Clinically non-functioning pituitary adenomas: Pathogenic, diagnostic and therapeutic aspects

Mercado, Moisés; Melgar, Virgilio; Salame, Latife; Cuenca, Dalia

doi:10.1016/j.endinu.2017.05.009

Cited by 52 publications

(60 citation statements)

References 104 publications

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“…Although gonadotropinomas have been shown to express SSTR (mainly SSTR2 and SSTR5) and type 2 dopamine receptors (DR2), the results with SSAs and dopamine agonists (DAs) are discrete regarding tumor shrinkage [67]. The limited available data indicate that SSAs achieve a significant reduction in tumor size in only 12% of patients [68][69][70][71]. More recently, the results of the PASSION-I phase 2 trial have shown that a reduction in size of at least 20% was achieved in only 16.7% of patients after pasireotide LAR treatment [72].…”

Section: Gonadotropinomasmentioning

confidence: 99%

Somatostatin Analogs in Clinical Practice: A Review

Gomes-Porras

Cárdenas-Salas

Álvarez-Escolá

2020

IJMS

159

136

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Somatostatin analogs are an invaluable therapeutic option in the diagnosis and treatment of somatotropinomas, thyrotropinomas, and functioning and non-functioning gastroenteropancreatic neuroendocrine tumors. They should also be considered an effective and safe therapeutic alternative to corticotropinomas, gonadotropinomas, and prolactinomas resistant to dopamine agonists. Somatostatin analogs have also shown to be useful in the treatment of other endocrine diseases (congenital hyperinsulinism, Graves' orbitopathy, diabetic retinopathy, diabetic macular edema), non-endocrine tumors (breast, colon, prostate, lung, and hepatocellular), and digestive diseases (chronic refractory diarrhea, hepatorenal polycystosis, gastrointestinal hemorrhage, dumping syndrome, and intestinal fistula).

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Section: Gonadotropinomasmentioning

confidence: 99%

Somatostatin Analogs in Clinical Practice: A Review

Gomes-Porras

Cárdenas-Salas

Álvarez-Escolá

2020

IJMS

159

136

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“…Even after complete or near-complete surgical resection, 12%–58% of NFPA patients experience regrowth within 5 years, which cannot be effectively controlled by available therapeutics [2–5]. In contrast to functioning adenomas for which several effective and relatively safe targeted pharmacological therapies have been developed, a specific medical treatment for NFPA is still lacking [6]. The new WHO classification underscores the adoption of a pituitary adenohypophyseal cell lineage as the main principle guiding the classification of adenomas.…”

Section: Introductionmentioning

confidence: 99%

Immunohistochemical Study of NR2C2, BTG2, TBX19, and CDK2 Expression in 31 Paired Primary/Recurrent Nonfunctioning Pituitary Adenomas

Yao¹,

Zhang

Wu³

et al. 2019

International Journal of Endocrinology

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This study investigated potential markers for predicting nonfunctioning pituitary adenoma (NFPA) invasion and recurrence by high-throughput tissue microarray analyses. We retrospectively studied two groups of patients: 60 nonrecurrent NFPA cases that included noninvasion and invasion subtypes and 43 recurrent cases that included primary NFPA. A total of 31 paired patient samples were evaluated (12 patients with one surgery and 31 who had undergone two operations, with both tumors analyzed). Expressions of nuclear receptor subfamily 2 group C member 2 (NR2C2), B cell translocation gene 2, T-box-19 (TBX19), and cyclin-dependent kinase 2 (CDK2) in surgically resected specimens were assessed by immunohistochemistry. The relationships between marker expression and clinical characteristics including age, sex, tumor volume, and follow-up time were analyzed. Tumor volume and invasion as well as follow-up time were significantly associated with invasion and recurrence (P < 0.01). Of the 60 nonrecurrent samples, 15/41 and 13/19 showed high NR2C2 expression in the noninvasion and invasion groups, respectively (χ2 =5.287, P = 0.021). NR2C2 was also overexpressed in 43 primary recurrent cases (χ2 =5.433, P = 0.02), whereas CDK2 (χ2 = 11.242, P = 0.001) and TBX19 (χ2 = 4.875, P = 0.027) were downregulated. In the 31 paired samples, NR2C2 was more highly expressed in the recurrent as compared to the primary tumor. High NR2C2 expression was associated with NFPA invasion, recurrence, and progression, while TBX19 and CDK2 were associated with NFPA recurrence.

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“…Most of them present the immunohistochemical expression of different pituitary hormones, despite a lack of the clinical evidence of the hormone overproduction and increase of respective hormone levels in blood. Such tumours are called "silent" pituitary adenomas [1][2][3][4][5][6][7]. The majority of CNFPAs (70--80%) express gonadotropins or their subunits [1][2][3][4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…©Polish Society for Histochemistry and Cytochemistry Folia Histochem Cytobiol. 2020 10.5603/FHC.a2020.0014 www.journals.viamedica.pl/folia_histochemica_cytobiologica Silent corticotropinomas (corticotroph adenomas not manifested by Cushing's disease) and somatotroph adenomas without acromegaly (silent somatotropinomas) are less frequent but not exceedingly rare [1][2][3][4][5][6][7][11][12][13][14][15][16][17][18][19]. In contrast, silent thyrotropin-expressing [1][2][3][4][5][6][7]20] and prolactin-expressing pituitary adenomas are considered as very rare and the data concerning the clinical and pathological characterization of the latter of them are very scarce [5,7,21,22].…”

Section: Introductionmentioning

confidence: 99%

Immunohistochemical detection of prolactin in clinically non-functioning pituitary adenomas

Winczyk

Toszek

Świętosławski

et al. 2020

Folia Histochem Cytobiol.

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Introduction. Approximately one third of pituitary adenomas are manifested neither by specific symptoms of hormone overproduction nor by elevated blood levels of pituitary hormones. However, these tumours, diagnosed before surgical intervention as clinically non-functioning pituitary adenomas (CNFPAs) express in majority different pituitary hormones, as can be revealed by means of immunohistochemical examination. One of the pituitary hormones which may be expressed in CNFPAs is prolactin (PRL) but the clinical and pathological data on this condition are very scarce. Material and methods. Sixty two pituitary adenomas, diagnosed before surgery as CNFPAs, were immunoassayed with antibodies against PRL, growth hormone (GH), luteinizing hormone (LH), follicle stimulating hormone (FSH), thyrotropin (TSH), alpha subunit (alpha-SU), corticotropin (ACTH) and dopamine receptor type 2. In a proportion of the patients the presurgical concentrations of insulin-like growth factor 1 (IGF-1) were estimated by means of enzyme-amplified chemiluminescence assay. Results. Twenty-three (37.1%) of the examined CNFPAs presented the positive immunoreaction with anti-PRL antibody. Most cases concerned women. Only in two cases (one woman and one man), PRL was the unique hormone expressed in the tumour. In the remaining adenomas PRL immunopositivity was accompanied by GH expression-17, LH or free bLH-13, FSH-2, free a subunit-4 or by ACTH-5 tumours. Seven (30.43%) of them were recurrent in comparison with 12.8% PRL-immunonegative recurrent CNFPAs. Dopamine receptors were positively immunostained in all the investigated PRL-immunopositive and all PRL-immunonegative adenomas. Conclusions. Our data confirm the observations that monohormonal silent prolactinomas are very rare but frequently silent PRL often co-expressed with GH or LH. Although in the whole population of patients with CNFPAs both sexes are equally represented, in the case of silent prolactinomas the female sex is prevalent. The observation of the higher rate of recurrent tumours within PRL-immunopositive adenomas versus PRL-immunonegative CNFPAs has to be confirmed on the larger material.

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Clinically non-functioning pituitary adenomas: Pathogenic, diagnostic and therapeutic aspects

Cited by 52 publications

References 104 publications

Somatostatin Analogs in Clinical Practice: A Review

Somatostatin Analogs in Clinical Practice: A Review

Immunohistochemical Study of NR2C2, BTG2, TBX19, and CDK2 Expression in 31 Paired Primary/Recurrent Nonfunctioning Pituitary Adenomas

Immunohistochemical detection of prolactin in clinically non-functioning pituitary adenomas

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