Neurosurgery outcome in patients with Cushing's disease with and without visualised pituitary adenoma on MRI, who underwent inferior petrosal sinus sampling

Belaya, Zhanna; Khandaeva, Patimat; Rozhinskaya, Ludimila; Vorontsov, A V; Sitkin, Ivan; Grigoriev, Andrey; Ivashenko, Oksana; Dzeranova, Larisa; Melnichenko, Galina

doi:10.1530/endoabs.37.gp.22.07

Cited by 2 publications

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“…Селективный забор крови из НКС является наиболее точным инструментом в дифференциальной диагностике АКТГ-зависимого гиперкортицизма [10,11]. Тем не менее за счет технических сложностей данной процедуры, высокой стоимости и возможности осложнений инвазивного вмешательства использование данного метода ограничивается существующими показаниями, определяющими необходимость его выполнения у 20-30% пациентов с АКТГ-зависимым гиперкортицизмом.…”

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Inferior petrosal sinus sampling in differential diagnosis of ACTH-dependent hypercortisolism

et al. 2018

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Survival rate of patients with endogenous hypercortisolism, as well as complications reversibility and treatment effectiveness depends on on-time and precise diagnosis. In case of apparent clinical picture with all laboratory tests confirmation, the most challenging appears the differential diagnosis of ACTH-dependent hypercortisolism as none laboratory test can reveal the genesis of ACTH hypersecretion. When there is no visualization of the pituitary adenoma, the only method to confirm the diagnosis is bilateral inferior petrosal sinus sampling (BIPSS). Nevertheless, around 16% of patients have inactive pituitary incidentalomas in combination with carcinoid tumor of other localization. Epidemiologic researches show that the size of such incidentalomas tend to be less than 6 mm. According to clinical guidelines in case of such small neoplasms it’s recommended to perform bilateral inferior petrosal sinus sampling. This clinical case represent a rare exception to the rules when there is a pituitary adenoma more than 6 mm and mild hypercortisolism, possibly as the result of lung carcinoid tumor.

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Section: заключениеunclassified

Inferior petrosal sinus sampling in differential diagnosis of ACTH-dependent hypercortisolism

et al. 2018

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“…До 20% пациентов с АКТГ-зависимым эндогенным гиперкортицизмом направляются на процедуру забора крови из нижних каменистых синусов [7]. Вместе с тем при нейрохирургическом вмешательстве у пациентов с ранее не обнаруженной при МРТ аденомой находят опухоли, по объему сопоставимые с микроаденомами, выявляемыми с помощью МРТ [8]. Причина этого феномена не ясна.…”

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Immunochistochemical characteristics of blood vessels in non-visualized and visualized on MRI pituitary adenoma in patients with Cushing’s disease

Khandaeva

Магомедовна²,

Voronkova

et al. 2016

Probl Endokrinol (Mosk)

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Background. Regardless of improvements in MRI, up to 20% of ACTH-secreting pituitary tumors are only identified at surgical exploration. Aim. Тo estimate whether there is any difference in blood vessels and the subsequent ability to uptake contrast agent in visualized microadenoma as compared to non-visualized on MRI ACTH-secreting pituitary tumors.Material and methods. Retrospective evaluation of ACTH-positive pituitary tumors from patients with Cushing’s disease (n=39) with either non-visualized pituitary tumor on MRI (n=17) or pituitary tumor less then 25 mm (n=22). MRI was performed using Siemens Magnetom Harmony 1.0T with gadolinium. Selected tumors were stained with anty-СD34 antibody (clone QBEnd/10, RTU, Leica) and anty-D2-40 antibody (clone D2-40, RTU, Dako). We evaluated the microvessels density and measured the diameter of larger and smaller vessel.Results. The microvessels density were not different in subject with visualized [123 (77; 136)] and non-visualized [112 (110,0; 126,5)] pituitary adenomas as well as number of slit-shaped vessels [32 (5; 50) in visualized vs 25 (5; 50) in non-visualized pituitary adenoma]. The diameter of these vessels also did not differ: the diameter of the largest vessels in patients without visualization 53 µm (32,5; 63,5) vs 33 µm (30,0; 51,5) the average diameter of the blood vessels 15 µm (14,5—26,0) against 13 µm (12; 14).Conclusions. The diameter and microvessels density in ACTH-producing pituitary adenoma does not affect the visualization of adenoma on MRI in patients with Cushing ‘s disease.

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Neurosurgery outcome in patients with Cushing's disease with and without visualised pituitary adenoma on MRI, who underwent inferior petrosal sinus sampling

Cited by 2 publications

References 0 publications

Inferior petrosal sinus sampling in differential diagnosis of ACTH-dependent hypercortisolism

Inferior petrosal sinus sampling in differential diagnosis of ACTH-dependent hypercortisolism

Immunochistochemical characteristics of blood vessels in non-visualized and visualized on MRI pituitary adenoma in patients with Cushing’s disease

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