Article
Neurosciences
Eric J. Lehrer, Roman O. Kowalchuk, Daniel M. Trifiletti, Jason P. Sheehan
Summary: Pituitary adenomas are common benign brain tumors, comprising 10%-20% of all central nervous system neoplasms. Stereotactic radiosurgery (SRS) has emerged as an effective treatment option for these tumors, with high tumor control rates. However, potential side effects such as endocrine dysfunction and visual deficits need to be considered. Hypofractionated SRS, delivered in multiple fractions, is an alternative treatment option for patients who are not suitable for single fraction SRS.
Article
Clinical Neurology
Zhijie Pei, Yi Fang, Shuwen Mu, Jun Li, Tianshun Feng, Kunzhe Lin, Shousen Wang
Summary: Perioperative assessment of adenohypophyseal hormones can improve therapeutic strategies and evaluate the prognosis of pituitary adenomas. Normalization of hormone levels facilitates overall assessment of the adenohypophysis.
NEUROSURGICAL FOCUS
(2022)
Article
Endocrinology & Metabolism
Ashley J. Han, Elena V. Varlamov, Maria Fleseriu
Summary: This study characterized the clinical features and natural history of nonfunctioning pituitary microadenomas and found that they are generally benign. It suggests that the initial MRI follow-up interval for these tumors can be extended up to 3 years, unless there are specific concerns.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2022)
Article
Endocrinology & Metabolism
Kyla Wright, Matthew Lee, Natalie Escobar, Donato Pacione, Matthew Young, Girish Fatterpekar, Nidhi Agrawal
Summary: Considering tumor volume can improve the differentiation between prolactinomas and NFAs, leading to more effective management strategies.
Article
Clinical Neurology
Hyung-Chul Lee, Hyun-Kyu Yoon, Jung Hee Kim, Yong Hwy Kim, Hee-Pyoung Park
Summary: The study suggests that preoperative steroid administration may not be necessary for patients without adrenal insufficiency undergoing endoscopic transsphenoidal surgery for nonfunctioning pituitary adenomas, as it does not affect the pituitary hormone levels postoperatively. However, further large-scale studies are needed to determine the impact of preoperative steroid administration on clinically meaningful events such as perioperative AI and postoperative 3-month ACTH deficiency in these patients.
JOURNAL OF NEUROSURGERY
(2021)
Article
Endocrinology & Metabolism
Nasrin Al-Shamkhi, Katarina Berinder, Henrik Borg, Pia Burman, Per Dahlqvist, Charlotte Hoybye, Daniel S. Olsson, Oskar Ragnarsson, Bertil Ekman, Britt Eden Engstrom
Summary: Objective data on pituitary function before and after transsphenoidal surgery in nonfunctioning pituitary adenomas were inconsistent. This study found that adrenocorticotrophic hormone deficiency increased significantly at 1 year postoperatively, while other axis function changes were not significant. Therefore, continuous individual evaluations are needed during longer follow-up of patients operated for NFPA.
EUROPEAN JOURNAL OF ENDOCRINOLOGY
(2023)
Article
Clinical Neurology
Georgios Mantziaris, Stylianos Pikis, Tomas Chytka, Roman Liscak, Kimball Sheehan, Darrah Sheehan, Selcuk Peker, Yavuz Samanci, Shray K. Bindal, Ajay Niranjan, L. Dade Lunsford, Rupinder Kaur, Renu Madan, Manjul Tripathi, Dhiraj J. Pangal, Ben A. Strickland, Gabriel Zada, Anne-Marie Langlois, David Mathieu, Ronald E. Warnick, Samir Patel, Zayda Minier, Herwin Speckter, Zhiyuan Xu, Rithika Kormath Anand, Jason P. Sheehan
Summary: This study analyzed 375 patients with residual nonfunctioning pituitary adenomas (NFPAs) who were treated with stereotactic radiosurgery (SRS) and compared the outcomes between early treatment and treatment at progression. The results showed that there was no significant difference in tumor control and preservation of hormonal/visual function between SRS at residual NFPA progression and adjuvant SRS. Deferring radiosurgical management to the time of radiological progression could prolong the onset of radiosurgically induced pituitary dysfunction.
JOURNAL OF NEUROSURGERY
(2023)
Article
Clinical Neurology
Kihwan Hwang, Yong Hwy Kim, Jung Hee Kim, Jung Hyun Lee, Hee Kyung Yang, Jeong-Min Hwang, Chae-Yong Kim, Jung Ho Han
Summary: The study on the natural history of asymptomatic nonfunctioning pituitary adenomas (NFPAs) with optic nerve compression showed that close follow-up and timely surgical intervention can effectively prevent visual and endocrine issues for cases with optic nerve compression, and conservative management is also acceptable for these tumors. Careful follow-up is necessary for tumors with cavernous sinus invasion.
JOURNAL OF NEUROSURGERY
(2021)
Review
Endocrinology & Metabolism
Antonio Bianchi, Sabrina Chiloiro, Antonella Giampietro, Simona Gaudino, Rosalinda Calandrelli, Ciro Mazzarella, Carmelo Caldarella, Mario Rigante, Marco Gessi, Liverana Lauretti, Laura De Marinis, Alessandro Olivi, Alfredo Pontecorvi, Francesco Doglietto
Summary: Growth hormone-secreting adenomas exhibit a wide range of behaviors and outcomes, from mild disease to aggressive neoplasms. Treatment for patients who do not respond to surgery or first-generation somatostatin receptor ligands may involve multiple surgical, medical, and radiation treatments. Currently, there are no markers that can predict the prognosis or aggressiveness of acromegaly. A multidisciplinary approach is necessary to tailor treatment for difficult/aggressive cases, including radiation therapy, chemotherapy, and emerging treatments.
FRONTIERS IN ENDOCRINOLOGY
(2023)
Article
Clinical Neurology
Naoto Mukada, Masahiko Tosaka, Rei Yamaguchi, Yukitaka Tanaka, Ayako Takahashi, Hiroya Shimauchi-Otaki, Sho Osawa, Yoshito Tsushima, Yuhei Yoshimoto
Summary: Nonfunctioning pituitary adenoma (NFPA) shows significant asymmetry on magnetic resonance imaging, with the tumor extending more freely laterally on the cavernous sinus side compared to the normal pituitary side. The presence of an internal carotid artery (ICA) notch is often found on the normal pituitary side, which may serve as a preoperative indication of the normal pituitary side.
WORLD NEUROSURGERY
(2022)
Article
Medicine, General & Internal
Yoon-Hee Choo, Youngbeom Seo, Oh-Lyong Kim
Summary: This study retrospectively analyzed the outcomes of the transsphenoidal approach for nonfunctioning pituitary adenomas treated at a single institute. The study found that the transsphenoidal approach is an effective and safe treatment, improving visual impairment and restoring endocrine function. Diabetes insipidus was the most common complication, and complete resection during surgery helped to lower the risk of recurrence.
ANNALS OF MEDICINE
(2022)
Article
Endocrinology & Metabolism
Tobias Hallen, Gudmundur Johannsson, Rahil Dahlen, Camilla A. M. Glad, Charlotte Orndal, Angelica Engvall, Helena Caren, Thomas Skoglund, Daniel S. Olsson
Summary: This study explored DNA methylation patterns associated with tumor progression in patients with nonfunctioning pituitary adenomas (NFPAs). The results showed that some methylation sites were associated with tumor progression and could potentially serve as biomarkers for early identification of tumor progression.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2022)
Article
Clinical Neurology
Mujdat Kara, Meltem Yilmaz, Meric Sengoz, Selcuk Peker
Summary: The study showed that GKRS was effective for patients with NFPA whether used as an adjuvant or primary treatment. Lower radiation doses were associated with lower tumor control rates, while larger tumor volumes were associated with higher rates of hypopituitarism and tumor progression.
BRITISH JOURNAL OF NEUROSURGERY
(2021)
Article
Endocrinology & Metabolism
Yi Fang, He Wang, Ming Feng, Wentai Zhang, Lei Cao, Chenyu Ding, Hongjie Chen, Liangfeng Wei, Shuwen Mu, Zhijie Pei, Jun Li, Heng Zhang, Renzhi Wang, Shousen Wang
Summary: Accurate predictive models for hormonal prognosis in NFPA were lacking. Machine learning models were developed to assess pituitary hormonal outcomes post-surgery, showing significant changes in hormone levels and the effectiveness of ML in predicting outcomes.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Article
Clinical Neurology
Yasuyuki Kinoshita, Akira Taguchi, Atsushi Tominaga, Kazunori Arita, Fumiyuki Yamasaki
Summary: Recovery from AGHD after initial TSS is more likely in younger female patients with higher peak GH levels assessed by preoperative PPT. Patients aged <= 62.2 years and with a peak GH level of >= 0.74 μg/L based on preoperative PPT are likely to recover from AGHD.
JOURNAL OF NEUROSURGERY
(2021)
Review
Endocrinology & Metabolism
Fabienne Langlois, Elena V. Varlamov, Maria Fleseriu
Summary: Hypophysitis is inflammation of the pituitary gland that can be caused by various factors. Diagnosis is challenging and often requires detailed history, clinical examination, and pituitary biopsy. Treatment includes hormone replacement, careful observation, imaging follow-up, and in some cases, surgery, immunosuppressive therapy, and radiation.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2022)
Article
Endocrinology & Metabolism
Stefano Frara, Paola Loli, Agnese Allora, Chiara Santini, Luigi di Filippo, Pietro Mortini, Maria Fleseriu, Andrea Giustina
Summary: COVID-19 patients may have pituitary diseases or hypopituitarism, which can worsen the severity of the disease. Hypopituitarism is associated with metabolic complications that contribute to poor outcomes and increased mortality in patients infected by SARS-CoV-2.
REVIEWS IN ENDOCRINE & METABOLIC DISORDERS
(2022)
Article
Endocrinology & Metabolism
Dawn Shao Ting Lim, Maria Fleseriu
Summary: Acromegaly is a condition that requires appropriate treatment to prevent significant morbidity and mortality. The treatment goals include normalization of insulin-like growth factor 1 and growth hormone, tumor shrinkage, symptom relief, complication management, and improvement of quality of life. Surgical resection is the first-line treatment option, and somatostatin receptor ligands (SRLs) are commonly used for medical therapy. However, SRL resistance can be predicted by certain factors, and alternative treatments such as growth hormone receptor antagonists or second-generation SRLs may be considered. Combination therapy can be pursued for patients who are not biochemically controlled or have residual tumor after monotherapy. Personalized management based on individual characteristics and preferences is important for achieving high-quality outcomes.
ENDOCRINE PRACTICE
(2022)
Article
Endocrinology & Metabolism
Ashley J. Han, Elena V. Varlamov, Maria Fleseriu
Summary: This study characterized the clinical features and natural history of nonfunctioning pituitary microadenomas and found that they are generally benign. It suggests that the initial MRI follow-up interval for these tumors can be extended up to 3 years, unless there are specific concerns.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2022)
Review
Endocrinology & Metabolism
Filippo Ceccato, Mattia Barbot, Alessandro Mondin, Marco Boscaro, Maria Fleseriu, Carla Scaroni
Summary: This study aimed to evaluate the diagnostic accuracy of the CRH test, desmopressin test, and HDDST for the differential diagnosis of CD and EAS. The CRH test showed the highest sensitivity for detecting CD and the highest specificity for detecting EAS, while the diagnostic accuracy of HDDST and desmopressin test was lower.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2023)
Article
Endocrinology & Metabolism
Amit Akirov, Laura Dery, Maria Fleseriu, Yaron Rudman, Ilan Shimon, Yossi Manisterski, Nirit Aviran-Barak, Varda Nadler, Sandra Alboim, Tzipora Shochat, Gloria Tsvetov, Dania Hirsch
Summary: This study aimed to evaluate the clinical presentation, biochemical profile, and etiology of Cushing's syndrome (CS) in women stratified by age. The results showed that adrenal etiology was more common in women over 65 years old, while pituitary etiology was more common in women under 45 years old. The initial presentation of CS also differed between age groups.
Review
Endocrinology & Metabolism
M. Fleseriu, Z. Zhang, K. Hanman, K. Haria, A. Houchard, S. Khawaja, A. Ribeiro-Oliveira, M. Gadelha
Summary: This systematic literature review investigated whether extended dosing intervals (EDIs) of pharmacological acromegaly treatments reduce patient burden and costs compared with standard dosing, while maintaining effectiveness. The results showed that EDIs provided similar clinical efficacy, safety, and health-related quality of life outcomes in adults with acromegaly, while also reducing costs compared to standard regimens. This study has important clinical implications for guiding the treatment of acromegaly.
Article
Endocrinology & Metabolism
Ashley J. J. Han, Maria Fleseriu, Elena V. V. Varlamov
Summary: Hypopituitarism and tumor growth are rare in patients with non-functioning pituitary microadenomas (NFPmA). However, patients often present with non-specific symptoms. This study aims to compare the presenting symptomatology in patients with NFPmA and patients with non-functioning pituitary macroadenomas (NFPMA).
HORMONES-INTERNATIONAL JOURNAL OF ENDOCRINOLOGY AND METABOLISM
(2023)
Article
Endocrinology & Metabolism
Maria Fleseriu, Mark Molitch, Alexander Dreval, Yulia Pokramovich, Irina Bondar, Yury Poteshkin, Djuro Macut, Barbara Obermayer-Pietsch, Yossi Gilgun-Sherki, Asi Haviv, Nienke Biermasz, Christian J. Strasburger
Summary: The study assessed the long-term efficacy and safety of oral octreotide capsules in patients with acromegaly. The results showed that the capsules were noninferior to injectable somatostatin receptor ligands, and transitioning from injectables to oral capsules improved symptoms.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2023)
Editorial Material
Endocrinology & Metabolism
Filippo Ceccato, Maria Fleseriu
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2023)
Editorial Material
Endocrinology & Metabolism
Maria Fleseriu, Dawn Shao Ting Lim
Summary: The path to becoming a clinical academic researcher is difficult and complicated, with numerous obstacles. A good mentor is crucial for personal growth and development, serving as a valuable sounding board throughout one's career.
NATURE REVIEWS ENDOCRINOLOGY
(2023)
Correction
Endocrinology & Metabolism
Stephan Petersenn, Maria Fleseriu, Felipe F. Casanueva, Andrea Giustina, Nienke Biermasz, Beverly M. K. Biller, Marcello Bronstein, Philippe Chanson, Hidenori Fukuoka, Monica Gadelha, Yona Greenman, Mark Gurnell, Ken K. Y. Ho, Jurgen Honegger, Adriana G. Ioachimescu, Ursula B. Kaiser, Niki Karavitaki, Laurence Katznelson, Maya Lodish, Dominique Maiter, Hani J. Marcus, Ann McCormack, Mark Molitch, Christopher A. Muir, Sebastian Neggers, Alberto M. Pereira, Rosario Pivonello, Kalmon Post, Gerald Raverot, Roberto Salvatori, Susan L. Samson, Ilan Shimon, Joanna Spencer-Segal, Greisa Vila, John Wass, Shlomo Melmed
NATURE REVIEWS ENDOCRINOLOGY
(2023)
Review
Endocrinology & Metabolism
Stephan Petersenn, Maria Fleseriu, Felipe F. Casanueva, Andrea Giustina, Nienke Biermasz, Beverly M. K. Biller, Marcello Bronstein, Philippe Chanson, Hidenori Fukuoka, Monica Gadelha, Yona Greenman, Mark Gurnell, Ken K. Y. Ho, Juergen Honegger, Adriana G. Ioachimescu, Ursula B. Kaiser, Niki Karavitaki, Laurence Katznelson, Maya Lodish, Dominique Maiter, Hani J. Marcus, Ann Mccormack, Mark Molitch, Christopher A. Muir, Sebastian Neggers, Alberto M. Pereira, Rosario Pivonello, Kalmon Post, Gerald Raverot, Roberto Salvatori, Susan L. Samson, Ilan Shimon, Joanna Spencer-Segal, Greisa Vila, John Wass, Shlomo Melmed
Summary: This Consensus Statement provides evidence-based graded consensus recommendations and key summary points for clinical practice on the diagnosis and management of prolactinomas. It covers various aspects including epidemiology, pathogenesis, clinical presentation, assessment, imaging strategies, complications, and treatment in special situations. The workshop emphasizes the need for additional therapeutic options to address clinical challenges in treating these patients.
NATURE REVIEWS ENDOCRINOLOGY
(2023)
Review
Endocrinology & Metabolism
Maria Fleseriu, Elena V. V. Varlamov, Jose M. M. Hinojosa-Amaya, Fabienne Langlois, Shlomo Melmed
Summary: This review discusses the challenges faced in managing Cushing disease in adults and provides valuable information to assist clinicians in devising an integrated and personalized approach for each patient. Cushing disease, caused by an ACTH-secreting pituitary corticotroph adenoma, leads to hypercortisolaemia and is associated with various life-threatening conditions. The complexity of the disease makes it difficult to diagnose, and careful testing is required to evaluate hormone levels in the hypothalamic-pituitary-adrenal axis. Treatment options range from surgical resection to medical therapy and radiation, depending on the persistence or recurrence of the disease. Lifelong surveillance is necessary to monitor for comorbidities and treatment-related side effects. Overall, this review sheds light on the management challenges of Cushing disease in adults and offers guidance for a personalized treatment approach.
NATURE REVIEWS ENDOCRINOLOGY
(2023)
Article
Endocrinology & Metabolism
Elena V. Varlamov, Greisa Vila, Maria Fleseriu
Summary: Patients with Cushing disease may experience various complications before and after transsphenoidal surgery, requiring multidisciplinary care. Preoperative management includes treating electrolyte disturbances, cardiovascular comorbidities, and diabetes, as well as prophylaxis for thromboembolism and infection. Postoperative care involves monitoring for adrenal insufficiency, adjusting medication for hypertension and diabetes, and evaluating recovery of thyroid, gonadal, and growth hormone deficiencies.
JOURNAL OF THE ENDOCRINE SOCIETY
(2022)