Nonfunctioning Pituitary Adenoma That Changed to a Functional Gonadotropinoma

Andino-Ríos, Gerson Geovany; Portocarrero-Ortíz, Lesly; Rojas-Guerrero, Carlos Alberto; Ortíz-Plata, Alma; Reza-Albarrán, Alfredo

doi:10.1155/2018/5027859

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…Additionally, we did not observe any cell lineage change or significant alteration of hormone production in presented patient's case. There are reports that in rare cases shift from clinically silent PA to hormonally active tumours is observed [30][31][32], however, these do not include exact tracing according to transcription factors defined by the WHO classification of 2017. To further assess potential shifts in cell lineage of operated recurrent PA cases comprehensive research of significant number of relapse PAs including T-pit, SF1, PIT-1 immuno-staining is needed.…”

Section: Discussionmentioning

confidence: 99%

Case report: recurrent pituitary adenoma has increased load of somatic variants

et al. 2020

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Background: Pituitary adenomas (PA) have an increased potential for relapse in one to 5 years after resection. In this study, we investigated the genetic differences in genomic DNA of primary and rapidly recurrent tumours in the same patient to explain the causality mechanisms of PA recurrence. Case presentation: The patient was a 69-year-old female with non-functional pituitary macroadenoma with extension into the left cavernous sinus (Knosp grade 2) who underwent craniotomy and partial resection in August 2010. Two years later, the patient had prolonged tumour growth with an essential suprasellar extension (Knosp grade 2), and a second craniotomy with partial tumour resection was performed in September 2012. In both tumours, the KI-67 level was below 1.5%. Exome sequencing via semiconductor sequencing of patient germline DNA and somatic DNA from both tumours was performed. Tmap alignment and Platypus variant calling were performed followed by variant filtering and manual review with IGV software. We observed an increased load of missense variants in the recurrent PA tumour when compared to the original tumour. The number of detected variants increased from ten to 26 and potential clonal expansion of four variants was observed. Additionally, targeted SNP analysis revealed five rare missense SNPs with a potential impact on the function of the encoded proteins. Conclusions: In this case study, an SNP located in HRAS is the most likely candidate inducing rapid PA progression. The relapsed PA tumour had a higher variation load and fast tumour recurrence in this patient could be caused by clonal expansion of the leftover tumour tissue.

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Section: Discussionmentioning

confidence: 99%

Case report: recurrent pituitary adenoma has increased load of somatic variants

et al. 2020

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“…Therefore, the role of circulating miRNAs may be less important. However, with regard to nonfunctional PA (NFPA) or PA with aggressive behavior, circulating miRNAs as noninvasive blood-based biomarkers can help in the diagnosis, prognosis, and monitoring of patients during the postoperative period [ 46 ].…”

Section: Circulating Mirnas and Pamentioning

confidence: 99%

MiRNAs as Noninvasive Biomarkers and Therapeutic Agents of Pituitary Adenomas

Beylerli

Beeraka

Gareev

et al. 2020

IJMS

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Pituitary adenoma (PA) accounts for 10–15% of all intracranial neoplasms. Even though most pituitary adenomas are benign, it is known that almost 35% of them exhibit an aggressive clinical course, including rapid proliferative activity and invasion of neighboring tissues. MicroRNAs (miRNAs) are short single-stranded RNA molecules that can influence post-transcriptional regulation by controlling target genes. Based on research data on miRNAs over the past 20 years, more than 60% of genes encoding human proteins are regulated by miRNAs, which ultimately control basic cellular mechanisms, including cell proliferation, differentiation, and apoptosis. Dysregulation of miRNAs has been observed in a number of diseases, especially tumors like PA. A majority of miRNAs are expressed within the cells themselves. However, the circulating miRNAs can be detected in several biological fluids of the human body. The identification of circulating miRNAs as new molecular markers may increase the ability to detect a tumor, predict the course of a disease, plan to choose suitable treatment, and diagnose at the earliest signs of impending neoplastic transformation. Therapy of PAs with aggressive behavior is a complex task. When surgery and chemotherapy fail, radiotherapy becomes the treatment of choice against PAs. Therefore, the possibility of implementing circulating miRNAs as innovative diagnostic and therapeutic agents for PA is one of the main exciting ideas.

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“…Некоторые авторы описывают смену секреторной активности аденом гипофиза, когда исходно гормонально-неактивное образование начинает секретировать гонадотропины через несколько лет наблюдения [23]. Это наблюдение лишний раз подчеркивает необходимость не только динамического контроля роста опухоли, но и клинического наблюдения пациентов с ГНАГ.…”

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An ovarian hyperstimulation syndrome caused by gonadotropinoma in a young woman

Горбачева

Przhiyalkovskaya

Azizyan

et al. 2019

Probl Endokrinol (Mosk)

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From 14 to 54% of all pituitary adenomas are nonfunctioning pituitary adenomas (NPAs), their prevalence is estimated as 7.041.3 cases per 100 000 population. The most common type of NPAs (73% of cases) are gonadotropinomas. In most cases, gonadotropinoma is characterized by secretion of biologically inactive hormones, so the release of gonadotropins does not lead to the development of any clinical symptoms. For this reason the diagnosis of gonadotropinomas is most often performed on the basis of immunohistochemical analysis. However, in rare cases, gonadotropinomas secrete biologically active hormones, most often follicle-stimulating (FSH). Ovarian hyperstimulation syndrome due to gonadotropin-secreting pituitary tumors occurs in about 3% of women with hormonally inactive pituitary adenomas at reproductive age and in 8% of patients with verified gonadotropinomas. This clinical case describes a young patient with a rare pathology: FSH/LH-secreting macroadenoma of the pituitary, which led to the development of ovary hyperstymulation symdrome. The diagnosis of pituitary adenoma was performed due to the identified hyperprolactinemia one month before the development of visual impairment, which can be considered a late diagnosis. Surgical treatment of gonadotropinomy was carried out successfully and without complications, remission of the disease was achieved, visual function was restored, the patient successfully became pregnant.

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Nonfunctioning Pituitary Adenoma That Changed to a Functional Gonadotropinoma

Cited by 5 publications

References 15 publications

Case report: recurrent pituitary adenoma has increased load of somatic variants

Case report: recurrent pituitary adenoma has increased load of somatic variants

MiRNAs as Noninvasive Biomarkers and Therapeutic Agents of Pituitary Adenomas

An ovarian hyperstimulation syndrome caused by gonadotropinoma in a young woman

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