Incidentally found small pituitary adenomas may have no effect on fertility

Abstract. Histological examination of the pituitary glands from 486 unselected autopsies revealed 97 clinically unsuspected adenomas in 78 glands (16%). Prolactinomas numbered 48; no hormone was found in 30, LH in 8, ACTH in 7, growth hormone (GH) and prolactin in 3, and GH alone in 1. Eleven of 194 female subjects and 37 out of 292 males had one or more prolactinoma. Clinical case notes, available for 57 of 78 subjects with adenomas, were reviewed to obtain data on fertility. Of the 25 women with case notes, 6 of the 11 with prolactinomas and 11 of the 14 with adenomas of other types had conceived. For the 32 males, 10 of the 23 with prolactinomas and 5 of the 9 with other types had procreated. These findings show that pituitary tumours not identified in life may have no major anti-fertility effect, and suggest that treatment of small intrasellar lesions discovered clinically by chance may not be necessary.

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Biosynthesis of Human Growth Hormone and Prolactin by Normal Pituitary Glands and Pituitary Adenomas

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem-33-1-1 ◽

1971 ◽

Vol 33 (1) ◽

pp. 1-7 ◽

Cited By ~ 22

Author(s):

P. HWANG ◽

H. FRIESEN ◽

J. HARDY ◽

D. WILANSKY

Keyword(s):

Growth Hormone ◽

Human Growth Hormone ◽

Pituitary Adenomas ◽

Human Growth ◽

Pituitary Glands

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QUANTITATIVE ANALYSIS OF IMMUNOREACTIVE HUMAN GROWTH HORMONE (HGH) IN THE SECRETORY GRANULES OF NORMAL PITUITARY GLANDS AND HGH-PRODUCING PITUITARY ADENOMAS: An Immunoelectron Microscopic Study Using the Protein A-Gold (PAG) Technique

Pathology International ◽

10.1111/j.1440-1827.1988.tb01094.x ◽

1988 ◽

Vol 38 (2) ◽

pp. 153-162

Author(s):

Katsumi Suzukawa ◽

Akira Kawaoi ◽

Kiyoshi Sato ◽

Shozo Ishii

Keyword(s):

Growth Hormone ◽

Quantitative Analysis ◽

Microscopic Study ◽

Human Growth Hormone ◽

Pituitary Adenomas ◽

Secretory Granules ◽

Protein A ◽

Human Growth ◽

Pituitary Glands

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Functional Morphology of Spontaneous Hyperplastic and Neoplastic Lesions in the Canine Pituitary Gland

Veterinary Pathology ◽

10.1177/030098588001700201 ◽

1980 ◽

Vol 17 (2) ◽

pp. 109-122 ◽

Cited By ~ 18

Author(s):

M. F. El Etreby ◽

R. Müller-Peddinghaus ◽

A. S. Bhargava ◽

G. Trautwein

Keyword(s):

Growth Hormone ◽

Cell Types ◽

Pars Intermedia ◽

Adrenocorticotrophic Hormone ◽

Pars Distalis ◽

Pituitary Tumours ◽

Prolactin Cells ◽

Neoplastic Lesions ◽

Nodular Hyperplasia ◽

Pituitary Glands

The pituitary glands of 10 male and 29 female dogs of different breeds had diffuse hyperplasia and hypertrophy of growth hormone or prolactin cells. Immunoreactive adrenocorticotrophin/melanotrophin was in the frequent focal hyperplastic lesions and micro-and macroadenomas of both pars distalis and pars intermedia of old female dogs. Pituitary tumours of other functional cell types were not found. Focal hyperplastic and neoplastic lesions usually were accompanied by spontaneous nodular hyperplasia or adenomas of the adrenal cortex as well as by changes in serum adrenocorticotrophic hormone and cortisol levels.

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Molecular pathogenesis of pituitary tumours

Oxford Textbook of Endocrinology and Diabetes ◽

10.1093/med/9780199235292.003.2052 ◽

2011 ◽

pp. 112-121

Author(s):

Ines Donangelo ◽

Shlomo Melmed

Keyword(s):

Growth Hormone ◽

Pituitary Adenomas ◽

Single Cells ◽

Hormone Secretion ◽

Cell Types ◽

Pituitary Tumour ◽

Thyroid Stimulating Hormone ◽

Gene Products ◽

Pituitary Tumours ◽

Secretory Products

Pituitary adenomas are discovered in up to 25% of unselected autopsies, however, clinically apparent tumours are considerably less common. The pituitary gland is composed of differentiated cell types: somatotrophs, lactotrophs, corticotrophs, thyrotrophs, and gonadotrophs. Tumours may arise from any of these cell types and their secretory products depend on the cell of origin. The functional classification of pituitary tumorus is based on identification of cell gene products by immunostaining or mRNA detection, as well as measurement of circulating tumour and target organ hormone levels. Oversecretion of adrenocorticotropic hormone (ACTH) results in cortisol excess with Cushing’s disease. Growth hormone overproduction leads to acromegaly with typical acral overgrowth and metabolic abnormalities. Prolactin hypersecretion results in hypogonadism and galactorrhoea. Rarely, thyroid-stimulating hormone (TSH) hypersecretion leads to goitre and thyrotoxicosis, and gonadotropin excess results in gonadal dysfunction (1). Mixed tumours cosecreting growth hormone with prolactin, TSH, or ACTH may also arise from single cells. Clinically nonfunctional tumours are those that do not efficiently secrete their gene products, and most commonly they are derived from gonadotroph cells. Pituitary tumours are further defined radiographically as microadenomas (<1 cm in diameter) or macroadenomas (>1 cm in diameter). However, this classification does not reflect whether the pituitary tumour is amenable to total resection and limits assessment of invasive progression during serial imaging. Therefore, it is useful to apply the classification proposed by Hardy in 1973 and modified by Wilson in 1990 (Table 2.3.2.1), whereby pituitary tumours are classified into one of five grades and one of six stages, providing important preoperative information. Pituitary tumours cause morbidity by both abnormal hormone secretion as well as compression of regional structures. As a considerable proportion of patients do not achieve optimal therapeutic control of mass effects and/or hormone hypersecretion despite advances in therapeutic approaches, understanding pathogenesis and pituitary tumour growth patterns in individual patients will enable identification of subcellular treatment targets, ultimately decreasing tumour-related morbidity and mortality. Determinants of initiation and progression of pituitary adenomas are not fully understood. This chapter describes a spectrum of mechanisms implicated in pituitary tumorigenesis, including the role of pituitary plasticity, imbalances in cell cycle regulation, transcription factors, signalling pathways, and angiogenesis (Fig. 2.3.2.1). Molecular events related to tumorigenesis in human pituitary adenoma subtypes are summarized in Table 2.3.2.2. The causal role for selected genetic imbalances leading to development of pituitary tumours has been confirmed in several transgenic mouse models (Table 2.3.2.3).

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Three-step immunoscintigraphy with anti-chromogranin A monoclonal antibody in tumours of the pituitary region

Acta Endocrinologica ◽

10.1530/eje.0.1350216 ◽

1996 ◽

Vol 135 (2) ◽

pp. 216-221 ◽

Cited By ~ 7

Author(s):

Paolo Colombo ◽

Antonio G Siccardi ◽

Giovanni Paganelli ◽

Patrizia Magnani ◽

Cristina Songini ◽

...

Keyword(s):

Monoclonal Antibody ◽

Growth Hormone ◽

Pituitary Adenoma ◽

Mammary Carcinoma ◽

Pituitary Adenomas ◽

Chromogranin A ◽

Follicle Stimulating Hormone ◽

Pituitary Tumours ◽

Acoustic Nerve ◽

Non Functioning Pituitary Adenomas

Colombo P, Siccardi AG, Paganelli G, Magnani P, Songini C, Buffa R, Faglia G, Fazio F. Three-step immunoscintigraphy with anti-chromogranin A monoclonal antibody in tumours of the pituitary region. Eur J Endocrinol 1996;135:216–21. ISSN 0804–4643 In the present paper we evaluated the ability of pretargeted immunoscintigraphy (ISG) with antichromogranin A (CgA) monoclonal antibody (Mc-ab A11) in visualizing pituitary masses. The results obtained in 23 patients are described along with those of [111In]pentetreotide scintigraphy (Octreoscan®) in 18 cases. Positive ISG was obtained in 9/11 (82%) non-functioning, 1/4 growth hormone-, 1/2 prolactin-, 1/2 thyrotropin-, 1/1 follicle-stimulating hormone-, 0/1 adrenocorticotrophin-secreting pituitary adenomas. In one patient with a positive ISG scan of a non-functioning pituitary adenoma, an associated neurinoma of the acoustic nerve was not imaged. The same occurred in one patient with a pituitary deposit from a mammary carcinoma and in another one with a cyst of the Rathke's pouch. Chromogranin A immunohistochemistry, carried out in 10 tumours, was positive in eight pituitary adenomas and negative in two non-adenomatous lesions. A concordant ISG occurred in all cases except for two pituitary adenomas: one cystic and necrotized and one post-operative remnant very small in size. In 18 patients with pituitary adenoma both ISG and Octreoscan® were positive in 61% of cases but with a different distribution among tumours. At variance with ISG, Octreoscan® visualized only 5/10 (50%) non-functioning pituitary adenomas and all (4/4) somatotropinomas. In conclusion, ISG is able to image pituitary tumours and particularly non-functioning pituitary adenomas. In this respect, it may be helpful in discriminating non-neuroendocrine masses of the pituitary region from non-functioning pituitary adenomas. G Faglia, Institute of Endocrine Sciences, University of Milan, Ospedale Maggiore IRCCS, via F. Sforza 35, 1-20122 Milan, Italy

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Endoscopic Endonasal Surgery for Growth Hormone Secreting Pituitary Adenomas

Skull Base ◽

10.1055/s-2011-1274238 ◽

2011 ◽

Vol 21 (S 01) ◽

Author(s):

Samuel Shin ◽

Matthew Tormenti ◽

Sue Challinor ◽

Tian Wang ◽

Juan Fernandez-Miranda ◽

...

Keyword(s):

Growth Hormone ◽

Pituitary Adenomas ◽

Endoscopic Endonasal Surgery ◽

Endonasal Surgery ◽

Endoscopic Endonasal

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THE EXTRACTION OF PROLACTIN FROM HUMAN PITUITARY GLANDS

Acta Endocrinologica ◽

10.1530/acta.0.0490001 ◽

1965 ◽

Vol 49 (1) ◽

pp. 1-16 ◽

Cited By ~ 12

Author(s):

M. Apostolakis

Keyword(s):

Growth Hormone ◽

Pituitary Gland ◽

List Type ◽

Distilled Water ◽

Hormone Activity ◽

Isoelectric Precipitation ◽

Human Pituitary ◽

Pituitary Glands ◽

Prolactin Content ◽

The Mean

ABSTRACT A method for the extraction of prolactin from human pituitary glands is described. It is based on acetone drying, distilled water extraction, acetone and isoelectric precipitation. Two main products are obtained: Fraction R8 with a mean prolactin activity of 12.2 IU/mg and fraction U8 with a mean prolactin activity of 8.6 IU/mg. The former fraction does not contain any significant gonadotrophin activity and the latter contains on an average 50 HMG U/mg. In both cases contamination with ACTH and MSH is minimal. The growth hormone activity of both these fractions is low. It is postulated that in man too, prolactin and growth hormone are two distinct hormones. A total of 1250 human pituitary glands have been processed by this method. The mean prolactin content per pituitary gland has been found to be 73 IU.

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