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Gonadotrophin-releasing hormone agonist-induced pituitary adenoma apoplexy and casual finding of a parathyroid carcinoma:A case report and review of literature

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World Journal of Clinical Cases 2019年第20期7卷 3259-3265页

作者： Vanessa Trivino Olga Fidalgo Antía Juane Jorge Pombo Fernando Cordido Department of Endocrinology Complejo Hospitalario Universitario A CorunaA Coruna 15006Spain Department of pathological anatomy Complejo Hospitalario Universitario A CorunaA Coruna 15006Spain

BACKGROUND pituitary apoplexy represents one of the most serious,life threatening endocrine emergencies that requires immediate ***-releasing hormone agonist(GnRHa)can induce pituitary apoplexy in those patients who have insidious pituitary adenoma *** SUMMARY A 46-year-old woman,with a history of hypertension and menorrhagia was transferred to our hospital from a secondary care hospital after complaints of headache and vomiting,with loss of consciousness 5 min after an injection of *** drug was prescribed by her gynecologist due to the presence of uterine *** clinical neurological examination revealed right cranial nerve III palsy,ptosis and movement limitation of the right *** first clinical consideration was a pituitary *** hormonal analysis revealed mild hyperprolactinemia and high follicle stimulating hormone level;PTH and calcium was high with glomerular filtration rate mildly to moderately decrease.A computed tomography scan,revealed an enlarged pituitary gland(3.5 cm)impinging upon the optic chiasm with bone involvement of the *** contrast media administration,the lesion showed homogeneous enhancement with high-density focus that suggests hemorrhagic infarction of the *** endoscopic surgery was perfomed and adenomatous tissue was *** was positive for luteinizing hormone(LH)and follicular-stimulating hormone(FSH).A solid hypoechoic nodule(14 mm x 13 mm x 16 mm)was found in the caudal portion of the right thyroid lobe after a parathyroid ultrasound.A genetic test of Multiple Endocrine Neoplasia type 1(MEN1)was negative.A right lower parathyroidectomy was performed and the pathologic study showed the presence of an encapsulated parathyroid carcinoma of 1.5 cm.A MEN type 4 genetic test was performed result was *** This case demonstrates an uncommon complication of GnRH agonist therapy in the setting of a pituitary macroadenoma an

关键词： pituitary apoplexy pituitary adenoma Primary hyperparathyroidism MEN type 1 MEN type 4 Parathyroid carcinoma Case report

MicroRNA-149 Regulates Proliferation,Migration,and Invasion of pituitary adenoma Cells by Targeting ADAM12 and MMP14

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Current Medical Science 2022年第6期42卷 1131-1139页

作者： Zhuo ZHANG Agnes Schäfer Benjamin Voellger Jun-wen WANG Ting LEI Christopher Nimsky Jörg W.Bartsch Department of Neurosurgery Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China Department of Neurosurgery Philipps University MarburgBaldingerstrasseMarburg35033Germany Sino-German Neuro-Oncology Molecular Laboratory Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China Center for Mind Brainand BehaviorHans-Meerwein-Strasse 6Marburg35032Germany

Objective pituitary adenomas(PAs)can adapt an aggressive phenotype by invading adjacent brain structures with rapid cellular *** studies demonstrated that excessive expression of metalloproteases ADAM12 and MMP-14 is instrumental for the active proliferation and invasiveness of PA cells in vitro and of tumors in ***,the mechanisms regulating ADAM12 and MMP-14 expression in PAs remain *** Target gene prediction and transcriptomic profiling of invasive *** human PA samples were performed to identify miRNA species potentially involved in the regulation of ADAM12 and *** cellular analyses of miRNA functions,two mouse PA cell lines(AtT20 and TtT/GF)were transfected with miR-149-3p and miR-149-5p,*** effects of miR-149(3p and 5p)on expression levels of ADAM12 and MMP14 were determined by Western blotting followed by an analysis of proliferation and colony formation assays,scratch migration assays,and invasion *** A significant downregulation of miRNA-149 was observed in invasive *** PA(0.32 vs.0.09,P<0.0001).In AtT-20 and TtT/GF mouse PAs cells,transfection of mimic miRNA-149(3p and 5p)caused a significantly reduced cell proliferation and matrigel invasion,whilst the effect on cell migration was less *** strands of miRNA-149(3p and 5p)markedly reduced protein levels of ADAM12 and MMP-14 by at least 40%in both cell *** This study proved that the invasiveness of PA cells is,at least partly,regulated by miRNA-149-dependent expression of ADAM12 and MMP-14.

关键词： pituitary adenoma microRNA miRNA-149 ADAM12 MMP-14 invasion

Surgical management of pituitary adenoma during pregnancy

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World Journal of Clinical Cases 2023年第12期11卷 2694-2707页

作者： Xin-Yu Jia Xiao-Peng Guo Yong Yao Kan Deng Wei Lian Bing Xing Department of Plastic Surgery Plastic Surgery HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100144China Department of Neurosurgery Key Laboratory of Endocrinology of Ministry of HealthChina Pituitary Adenoma Specialist CouncilPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical College HospitalBeijing 100730China Department of Plastic Surgery Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Neurosurgery Medical Research CenterState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical College HospitalBeijing 100730China

BACKGROUND Although conservative treatment is typically recommended for pregnant patients with pituitary adenoma(PA),surgical treatment is occasionally necessary for those with acute ***,surgical interventions utilized among these patients is poorly *** To evaluate the surgical indications,timing,perioperative precautions and postoperative complications of PAs during pregnancy and to provide comprehensive *** Six patients with PAs who underwent surgical treatment during pregnancy at Peking Union Medical College Hospital between January 1990 and June 2021 were recruited for this *** 35 pregnant patients who were profiled in the literature were included in our *** The 41 enrolled patients had acute symptoms including visual field defects,severe headaches or vision loss that required emergency pituitary *** apoplexies were found in 23 *** majority of patients(55.9%)underwent surgery in the second trimester of pregnancy.A multidisciplinary team was involved in patient care from the preoperative period through the postpartum *** the exception of 1 patient who underwent an induced abortion and 1 fetus that died due to a nuchal cord,39 patients delivered *** them,37 fetuses were healthy until the most recent *** PA surgery during pregnancy is effective and safe during the second and third *** patients requiring emergency PA surgery require multidisciplinary evaluation and healthcare management.

关键词： pituitary adenoma Pregnancy Surgery Surgical indication Surgical timing

ELEVATED SOLUBLE EPIDERMAL GROWTH FACTOR RECEPTOR LEVEL IN pituitary adenoma AND CARCINOMA

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Chinese Medical Sciences Journal 2004年第3期19卷 199-202页

作者： Yan-guoKong Zu-yuanRen Chang-baoSu Ren-zhiWang Wen-bingMa WeiLian LaboratoryofNeurosurgery PekingUnionMedicalCollegeHospitalChineseAcademyofMedicalSciences＆PekingUnionMedicalCollegeBeijing100730

To investigate effect of the soluble epidermal growth factor receptor (sEGFR/sErbB1) level in the periph-eral blood in development, invasiveness, apoplexy of each type of pituitary tumor. Methods The sEGFR level was determined in peripheral serum from 190 patients with pituitary diseases by enzyme linked immunosobent assay. The sEGFR levels were measured in 10 pituitary Rathke’s pouch, 18 pituitary hyperplasia, 161 pituitary adenomas including 30 microadenomas, 83 large adenomas, 48 giant adenomas, 1 pituitary carcinoma, and 28 hea-lthy controls. Results In the patients with pituitary hyperplasia, microadenoma, large adenoma, giant adenoma, and pituitary carci-noma, the sEGFR level was 188.92 ± 32.62, 209.83 ± 19.01, 333.20 ± 69.33, 405.85 ± 37.38, and 617.45 fmol/mL indepen-dently. They were all significantly higher than patients with pituitary Rathke’s pouch (156.78 ± 18.24 fmol/mL, P pituitary carcinoma was higher than pi-tuitary adenoma. In patients with pituitary adenoma, the sEGFR level was positive correlated to the size of pituitary adeno-mas (r = 0.998), the significant difference was observed for the sEGFR level in each group of the patients with pituitary adenomas (P pituitary ACTH-secreting microadenomas, the serum sEGFR levels in invasiveness (295.00 ± 77.80 fmol/mL) was higher than that in non-invasiveness (210.60 ± 16.4 fmol/mL, P pituitary ACTH-secreting, PRL-secreting, GH-secreting, and non-functioning large adenomas, the serum sEGFR levels in invasiveness (407.86 ± 28.50, 399.25 ± 30.10, 386.00 ± 13.08, and 369.25 ± 36.70 fmol/mL) was higher than that in non-invasiveness (335.25 ± 63.49, 300.64 ± 47.57, 297.00 ± 61.93, and 269.30 ± 25.68 fmol/mL) respectively (P pituitary PRL-secreting, GH-secreting, and non-functioning giant adenomas, the serum sEGFR levels n

关键词： pituitary adenoma pituitary carcinoma soluble epidermal growth factor receptor

HYPONATREMIA AFTER TRANSSPHENIODAL SURGERY OF pituitary adenoma

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Chinese Medical Sciences Journal 2003年第2期18卷 120-123页

作者：陶蔚任祖渊苏长保王任直杨义马文斌 Department of Neurosurgery PUMC HospitalCAMS & PUMCBeijing 100730

Objective. To clarify the frequency, presentation, associated factors, treatment and outcome of hy-ponatremia after transsphenoidal surgery of pituitary ***. Retrospectively reviewed the database of 183 patients who underwent transsphenoidal surgeryof pituitary adenomas between January 1999 and June 2000 in our ***.s. 38.8% (71/183) had postoperative hyponatremia. Among them, 59.2% (42/71) appeared onthe 4th to 7th day postoperatively. 59.2% (42/71) presented with nausea, vomiting, headache, dizzi-ness, confusion and weakness. Hyponatremia was related to age, tumor size and adenoma type, but notrelated to sex and degree of resection. Treatment consisted of salt replacement and mild fluid restrictionin 4 patients and salt and fluid replacement in 67 patients. Hyponatremia resolved within 16 days in allthe ***. Hyponatremia often appeared about 7 days after transsphenoidal surgery of pituitary ade-nomas, especially in elderly and patients with macroadenomas and huge pituitary adenomas. The principleof treatment was salt and fluid replacement.

关键词： hyponatremia pituitary adenoma transsphenoidal surgery

EFFECT OF PREOPERATIVE USE OF LONG-ACTING OCTREOTIDE ON GROWTH HORMONE SECRETING pituitary adenoma AND TRANSSPHENOIDAL SURGERY

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Chinese Medical Sciences Journal 2005年第1期20卷 23-26,页

作者： JianYin Chang-baoSu Zhi-qinXu YiYang Wen-binMa WeiTao ZhongYang Xue-weiXia DepartmentofNeurosurgery PekingUnionMedicalCollegeHospitalChineseAcademyofMedicalSciences＆PekingUnionMedicalCollegeBeijing100730

Objective To investigate whether somatostatin analog octreotide long acting release (LAR) shrinks growth hormone (GH) secreting adenomas, and improves the results of subsequent transsphenoidal surgery. Methods Seventeen previously untreated active acromegalic patients with pituitary adenomas were treated with LAR (30 mg intramuscular injection every 28 days) for 3 months prior to transsphenoidal surgery. Clinical reaction, mean GH secretion, and tumor volume were measured under basal conditions and after LAR treatment. Results Presurgical treatment improved acromegaly symptoms and induced a significant reduction of GH under the 5 ng/mL limit in microadenoma (P adenoma. Meanwhile, tumor shrinkage occurred in 58.8% (10/17) patients, with 1 case in the microadenoma group. All marked shrinkage (> 25%) occurred in the macroadenoma group. Statistical analysis showed tumor shrinkage caused by LAR was greater in macroadenoma group than that in microadenoma group (P adenoma was soft in 15 cases, with the exception of 2 cases in which the soft tumor was divided by fibrous septa, but all tumor removal was smooth. Conclusions A short term administration of preoperative LAR may induce a significant decrease in GH-secretion level and adenoma volume. Presurgical use of octreotide LAR improves surgical results especially in macroadenomas.

关键词： pituitary adenoma somatostatin analog transsphenoidal surgery

pituitary adenoma Complicated by Acute Bacterial Meningitis in a Patient in Kara (Togo)

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Open Journal of Internal Medicine 2023年第4期13卷 364-370页

作者： Lihanimpo Djalogue Leleng Agba Komi Edem Mossi Toyi Tchamdja Kodjo Agbeko Djagadou Abago Balaka Mohaman Awalou Djibril Internal Medicine Department of Kara University Hospital University of Kara Kara Togo Neurology Department of Kara University Hospital University of Kara Kara Togo Internal Medicine Department of Sylvanus Olympio University Hospital University of Lomé Lomé Togo Internal Medicine Department of Campus University Hospital University of Lomé Lomé Togo

Introduction: In the context of pituitary adenoma, bacterial meningitis is a possible complication of surgical or medical treatment. The occurrence of meningitis before any treatment is exceptional, explained by the existence of an osteomeningeal breach caused by the adenoma whose main symptom is rhinorrhea. Case Report: We report a case of bacterial meningitis complicating a prolactin pituitary macroadenoma. The patient had been referred for jet vomiting in a febrile context preceded by headaches and visual blurring. There was no rhinorrhea. The examination revealed a meningeal syndrome and the diagnosis of acute bacterial meningitis was made. The isolated germ was the pneumococcus. Faced with headaches and visual blurring, a cerebral scan revealed a pituitary macroadenoma and pituitary hormone dosage had shown hyperprolactinemia. The meningitis was sterilized and the prolactinoma was treated with dopaminergic agonists. This allowed the normalization of prolactinemia and the disappearance of symptoms. Conclusion: The pituitary adenoma was complicated by bacterial meningitis without treatment and the presence of a meningeal breach. Hormonal and bacterial treatments have been successful.

关键词： pituitary adenoma Prolactin Meningitis

Changes in the Vision-related Resting-state Network in pituitary adenoma Patients After Vision Improvement

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Chinese Medical Journal 2015年第9期128卷 1171-1176页

作者： Hai-Yan Qian Xing-Chao Wang Zhong-Yan Wang Zhen-Min Wang Pi-Nan Liu Zhong-Cheng Wang Department of Neurosurgery Beijing Tiantan Hospital Affiliated to Capital Medical University Beijing 100050 China Beijing Neurosurgery Institute Capital Medical University Beijing 100050 China Department of Radiology Beijing Tiantan Hospital Affiliated to Capital Medical University Beijing 100050 China

Background：The aim of this research was to investigate the changes in the vision-related resting-state network （V-RSN） in pituitary adenoma （PA） patients after vision improvement,which was induced by operative ***：Ten PA patients with an improved visual acuity or/and visual field after transsphenoidal pituitary tumor resection were recruited and underwent a complete neuro-ophthalmologic evaluation,as well as an magnetic resonance imaging （MRI） protocol,including structural and resting-state functional MRI sequences before and after the *** regional homogeneity （ReHo） of the V-RSN was *** sample t-test was performed to identify the significant differences in the V-RSN in the PA patients before and after transsphenoidal pituitary tumor ***：Compared with the preoperation counterparts,the PA patients with improved vision after the operation exhibited reduced ReHo in the bilateral thalamus,globus pallidus,caudate nucleus,putamen nucleus,supplementary motor area,and left hippocampal formation,and increased ReHo in the bilateral cuneus gyrus,calcarine gyrus,right lingual gyrus,and fusiform ***：PA patients with improved vision exhibit increased neural activity within the visual cortex,but decreased neural activity in subareas of the multisensory and multimodal systems beyond the vision cortex.

关键词： Multisensory and Multimodal System pituitary adenoma Resting-state Functional Magnetic Resonance Imaging Visual Improvement

RGD-FasL Induces Apoptosis of pituitary adenoma Cells

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Cellular & Molecular Immunology 2008年第1期5卷 61-68页

作者： Lukui Chen Guohong Zhuang Wenzhu Li Yunsheng Liu Junqing Zhang Xinhua Tian Department of Neurosurgery Zhongshan Hospital Xiamen University Xiamen Fujian 361004 China Cancer Research Center Medical College Xiamen University Xiamen Fujian 361000 China School of Life Science Xiamen University Xiamen Fujian 361000 China Department of Neurosurgery Xiangya Hospital Zhongnan University Changsha Hunan China

This study was to investigate the cytotoxic effects on pituitary adenoma cell lines GH3/MMQ/AtT20 induced by RGD-FasL and the underlying mechanism. Fas/DcR3 mRNAs were detected by RT-PCR and their surface expressions were measured by flow cytometry. Cytotoxicity exerted by RGD-FasL on tumor cells was measured with MTT assay and the induced apoptosis was determined by agarose gel electrophoresis. The cell cycle and apoptosis was assessed by flow cytometry with PI staining. The expressions of caspase8/9/3, Bcl-2, RANKL and JNK2 were detected by Western blotting. Approximately 13.7% of GH3 cells, 25.5% of MMQ cells, 22.2% of AtT20 cells express Fas, while 23.9% of GH3 cells, 24.1% of MMQ cells, 4.6% of AtT20 cells express DcR3. The cytotoxic effects of FasL/RGD-FasL on tumor cells were all taken in a dose-dependent manner. Cell lines MMQ/AtT20 showed the same sensitivity to RGD-FasL as to FasL, while cell line GH3 was less sensitive to RGD-FasL. The cell cycle analysis indicated that RGD-FasL could inhibit cells in G0/G1 phase and G2/M phase. In MMQ and AtT20 cells treated with RGD-FasL, the AI was not significantly different from that treated with FasL, while in GH3 cells treated with RGD-FasL, the AI was lower than that treated with FasL. The expressions of caspase-8/9/3, RANKL and JNK2 were increased while that of Bcl-2 was decreased after treatment with RGD-FasL, suggesting that RGD-FasL induces apoptosis through caspase activation. We concluded that RGD-FasL could possibly be considered as a novel therapeutical candidate for the treatment of pituitary adenomas. Cellular ＆ Molecular Immunology.

关键词： RGD-FasL pituitary adenoma apoptosis