Clinical and Histological Study of Pituitary Fibrosarcoma following Radiotherapy for Pituitary Adenoma

Sato, Kazufumi; Hayashi, Minoru; Komai, Toshio; Kubota, Toshihiko; Kawano, Hirokazu; Handa, Yuji

doi:10.2176/nmc.30.887

Cited by 9 publications

(6 citation statements)

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“…Also Matrigel (a commercial product, of BD Biosciences, derived from Engelbreth-Holm-Swarm (EHS) mouse sarcoma cells, being an ECM-like mix of proteins) increased the rate of attachment with GH3 cells. The observed effects of Matrigel on GH3 cells may be interpreted in light of the observation that there is an absence of surrounding basement membrane in pituitary tumours in vivo [53,63]. Adherence of GH3B6 cells was also enhanced by the presence of stromal (ASP9) cells [37] indicating a potential importance of the non-endocrine cells in pituitary behaviour.…”

Section: Lactotrophsmentioning

confidence: 78%

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Extracellular Matrix Proteins in the Anterior Pituitary Gland

Kanasaki¹

2011

TONEUROEJ

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Abstract; The importance of the extracellular matrix (ECM) has become recognised as an important component of the functioning of cells. However the roles of the ECM in the anterior pituitary gland have received little attention. The pituitary has the particular characteristics of possessing a number of endocrine cells as well as less well studied nonendocrine cells. Because each cell has specific and vital roles in the physiology being of an individual the ECM must also possess selective activities. The details of ECM behaviour have not yet been delineated in the pituitary and this review first considers general characteristics of ECM compounds and then examines the properties of peptides with regard to functioning of the cells of the pituitary. It is noted that there are variations between ECM associated with normal cells and with tumours, that there are both morphological and biochemical responses to alterations in the composition of substrate on which cells are grown, and that a development of further models of ECM will be required for continued advances in the understanding of the manner in which the pituitary behaves in normal, clinical and pathological circumstances. Overall, the observations suggest that modulation of the ECM provides opportunities for enhancing well-being of individuals.

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Section: Lactotrophsmentioning

confidence: 78%

“…It has been suggested that pituitary tumours in vivo are not surrounded by basement membrane [53]. Hence some of the regulating effects due to peptides localised in the basement membrane may be absent from that source and reduced overall.…”

Section: Cancer and The Ecmmentioning

confidence: 99%

Extracellular Matrix Proteins in the Anterior Pituitary Gland

Kanasaki¹

2011

TONEUROEJ

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“…After articles were excluded based on our present inclusion and exclusion criteria, finally 87 articles with a total of 137 (48 neuroepithelial tumors, 37 meningiomas, 52 sarcomas) patients in the 1959–2017 period were included in this review, although data is missing regarding overall survival and type of irradiation in a significant proportion of the reports (Figure 1, Table 1, Supplementary Table S1) [14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,…”

Section: Resultsmentioning

confidence: 99%

Secondary Intracranial Tumors Following Radiotherapy for Pituitary Adenomas: A Systematic Review

Yamanaka

Abe

Toshihiko³

et al. 2017

Cancers

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Pituitary adenomas are often treated with radiotherapy for the management of tumor progression or recurrence. Despite the improvement in cure rates, patients treated by radiotherapy are at risk of development of secondary malignancies. We conducted a comprehensive literature review of the secondary intracranial tumors that occurred following radiotherapy to pituitary adenomas to obtain clinicopathological characteristics. The analysis included 48 neuroepithelial tumors, 37 meningiomas, and 52 sarcomas which were published between 1959–2017, although data is missing regarding overall survival and type of irradiation in a significant proportion of the reports. The average onset age for the pituitary adenoma was 37.2 ± 14.4 years and the average latency period before the diagnosis of the secondary tumor was 15.2 ± 8.7 years. Radiotherapy was administered in pituitary adenomas at an average dose of 52.0 ± 19.5 Gy. The distribution of pituitary adenomas according to their function was prolactinoma in 10 (7.2%) cases, acromegaly in 37 (27.0%) cases, Cushing disease in 4 (2.9%) cases, PRL+GH in 1 (0.7%) case, non-functioning adenoma in 57 (41.6%) cases. Irradiation technique delivered was lateral opposing field in 23 (16.7%) cases, 3 or 4 field technique in 27 (19.6%) cases, rotation technique in 10 (7.2%) cases, radio surgery in 6 (4.3%) cases. Most of the glioma or sarcoma had been generated after lateral opposing field or 3/4 field technique. Fibrosarcomas were predominant before 1979 (p < 0.0001). The median overall survival time for all neuroepithelial tumors was 11 months (95% confidence intervals (CI), 3–14). Patients with gliomas treated with radiotherapy exhibited a non-significant positive trend with longer overall survival. The median overall survival time for sarcoma cases was 6 months (95% CI, 1.5–9). The median survival time in patients with radiation and/or chemotherapy for sarcomas exhibited a non-significant positive trend with longer overall survival. In patients treated with radiotherapy for pituitary adenomas, the risk of secondary tumor incidence warrants a longer follow up period. Moreover, radiation and/or chemotherapy should be considered in cases of secondary glioma or sarcoma following radiotherapy to the pituitary adenomas.

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“…Sarcomatous changes in sellar lesions do not necessarily indicate malignant or metastatic potential; few patients with PF secondary to sellar radiotherapy or pituitary adenoma showed relapse or metastasis after total resection. [1][2][3][4][5][6][7][8][9] These differences in clinical presentation and histopathology demonstrate that, compared with secondary PF, PPF has a higher of grade malignancy, including rapid Three different etiologic forms of PF have been documented in the literature: (1) radiotherapyinduced fi brosarcomatous transformation of pituitary lesions, such as adenoma or craniopharyngioma, which comprises the overwhelming majority of all PF case reports; [2][3][4][5][6] (2) spontaneous fi brosarcomatous transformation of primary prolactinoma without a recognizable cause; [1,[7][8][9] and (3) spontaneous fibrosarcomatous changes in the pituitary gland, which may metastasize to other areas of the head and pathologically appears to be the most malignant of the three types. [10,11] The patient in this report had the third form of PF, and was limited to a lifespan of only 11 months from diagnosis despite a multimodal treatment regimen combining surgery, chemotherapy, and radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5][6][7][8][9][10][11] Almost all these cases have been considered to be radiotherapy-induced complication in patients with pituitary adenoma or craniopharyngioma [2][3][4][5][6] or a spontaneous malignant transformation of prolactinoma. [7][8][9] Till date only two cases of primary PF (PPF), unrelated to irradiation or adenoma, have been published.…”

Section: Introductionmentioning

confidence: 99%

Primary pituitary fibrosarcoma presenting with multiple metastases: A case report and literature review

Sun

Guo

et al. 2010

Neurol India

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Even though many cases of pituitary fibrosarcoma (PF) have been reported, the etiologic classification of these tumors, however, remains undefined. Moreover, owing to the paucity of available case studies, the clinical characteristics of primary pituitary fibrosarcoma (PPF) have not been fully described. We report a 26-year-old female with pathologically confirmed PPF, who presented with features of elevated intracranial pressure, oculomotor nerve palsy, field defects and panhypopituitarism. Despite the combination therapy, which included tumor removal, radiotherapy, and chemotherapy, magnetic resonance imaging demonstrated multiple intracranial and extracranial metastases at a seven-month follow-up, and the survival duration from diagnosis was only 11 months. Based on a review of the literature, we propose preliminary etiologic classification criteria for PF as well as a new therapeutic approach to reduce PPF recurrence and metastasis, including extended surgical resection and postoperative whole-brain radiotherapy.

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Clinical and Histological Study of Pituitary Fibrosarcoma following Radiotherapy for Pituitary Adenoma

Cited by 9 publications

References 0 publications

Extracellular Matrix Proteins in the Anterior Pituitary Gland

Extracellular Matrix Proteins in the Anterior Pituitary Gland

Secondary Intracranial Tumors Following Radiotherapy for Pituitary Adenomas: A Systematic Review

Primary pituitary fibrosarcoma presenting with multiple metastases: A case report and literature review

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