- Clinical Parameters to Distinguish Silent Corticotroph Adenomas from Other Nonfunctioning Pituitary Adenomas. [Journal Article]
- WNWorld Neurosurg 2018 Apr 17
- CONCLUSIONS: Female sex, cavernous sinus invasion, intratumoral hemorrhage on sella magnetic resonance imaging, and decreased ACTH response in the CPFT are independent indicators of SCAs.
- Endocrine Remission After Pituitary Stereotactic Radiosurgery: Differences in Rates of Response for Matched Cohorts of Cushing Disease and Acromegaly Patients. [Journal Article]
- IJInt J Radiat Oncol Biol Phys 2018 Feb 20
- CONCLUSIONS: After radiosurgery, patients with ACTH-secreting tumors achieved endocrine remission sooner than did those with GH-secreting tumors. These results provide insight into the relative tumor biology and disease course after radiosurgery that will serve to further improve clinical outcomes and patient treatment in the future.
- Hypopituitarism After Single-Fraction Pituitary Adenoma Radiosurgery: Dosimetric Analysis Based on Patients Treated Using Contemporary Techniques. [Journal Article]
- IJInt J Radiat Oncol Biol Phys 2018 Mar 08
- CONCLUSIONS: Hypopituitarism after pituitary adenoma SRS increases in a time- and dose-dependent manner. Reducing the radiation exposure to the identifiable gland to a mean dose < 11.0 Gy whenever feasible may lower the incidence of new hormonal deficits after pituitary adenoma SRS.
- Clinical and imaging features of pituitary apoplexy and role of imaging in differentiation of clinical mimics. [Review]
- QIQuant Imaging Med Surg 2018; 8(2):219-231
- To discuss the clinical syndrome, review common imaging findings of pituitary apoplexy (PA) and role of imaging in therapy and follow-up. Also, to review other acute clinical scenarios with similar c...
To discuss the clinical syndrome, review common imaging findings of pituitary apoplexy (PA) and role of imaging in therapy and follow-up. Also, to review other acute clinical scenarios with similar clinical and/or imaging findings as PA. PA is a severe and potentially life-threatening medical emergency, characterized by constellation of symptoms/signs that occur as a result of acute hemorrhage and/or infarction in pituitary gland. Patients present with acute and sudden onset of symptoms/signs, most commonly with severe headache, vision deficits/ophthalmoplegia, altered mental status, and possible pan hypopituitarism. Pre-existing macro adenoma (65-90%), especially non-functioning and prolactinomas, are most susceptible to apoplexy, which undergoes hemorrhage or infarct, but PA can occur with normal pituitary or microadenoma. Because of the probable grave prognosis of PA, imaging characteristics of PA and other acute clinical scenarios with similar clinical and/or imaging findings should be familiar to radiologists. PA is potentially a life-threatening clinical syndrome, however, imaging and clinical findings can lead the radiologist towards appropriate diagnosis, and rule out other clinical mimics. When hemorrhage is secondary to an underlying lesion, regrowth of the pituitary tumor years after a PA episode is possible and patients require long-term clinical and imaging surveillance.
- Autoimmune Hypophysitis Presenting as Solid-Cystic Mass Managed Conservatively. [Journal Article]
- PJPol J Radiol 2017; 82:473-477
- CONCLUSIONS: AH should be included in the differential diagnosis of solid-cystic pituitary masses along with clinical correlation, which includes early involvement of ACTH and TSH and a relatively rapid development of hypopituitarism. In uncertain cases or with lack of compressive symptoms, a trial of steroids is worthwhile.
- ALTERATIONS IN THYROID HORMONE LEVELS FOLLOWING GROWTH HORMONE REPLACEMENT EXERT COMPLEX BIOLOGICAL EFFECTS. [Journal Article]
- EPEndocr Pract 2018; 24(4):342-350
- CONCLUSIONS: Changes in the thyroid axis following GH replacement are associated with complex tissue-specific effects. These fluctuations may induce a hypothyroid phenotype in some tissues while appearing to improve the biological action of thyroid hormone in other organs.
- Endocrine outcomes of endoscopic versus transcranial resection of craniopharyngiomas: A system review and meta-analysis. [Review]
- CNClin Neurol Neurosurg 2018 Apr 07; 169:107-115
- It is unclear whether the endoscopic technique has any advantages over transcranial approach in the aspect of endocrine outcomes in patients with craniopharyngiomas, thus, we conducted a systematic r...
It is unclear whether the endoscopic technique has any advantages over transcranial approach in the aspect of endocrine outcomes in patients with craniopharyngiomas, thus, we conducted a systematic review and meta-analysis. We conducted a comprehensive search of PubMed to identify relevant studies. Pituitary, hypothalamus functions and recurrence were used as outcome measures. A total of 39 cohort studies involving 3079 adult patients were included in the comparison. Among these studies, 752 patients across 17 studies underwent endoscopic transsphenoidal resection, and 2327 patients across 23 studies underwent transcranial resection. More patients in the endoscopic group (75.7%) had visual symptoms and endocrine symptoms (60.2%) than did patients in the transcranial group (67.0%, p = 0.038 and 42.0%, p = 0.016). There was no significant difference in hypopituitarism and pan-hypopituitarism after surgery between the two groups: 72.2% and 43.7% of the patients in endoscopic group compared to 80.7% and 48.3% in the transcranial group (p = 0.140 and p = 0.713). We observed same proportions of transient and permanent diabetes insipidus in both groups. Similar recurrence was observed in both groups (p = 0.131). Pooled analysis showed that neither weight gain (p = 0.406) nor memory impairment (p = 0.995) differed between the two groups. Meta-regression analysis revealed that gross total resection contributed to the heterogeneity of recurrence proportion (p < 0.001). We observed similar proportions of endocrine outcomes and recurrence in both endoscopic and transcranial groups. More recurrences were observed in studies with lower proportions of gross total resection.
- Criteria for diagnosis and postoperative control of acromegaly, and screening and management of its comorbidities: Expert consensus. [Journal Article]
- EDEndocrinol Diabetes Nutr 2018 Apr 10
- Acromegaly is a rare disease with many comorbidities that impair quality of life and limit survival. There are discrepancies in various clinical guidelines regarding diagnosis and postoperative contr...
Acromegaly is a rare disease with many comorbidities that impair quality of life and limit survival. There are discrepancies in various clinical guidelines regarding diagnosis and postoperative control criteria, as well as screening and optimal management of comorbidities. This expert consensus was aimed at establishing specific recommendations for the Spanish healthcare system. The existing recommendations, the scientific evidence on which they are based, and the main controversies are reviewed. Unfortunately, the low prevalence and high clinical variability of acromegaly do not provide strong scientific evidences. To mitigate this disadvantage, a modified Delphi questionnaire, combining the best available scientific evidence with the collective judgment of experts, was used. The questionnaire, generated after a face-to-face debate, was completed by 17 Spanish endocrinologists expert in acromegaly. A high degree of consensus was reached (79.3%), as 65 of the total 82 statements raised were accepted. Some criteria for diagnosis and postoperative control were identified by this procedure. Regarding comorbidities, recommendations have been established or suggested for screening and management of oncological, cardiovascular, respiratory (sleep apnea), metabolic (dyslipidemia and diabetes), musculoskeletal, and hypopituitarism-related disorders. Consensus recommendations may facilitate and homogenize clinical care to patients with acromegaly in the Spanish health system.
- Hypopituitarism Associated with Glycosuria. [Journal Article]
- EMEdinb Med J 1924; 31(2):82-86
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- Intra cavernous aneurysm of internal carotid artery masquerading as a pituitary adenoma: a case report. [Journal Article]
- BRBMC Res Notes 2018 Apr 10; 11(1):237
- CONCLUSIONS: Carotid aneurysm can mimc pituitary tumours clinically and radiologically on MRI scan. This rare possibility should be considered in evaluating supra-sellar masses to avoid catastrophic consequences.