Evaluation of Cavernous Sinus Invasion by Pituitary Adenoma Using Deep Learning Based Denoising MR

Abstract Objective: Pituitary adenoma coexists with intracranial aneurysms in 2.3% to 3.6%, and intracranial aneurysms is thought to be incidental. On the other hand higher age and cavernous sinus invasion are reported to increase the coexistence rate, so these two diseases may be related. Ten males and 14 females with coexistence of pituitary adenomas and intracranial aneurysms were retrospectively investigated among 923 patients (2.6%). Patients were subdivided into two groups with/without direct attachment of cerebral aneurysms to the pituitary adenomas. The clinical characteristics, therapeutic strategies, and possible effects of vascular remodeling factors were investigated.Results: Twelve patients had functioning pituitary adenomas, and cavernous sinus invasion was identified in 7 of 24 patients. Five of these 7 patients were treated with priority for the cerebral aneurysms until 2007, whereas 14 of 17 patients without involvement of the aneurysm tip in the tumor were treated with priority for pituitary adenomas in the later period. Among vascular remodeling factors strong expression of vascular endothelial growth factor (VEGF) was significantly associated with coexistence of pituitary adenoma and cerebral aneurysm (p < 0.05). So VEGF-induced arterial wall remodeling may be part of the mechanism of association between pituitary adenomas and cerebral aneurysms, suggesting possible causative mechanism.

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Endoscopic Endonasal Approach to Multilobular Giant Pituitary Adenoma with Cavernous Sinus Invasion and Petroclival Extension

World Neurosurgery ◽

10.1016/j.wneu.2020.11.055 ◽

2020 ◽

Author(s):

Tural Rahimli ◽

Tural Hidayetov ◽

Tural Rajabov

Keyword(s):

Pituitary Adenoma ◽

Cavernous Sinus ◽

Endoscopic Endonasal Approach ◽

Endonasal Approach ◽

Endoscopic Endonasal ◽

Giant Pituitary Adenoma ◽

Cavernous Sinus Invasion

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CCNB1 affects cavernous sinus invasion in pituitary adenomas through the epithelial–mesenchymal transition

Journal of Translational Medicine ◽

10.1186/s12967-019-2088-8 ◽

2019 ◽

Vol 17 (1) ◽

Author(s):

Bin Li ◽

Jianhua Cheng ◽

Hongyun Wang ◽

Sida Zhao ◽

Haibo Zhu ◽

...

Keyword(s):

Gene Expression ◽

Pituitary Adenoma ◽

Cell Lines ◽

Cavernous Sinus ◽

Pituitary Adenomas ◽

Epithelial Mesenchymal Transition ◽

Mesenchymal Transition ◽

Cavernous Sinus Invasion ◽

The Relationship ◽

E Cadherin

Abstract Background To investigate the relationship between cyclin B1 (CCNB1) gene expression and cavernous sinus invasion in pituitary adenomas. Methods Twenty-four pituitary adenoma tissue samples were examined by RT-qPCR and Western blot to assess the mRNA expression levels and protein levels of CCNB1, E-cadherin and N-cadherin. Correlation analyses between the expression levels of E-cadherin, N-cadherin and CCNB1 were performed. After lentivirus-mediated knockdown of CCNB1 in rat pituitary adenoma cell lines (GH3 and GT1-1), cell function changes were studied. The relationship between CCNB1 and epithelial-mesenchymal transition (EMT) was further verified by animal experiments. Results CCNB1 and N-cadherin gene expression were significantly higher in the invasive pituitary adenomas than in the non-invasive pituitary adenomas. Conversely, E-cadherin expression in the invasive pituitary adenomas was significantly lower. CCNB1 gene expression was downregulated in the GH3 and GT1-1 pituitary adenoma cell lines; N-cadherin expression was also decreased, but E-cadherin expression was increased. These results were confirmed in vivo. After downregulation of CCNB1, cell invasion and migration was significantly reduced in Transwell experiments. Conclusion High CCNB1 expression in pituitary adenoma affects cavernous sinus invasion through EMT.

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SURG-24. A RISK SCORE FOR PREDICTING DEVELOPMENT OF DIABETES INSIPIDUS AFTER PITUITARY ADENOMA RESECTION

Neuro-Oncology ◽

10.1093/neuonc/noz175.1024 ◽

2019 ◽

Vol 21 (Supplement_6) ◽

pp. vi244-vi244

Author(s):

Christina Jackson ◽

Chau Vo ◽

Marcus Daniels ◽

Kaisorn Chaichana

Keyword(s):

Pituitary Adenoma ◽

Diabetes Insipidus ◽

Cavernous Sinus ◽

Risk Score ◽

Protective Factor ◽

Postoperative Management ◽

Johns Hopkins Hospital ◽

Clinical Predictors ◽

Surgical Morbidity ◽

Cavernous Sinus Invasion

Abstract INTRODUCTION The development of diabetes insipidus (DI) after pituitary adenoma resection is associated with worse post-surgical morbidity and longer hospital stay. Identification of clinical predictors of development of DI would allow for appropriate stratification of patients to optimize preoperative counseling and postoperative management. METHODS We conducted a retrospective review of 349 patients who underwent pituitary adenoma resection at Johns Hopkins Hospital between 2003 and 2017. We used unadjusted and adjusted logistic regression to identify predictors of developing DI. Factors which were associated with DI development (p< 0.1), were included in our multivariable model. Factors which remained associated with DI development were then used to develop a DI risk score. RESULT: 67 (19.2%) patients developed post-surgical DI. Patients who had symptoms of prolactinoma, surgery through one nare, or were on steroid treatment were more likely to develop DI. Conversely, patients who had unilateral cavernous sinus invasion were less likely to develop DI. We used these predictors to generate the DI risk score. Patients were assigned 1 point for each risk factor (symptoms of prolactinoma, steroids, or surgery through one nare) for developing DI, but 1 point was subtracted if they had a protective factor (unilateral cavernous sinus invasion). Patients with 0 points had a 10.7% probability of developing DI, patients with 1 point had a 18.5% probability of developing DI, patients with 2 points had a 41.2% probability of developing DI, and patients with 3 points had a 44.4% probability of DI. CONCLUSIONS We identified several predictors of DI development after pituitary adenoma resection, and used these to generate a DI risk score. The DI risk score could help stratify patients’ likelihood of postsurgical DI development, although validation through larger prospective multi-center studies are needed.

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Clinical characteristics and risk factors for headache associated with non-functioning pituitary adenomas

Cephalalgia ◽

10.1177/0333102416648347 ◽

2016 ◽

Vol 37 (4) ◽

pp. 348-355 ◽

Cited By ~ 12

Author(s):

Bin Yu ◽

Nan Ji ◽

Yun Ma ◽

Bao Yang ◽

Peng Kang ◽

...

Keyword(s):

Risk Factors ◽

Pituitary Adenoma ◽

Family History ◽

Cavernous Sinus ◽

Clinical Characteristics ◽

Chinese Patients ◽

Primary Headaches ◽

Endocrine Activity ◽

Cavernous Sinus Invasion ◽

History Of

Background Headaches associated with pituitary adenoma have been reported to be related to the structural characteristics and endocrine factors of the tumour itself. Objectives The objective of this study was to investigate the prevalence and clinical characteristics of, and the risk factors for, non-functioning pituitary adenoma (NFPA)-associated headaches in Chinese patients with normal endocrine activity. Methods Ninety-seven patients with a NFPA with normal endocrine laboratory results were prospectively enrolled in this study. The relevant clinical demographic data were collected and examined with the appropriate statistical methods. Results The pre-operative prevalence of tumour-associated headaches was 48.5%; 87.2% of these patients had migraine-like headaches. A family history of primary headache (odds ratio (OR) 3.67; p = 0.032) and a higher tumour Knosp grade (OR 1.83; p = 0.001) were identified as risk factors for the occurrence of NFPA-associated headaches. The patient’s age, sex, visual disturbances, optic chiasm compression, tumour size and tumour volume were not significantly associated with NFPA-associated headaches ( p > 0.05). In addition, headache severity was significantly correlated with the Knosp grade ( r = 0.339; p = 0.001). The sides of the headaches and of cavernous sinus invasion were significantly concordant (48.9% agreement; κ = 0.257; p = 0.007). Conclusions Migraine-like headaches are a common clinical manifestation in patients with NFPAs. A family history of primary headaches and cavernous sinus invasion are risk factors for NFPA-associated headaches.

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Coexistence of intracranial aneurysm in 800 patients with surgically confirmed pituitary adenoma

Journal of Neurosurgery ◽

10.3171/2011.12.jns11875 ◽

2012 ◽

Vol 116 (5) ◽

pp. 942-947 ◽

Cited By ~ 28

Author(s):

Min Chul Oh ◽

Eui Hyun Kim ◽

Sun Ho Kim

Keyword(s):

Pituitary Adenoma ◽

Intracranial Aneurysm ◽

Cavernous Sinus ◽

Patient Population ◽

Pathological Examination ◽

Control Group ◽

Cavernous Sinus Invasion ◽

Factors Associated ◽

Significant Difference ◽

Matched Comparison

Object The purpose of this study was to assess factors associated with intracranial aneurysm (IA) in patients with pituitary adenoma (PA). In addition, these patients were compared with a control group from the general patient population in terms of the age-matched prevalence rate and the pattern of distribution of IA. Methods The authors retrospectively reviewed 800 patients who received transsphenoidal surgery for PA and 3850 control patients from the general patient population who were evaluated for routine health care at the authors' institution between 2004 and 2010. All patients underwent MR imaging and MR angiography. Hormone assessment and pathological examination performed using immunohistochemical (IHC) staining were completed for patients with PA. Results Coexistence of IA in patients with PA was detected in 18 patients (2.3%). Multivariate analysis showed that age (p = 0.04) and cavernous sinus invasion (p < 0.001) were correlated with the increased incidence of IA, but hormone type, IHC staining, and sex were not associated. An age-matched comparison of the prevalence of IA showed an increased prevalence in patients with PA compared with the controls (p = 0.014), and when categorized according to age by decade, the 6th decade was significantly different (p = 0.039). However, the intracranial distribution pattern of IA did not demonstrate a significant difference. Conclusions Older age and the existence of a cavernous sinus invasion were correlated with increased incidence of IA in patients with PA. An age-matched comparison showed an increased incidence of IA in patients with PA than in the controls.

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