Review
Endocrinology & Metabolism
Stephanie Du Four, Jorn Van Der Veken, Johnny Duerinck, Elle Vermeulen, Corina E. E. Andreescu, Michael Bruneau, Bart Neyns, Van Velthoven, Brigitte Velkeniers
Summary: In this article, we report a case series of five patients with pituitary carcinoma (PC) and highlight the challenges in diagnosis and treatment. PCs are rare intracranial neoplasms that usually develop from aggressive pituitary adenomas. The mean time interval from initial diagnosis to PC diagnosis was 10.7 years. Various treatment approaches, including surgery, radiotherapy, temozolomide, and immunotherapy, were used, with some patients achieving stable disease. The lack of predictive factors for an aggressive clinical course makes management challenging for PCs.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Endocrinology & Metabolism
Stephan Gaillard, Sosthene Adeniran, Chiara Villa, Anne Jouinot, Marie-Laure Raffin-Sanson, Loic Feuvret, Pierre Verrelle, Fideline Bonnet, Anthony Dohan, Jerome Bertherat, Guillaume Assie, Bertrand Baussart
Summary: The management of giant pituitary tumors is complex and requires a multi-modal approach, with surgery playing a central role. A multidisciplinary expert team can achieve tumor control and improve visual outcomes in the majority of patients.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Clinical Neurology
Robert C. Osorio, Matheus P. Pereira, Rushikesh S. Joshi, Kevin C. Donohue, Patricia Sneed, Steve Braunstein, Philip Theodosopoulos, Ivan H. El-Sayed, Jose Gurrola, Sandeep Kunwar, Lewis S. Blevins, Manish K. Aghi
Summary: This study examined the influence of socioeconomic status (SES) on the clinical presentations and outcomes of nonfunctional pituitary adenoma (NFPA) resections. The presence of a primary care provider (PCP) was found to be the most important factor, affecting hospital lengths of stay, readmission rates, follow-up adherence, and tumor recurrence.
JOURNAL OF NEUROSURGERY
(2022)
Article
Clinical Neurology
James R. Janopaul-Naylor, Manali Rupji, Jim Zhong, Bree R. Eaton, Naba Ali, Adriana G. Ioachimescu, Nelson M. Oyesiku, Hui-Kuo G. Shu
Summary: Modern LINAC RT is safe and effective for hormonal control and LC in patients with PAs. There was an increase in the proportion of patients requiring pituitary hormone replacement after RT.
WORLD NEUROSURGERY
(2022)
Article
Medicine, General & Internal
Carlos Perez-Lopez, Cristina Alvarez-Escola, Alberto Isla Guerrero
Summary: The treatment of non-functioning pituitary adenomas depends on symptoms, contact with the optic tract, and growth on imaging tests. Medical treatment is used after surgical and radiotherapy options are exhausted.
Article
Endocrinology & Metabolism
Xin Lian, Zhuoran Xu, Shuai Sun, Weiping Wang, Huijuan Zhu, Lin Lu, Xiaorong Hou, Fuquan Zhang
Summary: The study aimed to investigate the efficacy and toxicity of intensity-modulated radiotherapy (IMRT) in treating Cushing's Disease (CD). The results showed that IMRT was a highly effective therapy with low side effects for CD patients, with comparable rates of endocrine remission, tumor control, and recurrence to previous reports.
FRONTIERS IN ENDOCRINOLOGY
(2023)
Article
Clinical Neurology
Ben A. Strickland, Shane Shahrestani, Robert G. Briggs, Anna Jackanich, Sherwin Tavakol, Kyle Hurth, Mark S. Shiroishi, Chia-Shang J. Liu, John D. Carmichael, Martin Weiss, Gabriel Zada
Summary: SCAs are a subtype of NFAs that are more biologically aggressive, with patients presenting with more cranial neuropathy and headaches, and a shorter progression-free survival duration.
JOURNAL OF NEUROSURGERY
(2021)
Article
Oncology
Thomas Charleux, Veronique Vendrely, Aymeri Huchet, Renaud Trouette, Amandine Ferriere, Antoine Tabarin, Vincent Jecko, Hugues Loiseau, Charles Dupin
Summary: The first line of treatment for nonfunctioning pituitary adenoma (NFPA) is surgery. Adjuvant radiotherapy or surveillance and new treatment (second surgical operation or salvage radiotherapy) in case of recurrence are options discussed at the multidisciplinary tumor board. The purpose of this study was to evaluate the therapeutic outcome for each option. Results showed that adjuvant radiotherapy was not superior to salvage radiotherapy in preventing recurrence, therefore salvage radiotherapy is recommended in case of recurrence or progression to avoid a second surgical operation.
RADIATION ONCOLOGY
(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
Alies J. Dekkers, Friso de Vries, Amir H. Zamanipoor Najafabadi, Emmy M. van der Hoeven, Marco J. T. Verstegen, Alberto M. Pereira, Wouter R. van Furth, Nienke R. Biermasz
Summary: This study retrospectively assessed the healthcare costs and cost drivers in perioperative care for pituitary tumour patients. The results showed that length of hospital stay and complications were the main drivers of costs, and certain baseline features were also associated with higher costs.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Oncology
Jack L. Birkenbeuel, Brandon M. Lehrich, Khodayar Goshtasbi, Arash Abiri, Frank P. K. Hsu, Edward C. Kuan
Summary: This study evaluates the clinical and sociodemographic factors that predict surgery refusal in pituitary adenoma patients and the impact on overall survival. Age, race, comorbidities, and insurance status are identified as independent predictors of surgery refusal. Patients with macroadenomas who refuse surgery have a significant decrease in overall survival.
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
Lea M. Alhilali, Andrew S. Little, Kevin C. J. Yuen, Jae Lee, Timothy K. Ho, Saeed Fakhran, William L. White
Summary: In this study of 102 patients undergoing microscopic transsphenoidal resection of a pituitary adenoma, early postoperative MRI showed high sensitivity and specificity for detecting residual tumors, with better reliability than late postoperative MRI. Early MRI identified 4 residual tumors that were missed by intraoperative assessment and late MRI, providing important guidance for reoperation in select patients.
JOURNAL OF NEUROSURGERY
(2021)
Article
Clinical Neurology
Christina E. Sarris, Scott T. Brigeman, Estelle Doris, Maggie Bobrowitz, Thomas Rowe, Eva M. Duran, Griffin D. Santarelli, Ryan M. Rehl, Garineh Ovanessoff, Monica C. Rodriguez, Kajalben Buddhdev, Kevin C. J. Yuen, Andrew S. Little
Summary: After implementing a comprehensive quality improvement program for pituitary surgery patients, there were significant improvements in patient outcomes, decreased outcome variability, and enhanced hospital financial performance. Future studies may provide further insight into disease remission, patient satisfaction, and how the surgeon learning curve impacts quality efforts.
JOURNAL OF NEUROSURGERY
(2021)
Article
Clinical Neurology
Alexander Micko, Matthew S. Agam, Andrew Brunswick, Ben A. Strickland, Martin J. Rutkowski, John D. Carmichael, Mark S. Shiroishi, Gabriel Zada, Engelbert Knosp, Stefan Wolfsberger
Summary: The aim of this study is to assess the treatment strategies and outcomes of giant pituitary adenomas (GPAs) in the era of endoscopic transsphenoidal surgery (ETS). The study found that the extent of resection is dependent on the morphology of the GPA. Treatment strategies for residual pituitary adenoma include early transcranial reoperation, delayed endoscopic transsphenoidal/transcranial reoperation, and adjuvant radiosurgery.
JOURNAL OF NEUROSURGERY
(2022)