is a causal relationship or if these events are unrelated. Close adherence to guidelines for caregivers can greatly reduce risk of infection. (Source: Pituitary)
Source: Pituitary - September 10, 2020 Category: Endocrinology Source Type: research

Genetic spectrum and predictors of mutations in four known genes in Asian Indian patients with growth hormone deficiency and orthotopic posterior pituitary: an emphasis on regional genetic diversity
ConclusionAt variance with world literature, we found reverse predominance ofGHRHR overGH1 mutations,POU1F1 overPROP1 mutations and predominance ofGHRHR p.Glu72* mutations thus re-affirming the regional diversity in GHD genetics. We report positive and negative predictors of mutations in GHD. (Source: Pituitary)
Source: Pituitary - September 6, 2020 Category: Endocrinology Source Type: research

Effect of long-term growth hormone replacement on glucose metabolism in adults with growth hormone deficiency: a systematic review and meta-analysis
AbstractPurposeThis systematic review and meta-analysis was performed to summarize the long-term (more than 6  months) effect of growth hormone (GH) replacement therapy (GHRT) on glucose metabolism among adults growth hormone deficiency (AGHD) patients.MethodsWe searched MEDLINE, EMBASE and the Cochrane Library databases from inception till March 2020 for relevant studies evaluating the effect of GHRT on glucose metabolism in AGHD patients. Results were stratified into two periods (6 –12 months and more than12 months) according to the length of follow-up.ResultsThirty-three studies including 11 randomized c...
Source: Pituitary - September 4, 2020 Category: Endocrinology Source Type: research

Cystic appearance on magnetic resonance imaging in bihormonal growth hormone and prolactin tumors in acromegaly
ConclusionImaging characteristics are an increasingly important adenoma behavior determinant. An adenoma cystic component may suggest that a GH adenoma is a BA. Cystic tumors exhibited lower rates of surgical remission in this series; therefore, optimized individual patient treatment is needed, as patients could be candidates for primary medical treatment. (Source: Pituitary)
Source: Pituitary - August 31, 2020 Category: Endocrinology Source Type: research

Treatment of sellar metastases with gamma knife radiosurgery in patients with advanced cancer
ConclusionSRS provides an alternative treatment approach for sellar/suprasellar metastases with excellent local control, symptom improvement and maintenance of systemic therapy as desired. As such, CNS failure is rarely the proximate cause of demise in pituitary metastases provided that endocrinopathies are recognized and managed appropriately. (Source: Pituitary)
Source: Pituitary - August 28, 2020 Category: Endocrinology Source Type: research

Ectopic hyperprolactinaemia due to a malignant uterine tumor resembling ovarian sex cord tumors (UTROCST)
ConclusionsOur case demonstrates the importance of screening for extracranial hyperprolactinaemia in the context of: (1) substantially raised prolactin (10 × ULN) and (2) normal cranial MRI assuming macroprolactin has been excluded. The majority of extracranial ectopic prolactin-secreting tumors occur in the reproductive organs. (Source: Pituitary)
Source: Pituitary - August 27, 2020 Category: Endocrinology Source Type: research

Radiomics model predicts granulation pattern in growth hormone-secreting pituitary adenomas
ConclusionRadiomic features may be useful biomarkers to differentiate granulation pattern of GH-secreting pituitary adenoma patients, and showed better performance than qualitative assessment or rSI evaluation. (Source: Pituitary)
Source: Pituitary - August 25, 2020 Category: Endocrinology Source Type: research

Copeptin response to hypoglycemic stress is linked to prolactin activation in children
AbstractPurposeThe physiological role of arginine vasopressin (AVP) in the acute stress response in humans and especially in children is unclear. The aim of this study was to explore the interaction between copeptin, a well-established surrogate marker of AVP release, and anterior pituitary hormone activation in response to acute hypoglycemic stress in children and adolescents.MethodsWe conducted an exploratory single center study involving 77 children and adolescents undergoing insulin-induced hypoglycemia. Blood levels of copeptin, ACTH, cortisol, GH, prolactin, interleukin-6 (IL-6), adrenaline and noradrenaline were det...
Source: Pituitary - August 25, 2020 Category: Endocrinology Source Type: research

Sarcomas of the sellar region: a systematic review
AbstractPurpose and methodsSarcomas of the sellar region are uncommon and unexpected tumors. Here, we review the cases reported in literature via a systematic search.ResultsNinety-four patients, 58.5% male with mean age of 39.2  ± 17.2 years were included. Fifty-seven (62%) had soft tissue sarcomas (STS) and 35 (38%) bone sarcomas (BS). Sarcoma was a primary tumor in 66%, developed after radiotherapy in 31.9% and 7.4% were metastatic. Median time between radiotherapy and sarcoma development was 10.5 (11) years. Main presentation symptoms were visual disorders (87.9%), headache (61.5%) and III cran...
Source: Pituitary - August 11, 2020 Category: Endocrinology Source Type: research

Clinical efficacy of optical coherence tomography in sellar mass lesions: a meta-analysis
ConclusionsSellar mass lesions were associated with the changes in OCT measurements. The characteristic patterns of the OCT parameters may refine the diagnostic accuracy. Moreover, the alterations of OCT metrics before VF defects indicate the efficacy of OCT in early detection. Different types of pituitary adenomas may vary in OCT measurements, and their specific features warrant further research efforts. (Source: Pituitary)
Source: Pituitary - August 6, 2020 Category: Endocrinology Source Type: research

Ectopic pituitary adenomas: clinical features, diagnostic challenges and management
ConclusionsEPA clinical characteristics varied across different tumor locations and hormone-secreting types. In addition to comprehensive hormone evaluation and careful review of imaging data, nuclear medicine and surgical biopsy should also be considered when facing differential difficulty. EPA management should be individualized. (Source: Pituitary)
Source: Pituitary - August 4, 2020 Category: Endocrinology Source Type: research

Granular cell tumors of the sellar region: what should be done after subtotal resection? A systematic review
ConclusionOur systematic literature review suggests there is a limited role for chemo and/or radiotherapy in the management of incomplete GCT resection. It may be reasonable recommending close clinical follow up in patients with incomplete resection. (Source: Pituitary)
Source: Pituitary - July 31, 2020 Category: Endocrinology Source Type: research

The 5-factor modified frailty index predicts health burden following surgery for pituitary adenomas
AbstractPurposeFrailty is known to influence cost-related surgical outcomes in neurosurgery, but quantifying frailty is often challenging. Therefore, we investigated the predictive value of the 5-factor modified frailty index (mFI-5) on total hospital charges, LOS, and 90-day readmission for patients undergoing pituitary surgery.MethodsThe medical records of all patients undergoing endoscopic endonasal resection of pituitary adenomas at an academic medical center between January 2017 and December 2018 were retrospectively reviewed. Bivariate statistical analyses were conducted using Fisher ’s exact test, chi-square t...
Source: Pituitary - July 27, 2020 Category: Endocrinology Source Type: research

Secondary pituitary hormonal dysfunction patterns: tumor size and subtype matter
AbstractPurposePatients with sellar masses (SM) frequently have secondary hormonal deficiency (SHD) at initial presentation. While larger SM are more likely to present with SHD, it is unclear whether SHD at presentation is influenced by the type of SM.MethodsWe conducted a retrospective analysis of patients with SM prospectively enrolled in our comprehensive provincial neuropituitary registry between November 2005 and December 2018. SM were subdivided based on size:    3 cm.ResultsA total of 914 patients met the inclusion criteria, including: 346 nonfunctioning adenomas (NFA), 261 prolactinomas (PRLoma),...
Source: Pituitary - July 26, 2020 Category: Endocrinology Source Type: research

The importance of specialized sleep investigations in children with a suprasellar tumor
ConclusionSleep disturbances in children with hypopituitarism due to a (supra) sellar tumor can have different entities which require specific therapy. Awareness of these different entities is important to enable appropriate counseling. Referral to an expertise sleep center may be advised, if standard educational support is insufficient. (Source: Pituitary)
Source: Pituitary - July 19, 2020 Category: Endocrinology Source Type: research

Outcomes of pituitary surgery for Cushing ’s disease: a systematic review and meta-analysis
AbstractPurposeTranssphenoidal surgery (TSS) is the first-line treatment for Cushing ’s disease (CD). This review aimed to synthesize the remission and recurrence rates following TSS for CD and identify predictors of these outcomes.MethodsMedline (1946-) and Embase (1947-) were searched until 23rd January 2019 for original studies. A meta-analysis was performed of remission and recurrence rates. Studies were excluded if patients had prior radiosurgery/radiotherapy, mixed pathologies or interventions without separated data, follow-up not reported or population size  
Source: Pituitary - July 19, 2020 Category: Endocrinology Source Type: research

Cosecreting TSH/GH pituitary adenomas —an 8-year experience in a single tertiary center
ConclusionsThyrotropin/growth hormone pituitary adenoma is rare. Some patients do not present with the typical manifestations; however, the possibility of a cosecretion tumor should not be excluded. A preoperative comprehensive evaluation of anterior pituitary hormones is necessary. Thyrotropin/growth hormone pituitary adenoma revealed a high tendency of invasion, and the prognosis of patients with thyrotropin/growth hormone pituitary adenoma was poor. If necessary, timely postoperative drug administration or radiotherapy should be carried out. (Source: Pituitary)
Source: Pituitary - July 16, 2020 Category: Endocrinology Source Type: research

The diagnosis and management of primary and iatrogenic soft tissue sarcomas of the sella
ConclusionsWe report the prevalence and survival rates of STS of the sella. Multimodal therapy, including maximal safe resection, chemotherapy, and radiotherapy are necessary to optimize outcomes for this uncommon pathology. (Source: Pituitary)
Source: Pituitary - June 30, 2020 Category: Endocrinology Source Type: research

Prognostic factors of biochemical remission after transsphenoidal surgery for acromegaly: a structured review
ConclusionSurgical outcome prognostication systems could be further generated by machine learning algorithms in order to support development and implementation of personalized care in patients with acromegaly. (Source: Pituitary)
Source: Pituitary - June 28, 2020 Category: Endocrinology Source Type: research