Current opinion on the diagnosis and management of non-functioning pituitary adenomas

Lamback, Elisa Baranski; Wildemberg, Luiz Eduardo; Gadelha, Mônica R.

doi:10.1080/17446651.2021.1988851

Cited by 5 publications

(7 citation statements)

References 120 publications

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“…En el caso de un valor indeterminado, se puede realizar una prueba de estimulación con ACTH sintética (cosintropina). Un valor de cortisol menor de 18 μg/dl en el momento de hipoglucemia (< 40 mg/dl, con síntomas) sugiere la presencia de insuficiencia suprarrenal 13 .…”

Section: Pruebas Dinámicasunclassified

“…Los tumores AHCNF sin biomarcadores de determinación de linaje se clasifican como tumores de células nulas; estos están disminuyendo en incidencia a medida que mejoran las herramientas utilizadas para clasificar estos tumores. Su prevalencia se modificó de un 16% a menos del 2% [25][26][27][28][29][30][31][32][33] (Tabla 1).…”

Section: Clasificaciónunclassified

“…El porcentaje de mortalidad para la cirugía TE está por debajo del 1% y para la CT del 6%. Las complicaciones quirúrgicas incluyen: fístula de líquido cefalorraquídeo (3%), meningitis (1%), lesión de la arteria carótida interna (1%), perforación septal (< 3%), diabetes insípida transitoria (11%) o permanente (5%), nuevo defecto del campo visual (3%), hipopituitarismo de novo (9%) o empeoramiento del hipopituitarismo preexistente (30%) 13,17,19,22 .…”

Section: Quirúrgicounclassified

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Posición del Grupo de Trabajo de Neuroendocrinología respecto a los adenomas de hipófisis no funcionantes

Vargas-Ortega,

Abreu-Rosario,

Balcázar-Hernández

et al. 2024

RME

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Clinically non-functioning pituitary adenomas (CNPHA) are characterized by the absence of hormonal hypersecretion with a spectrum of clinical manifestations, from asymptomatic course to the presence of compressive symptoms or pituitary apoplexy. The treatment of choice is surgery, however, there are different adjuvant treatments that improve the prognosis. Current evidence continues to increase the information on the diagnosis and treatment of this disease. The objective of this document is to update the position of the Mexican Society of Nutrition and Endocrinology regarding the diagnosis, treatment and follow-up of people living with CNPHA, reviewing the literature by the Working Group of Neuroendocrinology of our society and establishing recommendations applicable to our population.

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Section: Pruebas Dinámicasunclassified

Section: Clasificaciónunclassified

Section: Quirúrgicounclassified

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Posición del Grupo de Trabajo de Neuroendocrinología respecto a los adenomas de hipófisis no funcionantes

Vargas-Ortega,

Abreu-Rosario,

Balcázar-Hernández

et al. 2024

RME

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“…Non-functioning pituitary tumors (NFPT) are largely represented by gonadotroph tumors, such as silent ACTH; GH or PRL adenomas should not be included in this class of pituitary tumors [117]. Transsphenoidal surgery is the first option in NFPT, eventually combined with external radiotherapy [118]. However, a high expression level at the membrane of DRD2 was noted in such tumors [119].…”

Section: Non-functioning Ptmentioning

confidence: 99%

Current and Emerging Medical Therapies in Pituitary Tumors

Sahakian

Castinetti

Brue

et al. 2022

JCM

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Pituitary tumors (PT) represent in, the majority of cases, benign tumors for which surgical treatment still remains, except for prolactin-secreting PT, the first-line therapeutic option. Nonetheless, the role played by medical therapies for the management of such tumors, before or after surgery, has evolved considerably, due in part to the recent development of well-tolerated and highly efficient molecules. In this review, our aim was to present a state-of-the-art of the current medical therapies used in the field of PT and the benefits and caveats for each of them, and further specify their positioning in the therapeutic algorithm of each phenotype. Finally, we discuss the future of PT medical therapies, based on the most recent studies published in this field.

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“…Whereas active surveillance with regular clinical, hormonal and imaging assessment is appropriate for selected patients with nfPitNETs, the first-line treatment for most patients is transsphenoidal surgical resection. However, nfPitNETs often have supra- or parasellar extension, which preclude the total resection of the tumor [ 4 ]. This results in residual tumor regrowth in 47% of patients and 24% reoccurrence after complete macroscopic resection [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Update on Current Evidence for the Diagnosis and Management of Nonfunctioning Pituitary Neuroendocrine Tumors

Whyte,

Nezu,

Chik

et al. 2023

Endocrinol Metab

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Pituitary neuroendocrine tumors (PitNETs) are the third most frequently diagnosed intracranial tumors, with nonfunctioning PitNETs (nfPitNETs) accounting for 30% of all pituitary tumors and representing the most common type of macroPitNETs. NfPitNETs are usually benign tumors with no evidence of hormone oversecretion except for hyperprolactinemia secondary to pituitary stalk compression. Due to this, they do not typically present with clinical syndromes like acromegaly, Cushing’s disease or hyperthyroidism and instead are identified incidentally on imaging or from symptoms of mass effects (headache, vision changes, apoplexy). With the lack of effective medical interventions, first-line treatment is transsphenoidal surgical resection, however, nfPitNETs often have supra- or parasellar extension, and total resection of the tumor is often not possible, resulting in residual tumor regrowth or reoccurrence. While functional PitNETs can be easily followed for recurrence using hormonal biomarkers, there is no similar parameter to predict recurrence in nfPitNETs, hence delaying early recognition and timely management. Therefore, there is a need to identify prognostic biomarkers that can be used for patient surveillance and as therapeutic targets. This review focuses on summarizing the current evidence on nfPitNETs, with a special focus on potential new biomarkers and therapeutics.

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Current opinion on the diagnosis and management of non-functioning pituitary adenomas

Cited by 5 publications

References 120 publications

Posición del Grupo de Trabajo de Neuroendocrinología respecto a los adenomas de hipófisis no funcionantes

Posición del Grupo de Trabajo de Neuroendocrinología respecto a los adenomas de hipófisis no funcionantes

Current and Emerging Medical Therapies in Pituitary Tumors

Update on Current Evidence for the Diagnosis and Management of Nonfunctioning Pituitary Neuroendocrine Tumors

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