New WHO classification of pituitary adenomas (4th edition): assessment of pituitary transcription factors and the prognostic histological factors

Nishioka, Hiroshi; Inoshita, Naoko

doi:10.1007/s10014-017-0307-7

Cited by 77 publications

(104 citation statements)

References 10 publications

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“…Thyrotropinomas are rare pituitary adenomas and are classified in the recent WHO guidelines as aggressive tumours that can be locally invasive (1,3). In the last few decades, they have been more frequently reported due to greater clinical awareness, and the advent of αGSU assays (1).…”

Section: Discussionmentioning

confidence: 99%

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Clinical challenges of a co-secreting TSH/GH pituitary adenoma

Namboodiri

Learoyd

et al. 2019

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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Co-secreting thyrotropin/growth hormone (GH) pituitary adenomas are rare; their clinical presentation and long-term management are challenging. There is also a paucity of long-term data. Due to the cell of origin, these can behave as aggressive tumours. We report a case of a pituitary plurihormonal pit-1-derived macroadenoma, with overt clinical hyperthyroidism and minimalGHexcesssymptoms.ThediagnosiswasconfirmedbypathologyshowingelevatedthyroidandGHaxeswithfailureof physiologicalGHsuppression,elevatedpituitaryglycoproteinhormonealphasubunit(αGSU)andmacroadenomaonimaging. Pre-operatively the patient was rendered euthyroid with carbimazole and underwent successful transphenoidal adenomectomy (TSA) with surgical cure. Histopathology displayed an elevated Ki-67 of 5.2%, necessitating long-term follow-up. Correspondence should be addressed to V PredaLearning points:• Thyrotropinomas are rare and likely under-diagnosed due to under-recognition of secondary hyperthyroidism.• Thyrotropinomas and other plurihormonal pit-1-derived adenomas are more aggressive adenomas according to WHO guidelines.• Co-secretion occurs in 30% of thyrotropinomas, requiring diligent investigation and long-term follow-up of complications.H Y Ng and others TSH/GH pituitary adenoma

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Section: Discussionmentioning

confidence: 99%

“…Careful follow-up of these cases is required. Early detection is key to optimise patient management (3).…”

Section: Introductionmentioning

confidence: 99%

Clinical challenges of a co-secreting TSH/GH pituitary adenoma

Namboodiri

Learoyd

et al. 2019

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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“…The main features of some PAs include: 1) more aggressive biologic behavior, which typically corresponds to a proliferative index that is higher than usual; 2) an invasive behavior, so that the PAs extend in the extrasellar region and/or histologically invade the surrounding dural, periosteal, or mucosal tissues. Aggressiveness and invasiveness are sometimes used as synonyms, as the two features are frequently present in the same tumor, but they should not be confused as they describe two distinct characteristics of PAs (Figure 1) [1][2][3][4][5][6][7]. .…”

Section: Introductionmentioning

confidence: 99%

Pituitary Adenomas and Invasiveness from Anatomo-Surgical, Radiological, and Histological Perspectives: A Systematic Literature Review

Serioli

Doglietto

Fiorindi

et al. 2019

Cancers

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Invasiveness in pituitary adenomas has been defined and investigated from multiple perspectives, with varying results when its predictive value is considered. A systematic literature review, following PRISMA guidelines, was performed, searching PubMed and Scopus databases with terms that included molecular markers, histological, radiological, anatomical and surgical data on invasiveness of pituitary adenomas. The results showed that differing views are still present for anatomical aspects of the sellar region that are relevant to the concept of invasiveness; radiological and histological diagnoses are still limited, but might improve in the future, especially if they are related to surgical findings, which have become more accurate thanks to the introduction of the endoscope. The aim is to achieve a correct distinction between truly invasive pituitary adenomas from those that, in contrast, present with extension in the parasellar area through natural pathways. At present, diagnosis of invasiveness should be based on a comprehensive analysis of radiological, intra-operative and histological findings.

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“…Approximately 30 to 40% of all surgically treated pituitary adenomas are CNFTs. 2 One study 3 reported CNFTs to constitute 15 to 54% of all adenomas. The World Health Organization (WHO) classification 2,4 of pituitary adenoma was revised in 2017.…”

Section: Introductionmentioning

confidence: 99%

“…2 One study 3 reported CNFTs to constitute 15 to 54% of all adenomas. The World Health Organization (WHO) classification 2,4 of pituitary adenoma was revised in 2017. The revised classification advocates identification of pituitary adenoma histological subtypes based on immunohistochemistry of pituitary hormone along with pituitary transcription factors.…”

Section: Introductionmentioning

confidence: 99%

Pituitary Microadenoma Treated with Individualized Homeopathic Medicine: A Case Report

Mathur¹

2020

Homeopathy

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Background Pituitary adenomas are common benign tumors of the pituitary gland with an overall estimated prevalence of 16.7%. As per the revised World Health Organization (WHO) classification, these tumors are identified by their histological subtypes and are designated by their pituitary cell lineage instead of the hormone they produce. The lactotroph adenoma is the most common subtype of hormone-producing pituitary adenoma. Surgery is the mainstay of treatment, but complications are encountered. So far, there is no reported study evaluating individualized homeopathic intervention in pituitary adenoma in peer-reviewed journals. Methods This case study describes a case of functional lactotroph microadenoma with history of failed surgical treatment and heavy intrasellar hemorrhage occurring during the surgery. Phosphorus was prescribed as an individualized homeopathic medicine on the basis of symptoms—hemorrhagic complication during surgical procedure and aggravation of headache thereafter. Results There was a marked subjective improvement along with complete tumor regression, as evidenced by repeat magnetic resonance imaging scans. The Modified Naranjo Criteria total score was +10 out of a possible +13, providing some evidence to attribute the clinical outcome with the homeopathic intervention. Conclusion This case study reconfirms the association between increased frequency of headaches and pituitary hemorrhage among cases of lactotroph adenoma. It also suggests that individualized homeopathic treatment may be helpful in pituitary adenomas with increased risk of complications such as intrasellar hemorrhage.

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New WHO classification of pituitary adenomas (4th edition): assessment of pituitary transcription factors and the prognostic histological factors

Cited by 77 publications

References 10 publications

Clinical challenges of a co-secreting TSH/GH pituitary adenoma

Clinical challenges of a co-secreting TSH/GH pituitary adenoma

Pituitary Adenomas and Invasiveness from Anatomo-Surgical, Radiological, and Histological Perspectives: A Systematic Literature Review

Pituitary Microadenoma Treated with Individualized Homeopathic Medicine: A Case Report

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