scholarly journals Angiogenesis in pituitary adenomas - relationship to endocrine function, treatment and outcome

2000 ◽  
Vol 165 (2) ◽  
pp. 475-481 ◽  
Author(s):  
HE Turner ◽  
Z Nagy ◽  
KC Gatter ◽  
MM Esiri ◽  
AL Harris ◽  
...  
Keyword(s):  
Pituitary Adenomas ◽  
Significant Negative Correlation ◽  
Endocrine Function ◽  
Response To Treatment ◽  
Pituitary Tumours ◽  
Hormone Production ◽  
Ulex Europaeus ◽  
Surgical Cure ◽  
Pre Treatment ◽  
Acth Secreting

Angiogenesis has been shown to be related to tumour behaviour, prognosis and response to treatment in many different tumour types. The aim of this study was to examine the relationship between angiogenesis and tumour behaviour and response to treatment in pituitary adenomas. The microvessel density (MVD) of pituitary tumours was assessed by counting blood vessels labelled with 3 different endothelial markers using antibodies to CD31, factor eight-related antigen and biotinylated Ulex europaeus (agglutinin I UEAI). One hundred and forty-two surgically removed pituitary adenomas (46 GH secreting, 6 microprolactinomas, 19 macroprolactinomas, 18 ACTH secreting and 53 functionless tumours) were carefully characterized and assessed. There was a significant negative correlation between age and MVD of GH secreting tumours (R(2)=33.8, P=0.005). Age was not related to MVD in other tumour types. Pre-treatment hormone production by the adenomas was related to MVD in prolactinomas (P<0.05), but not in GH secreting tumours. Invasive prolactinomas were significantly more vascular than non-invasive tumours (P<0.05). Drug treatment with metyrapone or bromocriptine did not appear to influence tumour angiogenesis. Surgical cure was more likely in macroprolactinomas and in ACTH secreting tumours with lower MVD. These results show that factors related to angiogenesis are very important in determining a number of clinical features of pituitary tumours, in particular the invasiveness of macroprolactinomas, the effect of age in tumours secreting GH and the outcome of surgical treatment in macroprolactinomas and ACTH secreting tumours.

The Hla System and the Clinical Response to Treatment with Chlorpromazine

1976 ◽  
Vol 129 (5) ◽  
pp. 486-489 ◽  
Author(s):  
E. Smeraldi ◽  
L. Bellodi ◽  
E. Sacchetti ◽  
C. L. Cazzullo
Keyword(s):  
Clinical Response ◽  
Negative Correlation ◽  
Significant Positive Correlation ◽  
Significant Negative Correlation ◽  
Response To Treatment ◽  
Positive Correlation ◽  
Hla System ◽  
Schizophrenic Patients ◽  
Clinical Responses ◽  
Pre Treatment

SummaryA group of 33 schizophrenic patients were typed for HLA-SD antigens and their qualitative clinical responses to chlorpromazine therapy determined. A highly significant positive correlation was found between response to chlorpromazine and HLA-A1 positive, while HLA-A2 positive subjects showed a significant negative correlation to chlorpromazine treatment.In a second group of 17 patients the clinical responses to chlorpromazine were evaluated quantitatively, by WPRS, in HLA-A1 positive and HLA-A1 negative patients. There were no pre-treatment differences in the scores. After treatment the scores of positive patients were significantly lower, indicating that they responded to a greater degree.Since the frequency of HLA-A1 in hebephrenic patients is higher than that in other schizophrenics this may explain our earlier finding that hebephrenics, as a group, respond better to chlorpromazine than do other schizophrenics.

scholarly journals Angiogenesis in Pituitary Adenomas and the Normal Pituitary Gland

2000 ◽  
Vol 85 (3) ◽  
pp. 1159-1162 ◽  
Author(s):  
Helen E. Turner ◽  
Zsusha Nagy ◽  
Kevin C. Gatter ◽  
Margaret M. Esiri ◽  
Adrian L. Harris ◽  
...  
Keyword(s):  
Pituitary Gland ◽  
Pituitary Adenomas ◽  
Anterior Pituitary ◽  
Pituitary Tumors ◽  
Anterior Pituitary Gland ◽  
Ulex Europaeus ◽  
Normal Pituitary Gland ◽  
Ulex Europaeus Agglutinin I ◽  
Acth Secreting ◽  
Tumor Types

Abstract Angiogenesis is essential for tumor growth beyond a few millimeters in diameter, and the intratumoral microvessel count that represents a measure of angiogenesis has been correlated with tumor behavior in a variety of different tumor types. To date no systematic study has assessed pituitary tumors of different secretory types, correlating vascular count with tumor size. The vascular densities of pituitary tumors and normal anterior pituitary were therefore assessed by counting vessels labeled using the vascular markers CD31 and ulex europaeus agglutinin I. One hundred and twelve surgically removed pituitary adenomas (30 GH-secreting, 25 prolactinomas, 15 ACTH-secreting, and 42 nonfunctioning tumors) were compared with 13 specimens of normal anterior pituitary gland. The vascular counts in the normal anterior pituitary gland were significantly higher (P &lt; 0.05) than those in the tumors using both CD31 and ulex europaeus agglutinin I. In addition, microprolactinomas were significantly less vascular (P &lt; 0.05) than macroprolactinomas, although there was no such difference between vascular densities of microadenomas and macroadenomas producing GH. ACTH-secreting tumors were, like microprolactinomas, of much lower vascular density than the normal pituitary and other secreting and nonsecreting tumor types. In marked contrast to other tumors, pituitary adenomas are less vascular than the normal pituitary gland, suggesting that there may be inhibitors of angiogenesis that play an important role in the behavior of these tumors.

Pituitary adenomas in childhood and adolescence

1994 ◽  
Vol 80 (2) ◽  
pp. 209-216 ◽  
Author(s):  
Michael D. Partington ◽  
Dudley H. Davis ◽  
Edward R. Laws ◽  
Bernd W. Scheithauer
Keyword(s):  
Pituitary Adenomas ◽  
Remission Rate ◽  
Endocrine Function ◽  
Childhood And Adolescence ◽  
Age Group ◽  
Content Type ◽  
Presenting Symptoms ◽  
Acth Secreting ◽  
Fine Print

✓ Pituitary adenomas are uncommon in childhood. Between 1975 and 1988, 36 patients underwent trans-sphenoidal resection at the Mayo Clinic before their 17th birthday. Fifteen (41.7%) had prolactin (PRL)-secreting tumors, 16 (44.4%) had adrenocorticotropic hormone (ACTH)-secreting tumors (including two patients with Nelson-Salassa syndrome), and three (8.3%) had tumors secreting growth hormone (GH); two patients (5.6%) had clinically nonfunctioning tumors. Of the 36 patients, 21 (58.3%) were girls, and girls predominated in every group except that with ACTH-secreting tumors, where they accounted for only 37.5% of the patients. The average age at the time of surgery was 14.7 ± 2.2 years, the youngest patient being 7.3 years old. The ACTH-secreting tumors were associated with an earlier onset of symptoms than the other tumor types: six (37.5%) of 16 patients became symptomatic before 10 years of age, compared with two (10.0%) of the 20 other patients. Presenting symptoms primarily reflected endocrine dysfunction, with neurological presentation (visual field deficits) occurring in only two patients. There were no deaths in this patient group. Significant operative morbidity included steroid-induced psychosis in one patient and diabetes insipidus in three, which resolved in two. Plurihormonal tumors, broadly defined as tumors producing more than one hormone, were common, comprising five (36%) of 14 PRL-secreting tumors, all three GH-secreting tumors, and one of two clinically nonfunctioning tumors, or 25.7% overall. Macroadenomas accounted for 89% of plurihormonal tumors. Long-term follow-up review (median > 5 years) revealed good control of PRL-secreting tumors (although five of 15 patients had received postoperative radiotherapy), contrasted with a 25% late recurrence rate for ACTH-secreting tumors, which had an 80% initial remission rate. The majority of patients had good endocrine function, including reproductive function. It is concluded that: 1) although pediatric pituitary adenomas occur primarily in adolescence, Cushing's disease is found at any age; 2) transsphenoidal surgery is feasible and safe in this age group; 3) plurihormonal tumors occur more frequently in the pediatric age group than in adults; and 4) long-term control rates in PRL- and ACTH-secreting tumors are probably similar to those seen in adults.

Failure of valproic acid to inhibit the growth of an ACTH-secreting pituitary adenoma

1984 ◽  
Vol 105 (4) ◽  
pp. 449-454 ◽  
Author(s):  
Grant Gwinup ◽  
Alan N. Elias ◽  
Benjamin Choi
Keyword(s):  
Valproic Acid ◽  
Pituitary Adenoma ◽  
Pituitary Adenomas ◽  
Chronic Administration ◽  
Pituitary Tumours ◽  
Plasma Acth ◽  
Lower Plasma ◽  
Acid Therapy ◽  
Acth Concentration ◽  
Acth Secreting

Abstract. Di-n-propylacetic acid (valproic acid) has been reported to lower plasma ACTH concentration after both acute and chronic administration of the drug. To date, there is no report on the efficacy of the drug in inducing regression of ACTH-secreting pituitary adenomas. We report herein our findings in a patient with Nelson's syndrome who was treated with valproic acid for over a year. Despite a lowering of her plasma ACTH concentration during therapy with valproic acid, the patient's tumour showed no evidence of regression while she was taking the drug. In view of these findings, valproic acid therapy for ACTH-secreting pituitary tumours needs to be re-evaluated.

Ectopic ACTH-secreting pituitary adenomas

2014 ◽  
Vol 122 (03) ◽  
Author(s):  
UJ Knappe ◽  
C Jaspers ◽  
D Buschsieweke ◽  
R Salbeck ◽  
W Saeger ◽  
...  
Keyword(s):  
Pituitary Adenomas ◽  
Ectopic Acth ◽  
Acth Secreting

T2-Weighted signal intensity of functional pituitary adenomas: correlation with clinicopathological findings and response to treatment

2017 ◽  
Author(s):  
Sema Ciftci Dogansen ◽  
Seher Tanrikulu ◽  
Gulsah Yenidunya Yalin ◽  
Sakin Tekin ◽  
Nihan Nizam ◽  
...  
Keyword(s):  
Pituitary Adenomas ◽  
Signal Intensity ◽  
Response To Treatment ◽  
Clinicopathological Findings

scholarly journals Protease Inhibitor Anti-HIV, Lopinavir, Impairs Placental Endocrine Function

2021 ◽  
Vol 22 (2) ◽  
pp. 683
Author(s):  
Camille Fraichard ◽  
Fidéline Bonnet-Serrano ◽  
Christelle Laguillier-Morizot ◽  
Marylise Hebert-Schuster ◽  
René Lai-Kuen ◽  
...  
Keyword(s):  
Transcription Factor ◽  
Metastatic Lymph Node ◽  
Endocrine Function ◽  
Maternal Circulation ◽  
Hormone Production ◽  
Mitofusin 2 ◽  
Villous Trophoblast ◽  
Activating Transcription Factor ◽  
Upr Pathway

Protease Inhibitors (PI e.g., ritonavir (RTV) and lopinavir (LPV)) used to treat pregnant mothers infected by HIV induce prematurity and endocrine dysfunctions. The maintenance of pregnancy relies on placental hormone production (human Chorionic Gonadotrophin (hCG) and progesterone (P4)). Those functions are ensured by the villous trophoblast and are mainly regulated by the Unfolded Protein Response (UPR) pathway and mitochondria. We investigated, in vitro, if PI impair hCG and P4 production and the potential intracellular mechanisms involved. Term villous cytotrophoblast (VCT) were cultured with or without RTV or LPV from 6 to 48 h. VCT differentiation into syncytiotrophoblast (ST) was followed measuring hCG and P4 secretion. We evaluated the expression of P4 synthesis partners (Metastatic Lymph Node 64 (MLN64), cholesterol side-chain cleavage (P450SCC), Hydroxy-delta-5-Steroid Dehydrogenase and 3 Beta-and steroid delta-isomerase 1 (HSD3B1)), of mitochondrial pro-fusion factors (Mitofusin 2 (Mfn2), Optic Atrophy 1 (OPA1)) and of UPR factors (Glucose-Regulated Protein 78 (GRP78), Activating Transcription Factor 4 (ATF4), Activating Transcription Factor 6 (ATF6), spliced X-box Binding Protein 1 (sXBP1)). RTV had no significant effect on hCG and P4 secretion, whereas lopinavir significantly decreased both secretions. LPV also decreased P450SCC and HSD3B1 expression, whereas it increased Mfn2, GRP78 and sXBP1 expression in ST. RTV has no effect on the endocrine placenta. LPV impairs both villous trophoblast differentiation and P4 production. It is likely to act via mitochondrial fusion and UPR pathway activation. These trophoblastic alterations may end in decreased P4 levels in maternal circulation, inducing prematurity.

Gastrin in pituitary tumours

1987 ◽  
Vol 115 (3) ◽  
pp. 419-422 ◽  
Author(s):  
Linda Bardram ◽  
Jörgen Lindholm ◽  
Jens F. Rehfeld
Keyword(s):  
Cushing’S Syndrome ◽  
Pituitary Adenomas ◽  
Cushing's Syndrome ◽  
Pituitary Tumours ◽  
Nelson’S Syndrome ◽  
Nelson's Syndrome

Abstract. Twelve of 87 pituitary adenomas from patients with acromegaly, Cushing's syndrome, Nelson's syndrome, hyperprolactinaemia and without symptoms of hormone hypersecretion contained gastrin in concentrations from 0.5 to 166 pmol/g. Only ACTH-producing tumours contained gastrin, which occurred in forms smaller than those present in the normal adenohypophysis. The results indicate that corticotropic tumours may synthesize gastrin in moderate amounts.

scholarly journals Pediatric Pituitary Adenoma: Case Series, Review of the Literature, and a Skull Base Treatment Paradigm

2018 ◽  
Vol 79 (01) ◽  
pp. 091-114 ◽  
Author(s):  
Avital Perry ◽  
Christopher Graffeo ◽  
Christopher Marcellino ◽  
Bruce Pollock ◽  
Nicholas Wetjen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pituitary Adenoma ◽  
Skull Base ◽  
Pituitary Adenomas ◽  
Pediatric Population ◽  
Csf Leak ◽  
Persistent Disease ◽  
Treatment Paradigm ◽  
Surgical Cure

Background Pediatric pituitary adenoma is a rare skull base neoplasm, accounting for 3% of all intracranial neoplasms in children and 5% of pituitary adenomas. Compared with pituitary tumors in adults, secreting tumors predominate and longer disease trajectories are expected due to the patient age resulting in a natural history and treatment paradigm that is complex and controversial. Objectives The aims of this study were to describe a large, single-institution series of pediatric pituitary adenomas with extensive long-term follow-up and to conduct a systematic review examining outcomes after pituitary adenoma surgery in the pediatric population. Methods The study cohort was compiled by searching institutional pathology and operative reports using diagnosis and site codes for pituitary and sellar pathology, from 1956 to 2016. Systematic review of the English language literature since 1970 was conducted using PubMed, MEDLINE, Embase, and Google Scholar. Results Thirty-nine surgically managed pediatric pituitary adenomas were identified, including 15 prolactinomas, 14 corticotrophs, 7 somatotrophs, and 4 non-secreting adenomas. All patients underwent transsphenoidal resection (TSR) as the initial surgical treatment. Surgical cure was achieved in 18 (46%); 21 experienced recurrent/persistent disease, with secondary treatments including repeat surgery in 10, radiation in 14, adjuvant pharmacotherapy in 11, and bilateral adrenalectomy in 3. At the last follow-up (median 87 months, range 3–581), nine remained with recurrent/persistent disease (23%).Thirty-seven publications reporting surgical series of pediatric pituitary adenomas were included, containing 1,284 patients. Adrenocorticotropic hormone (ACTH)-secreting tumors were most prevalent (43%), followed by prolactin (PRL)-secreting (37%), growth hormone (GH)-secreting (12%), and nonsecreting (7%). Surgical cure was reported in 65%. Complications included pituitary insufficiency (23%), permanent visual dysfunction (6%), chronic diabetes insipidus (DI) (3%), and postoperative cerebrospinal fluid (CSF) leak (4%). Mean follow-up was 63 months (range 0–240), with recurrent/persistent disease reported in 18% at the time of last follow-up. Conclusion Pediatric pituitary adenomas are diverse and challenging tumors with complexities far beyond those encountered in the management of routine adult pituitary disease, including nuanced decision-making, a technically demanding operative environment, high propensity for recurrence, and the potentially serious consequences of hypopituitarism with respect to fertility and growth potential in a pediatric population. Optimal treatment requires a high degree of individualization, and patients are most likely to benefit from consolidated, multidisciplinary care in highly experienced centers.

Type IV Collagen Immunostaining Is a Simple, Reliable Diagnostic Tool for Distinguishing Between Adenomatous and Normal Pituitary Glands

2007 ◽  
Vol 131 (6) ◽  
pp. 931-935 ◽  
Author(s):  
Jason Jarzembowski ◽  
Ricardo Lloyd ◽  
Paul McKeever
Keyword(s):  
Pituitary Adenomas ◽  
Type Iv Collagen ◽  
Basement Membranes ◽  
Immunohistochemical Detection ◽  
Secondary Effects ◽  
Hormone Production ◽  
Clonal Population ◽  
Normal Gland ◽  
Type Iv ◽  
Pituitary Glands

Abstract Context.—Pituitary adenomas are clinically diagnosed based on radiologic studies and/or secondary effects of hormone production. Definitive pathologic identification relies on immunohistochemical detection of a clonal population of hormone-producing cells. However, not all adenomas secrete hormones, so performing a battery of stains is inefficient. Reports have shown decreased type IV collagen in the stroma of other epithelial tumors. Objective.—To validate type IV collagen immunohistochemistry as a diagnostic method. Design.—We immunostained 27 adenomas and 19 normal pituitaries. The areas with the sparsest type IV collagen fibers were viewed at 3 magnifications (×10, ×20, and ×40 objectives), counting 1, 3, or 10 microscopic fields. A field was scored as “traversable” if a path existed from any point on the periphery of the field to a point on the approximately opposite periphery that did not cross any stained fibers. Results were compared with reticulin staining and to the existing diagnosis previously determined by histology, hormone immunostaining, and clinical correlation. Results.—Adenomas have less type IV collagen in their basement membranes, leading to sparser, trabecular staining in neoplasms versus a more rigid meshwork pattern in normal glands. One might envision the stained fibers as maze walls—one can traverse medium-powered fields in an adenoma, but one hits dead ends and gets trapped in those of a normal gland. Finding a single representative ×10 field to be traversable was 97.5% sensitive and 96.5% specific for an adenoma. Reticulin staining yielded identical results. Conclusions.—Type IV collagen immunostaining is a simple and reliable method of diagnosing pituitary adenomas.

Sign in / Sign up

Export Citation Format

Share Document