Subclinical hyperfunctioning pituitary adenomas: The silent tumors

Cooper, Odelia; Melmed, Shlomo

doi:10.1016/j.beem.2012.01.002

Cited by 80 publications

(45 citation statements)

References 89 publications

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“…The mean number (range) of patients diagnosed with PAs per year was 54 (42-69); 26 (17-36) in men and 28 (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) in women. The age-SIRs per 100 000 people per year are presented in Fig.…”

Section: Time Trends Of Incidencementioning

confidence: 99%

The incidence rate of pituitary adenomas in western Sweden for the period 2001–2011

Tjörnstrand

Gunnarsson

Evert

et al. 2014

European Journal of Endocrinology

234

156

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Objective: The number of studies on the incidence of pituitary adenomas (PAs) is limited. The aim of this study was to evaluate the standardised incidence rate (SIR) of PAs in western Sweden. Design, subjects and methods: Data from adult patients diagnosed with PAs in 2001-2011, living in the Vä stra Gö taland County, were collected from the Swedish Pituitary Registry (SPR). In addition, medical records on all patients diagnosed with PAs at the six hospitals in the region were reviewed. In total, 592 patients were included in the study. Age-SIR, given as rate/100 000 inhabitants (95% CI), was calculated using the WHO 2000 standard population as a reference. Results: The total SIR for PAs was 3.9/100 000 (3.6-4.3); 3.3/100 000 (2.9-3.7) for men and 4.7/100 000 (4.1-5.3) for women. In men, SIR increased with age, while in women SIR peaked at 25-34 years, mainly due to prolactinomas. Non-functioning PA (NFPA) was the most common PA (54%, 1.8/100 000 (1.6-2.0)) followed by prolactinomas (32%, 1.6/100 000 (1.3-1.9)), acromegaly (9%, 0.35/100 000 (0.25-0.45)), Cushing's disease (4%, 0.18/100 000 (0.11-0.25)) and TSH-producing PA (0.7%, 0.03/100 000 (0.00-0.05)). The proportion of macroadenomas for NFPA was 82%, prolactinomas 37%, GH-producing PA 77%, ACTH-producing PA 28% and TSH-producing PA 100%. The lifetime risk for PAs was 0.27% (0.24-0.31) in men and 0.29% (0.26-0.33) in women. Conclusion: This study provides a reliable estimate on the overall incidence of PAs and confirms an increased incidence of PAs compared with studies conducted in the pre-magnetic resonance imaging era. The lower proportion of prolactinomas compared with previous studies is probably explained by the different criteria used.

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Section: Time Trends Of Incidencementioning

confidence: 99%

The incidence rate of pituitary adenomas in western Sweden for the period 2001–2011

Tjörnstrand

Gunnarsson

Evert

et al. 2014

European Journal of Endocrinology

234

156

View full text Add to dashboard Cite

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“…Diagnosis is usually established by detecting the predominant complications of neurological character, perhaps some degree of hypopituitarism, headache, and other clinical manifestations induced by the unpredictable biological behavior of those tumors. Prevalence of specific cellular lineage varies, but is has been calculated to be as 7 to 9 cases out of 100,000 inhabitants, including the silent gonadotrope, corticotrope, thyrotrope, oncocytic, null cell, lactotrope, and other silent cellular lineages [4,9]. In contrast to these data, a higher prevalence was registered in Belgium with a figure of 94 patients out of 100,000 people [10].…”

Section: Introductionmentioning

confidence: 95%

“…The frequency of benign tumors of the pituitary is 10-20% of the primary intracranial tumors [1] with an incidence of 2.7 to 28 people out of 100,000 people a year [2][3][4], although there is a great variance in the reported incidence of the pituitary adenomas. An early diagnosis is obtained in the case of female patients [5] as reported by Nabarro [6].…”

Section: Introductionmentioning

confidence: 99%

Clinical and Neurological Manifestations of Non-Functioning Pituitary Adenomas (NFPA). Is it ok to Suspect an Early Invasiveness?

Sánchez-Turcios¹,

Rangel-Morales²,

Fj³

2015

EMIJ

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Introduction: Clinically non-functioning pituitary adenomas (NFPA) are a heterogeneous set of complex adenomas with a wide variety of immunohistochemical subtypes such as silent gonadotrope, null cell adenoma, silent corticotrope adenoma, and other silent tumors of somatotrope, thyrotrope, and lactotrope lineages. The diagnosis is established by hypothalamus-pituitary MRI, which gives the volume of the tumor, and by determining the pituitary hormones, peripheral hormones when indicated, and neurologic manifestations. In NPFA, there is neither a typical hormonal hyper secretion nor a determined clinical syndrome.

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“…Pituitary adenomas (PA) are rare tumors, representing approximately 15% of intracranial tumors [1]. Th e diagnosis is based on clinical, biochemical and imaging data and confi rmed by histology and immunohistochemistry (IHC).…”

Section: Introductionmentioning

confidence: 99%

Herlant’s Tetrachrome Staining, a Useful Tool for Pituitary Adenoma Diagnosis

Chinezu

Trouillas

Loghin

et al. 2013

Acta Medica Marisiensis

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Introduction: The morphologic diagnosis of pituitary adenomas (PA) is based on immunohistochemistry (IHC). In Romania, IHC diagnosis of PA is restricted, all of the specific antibodies being very expensive. A histochemical staining, Herlant’s tetrachrome (HTCS), was described several years ago, but it was not widely used for diagnostic purposes because of technical difficulties. The aim of this paper is to bring into discussion this staining, to highlight its benefits, to improve the technical procedures and to establish a protocol, which combining both HTCS and IHC, facilitates the diagnosis of PA and, especially, substantially reduces the costs. Methods: HTCS was performed using normal pituitary glands. The optimal time of staining and the optimal concentration of different solutions were established for each step of the staining. Results: The improved technical procedure of HTCS is described. The staining features of all cellular types of the pituitary gland are depicted and illustrated: the chromophore cells, GH-secreting cells stained in orange, PRL-secreting cells in red-violet and ACTH-cells in dark blue, while cromophobe cells stained light blue. These staining features can be extrapolated to the diagnosis of PAs, as they consist of a proliferation of such cells. Conclusion: HTCS’s benefit is in functional PAs: it can identify GH, PRL, ACTH and TSH-adenomas, according to the cell type staining. A two-step diagnostic protocol is proposed, allowing the use of two, maximum three antibodies, instead of six: first step HTCS, and second step IHC

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Subclinical hyperfunctioning pituitary adenomas: The silent tumors

Cited by 80 publications

References 89 publications

The incidence rate of pituitary adenomas in western Sweden for the period 2001–2011

The incidence rate of pituitary adenomas in western Sweden for the period 2001–2011

Clinical and Neurological Manifestations of Non-Functioning Pituitary Adenomas (NFPA). Is it ok to Suspect an Early Invasiveness?

Herlant’s Tetrachrome Staining, a Useful Tool for Pituitary Adenoma Diagnosis

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