Localization of pituitary adenomas by using intraoperative ultrasoound pituitary in patients with Cushing's disease and no demonstrable tumor on magnetic resonance imaging

Watson, Joe C.; Shawker, Thomas H.; Nieman, Lynnette K.; DeVroom, Hetty L.; Doppman, John L.; Oldfield, Edward H.

doi:10.3171/jns.1998.89.6.0927

Cited by 96 publications

(49 citation statements)

References 18 publications

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“…Zada et al 38 , refieren resecciones completas en un 75% en tumores con una PRL inferior a 200 ng/ml comparables al resto de los autores 35 . En pacientes con enfermedad de Cushing con microadenomas los niveles de remisión se sitúan cerca del 100%, siendo más bajos cuando no hay una imagen evidente preoperatoria, en macroadenomas invasivos y en las reintervenciones 4,34,36 . En pacientes con acromegalia la remisión es de un 75% en los microadenomas y de alrededor de un 50% en los macroadenomas 38 .…”

Section: Discussionunclassified

Comparación del abordaje sublabial transesfenoidal microquirúrgico frente al abordaje endonasal transesfenoidal endoscópico: Estudio prospectivo de 50 pacientes

Enseñat¹,

Quesada²,

Aparicio

et al. 2009

Neurocirugía

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Section: Discussionunclassified

Comparación del abordaje sublabial transesfenoidal microquirúrgico frente al abordaje endonasal transesfenoidal endoscópico: Estudio prospectivo de 50 pacientes

Enseñat¹,

Quesada²,

Aparicio

et al. 2009

Neurocirugía

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“…About 90% of ACTH-secreting pituitary tumors are microadenomas [Shimon et al, 1998]. In fact, it has been reported that MRI scan do not detect demonstrable tumors in approximately 40% of patients with active Cushing disease [Watson et al, 1998]. Almost all patients with Cushing's disease have an associated ACTH-secreting pituitary adenoma that is the most common cause of endogenous hypercortisolism, accounting for approximately 65-70% of all cases of Cushing's syndrome [Arafah et al, 2001].…”

Section: Classification and Clinical Aspects Of Pituitary Tumorsmentioning

confidence: 99%

Gene Therapy for Pituitary Tumors

Seilicovich¹,

Pisera²,

Sciascia³

et al. 2005

CGT

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Pituitary tumors are the most common primary intracranial neoplasms. Although most pituitary tumors are considered typically benign, others can cause severe and progressive disease. The principal aims of pituitary tumor treatment are the elimination or reduction of the tumor mass, normalization of hormone secretion and preservation of remaining pituitary function. In spite of major advances in the therapy of pituitary tumors, for some of the most difficult tumors, current therapies that include medical, surgical and radiotherapeutic methods are often unsatisfactory and there is a need to develop new treatment strategies. Gene therapy, which uses nucleic acids as drugs, has emerged as an attractive therapeutic option for the treatment of pituitary tumors that do not respond to classical treatment strategies if the patients become intolerant to the therapy. The development of animal models for pituitary tumors and hormone hypersecretion has proven to be critical for the implementation of novel treatment strategies and gene therapy approaches. Preclinical trials using several gene therapy approaches for the treatment of anterior pituitary diseases have been successfully implemented. Several issues need to be addressed before clinical implementation becomes a reality, including the development of more effective and safer viral vectors, uncovering novel therapeutic targets and development of targeted expression of therapeutic transgenes. With the development of efficient gene delivery vectors allowing long-term transgene expression with minimal toxicity, gene therapy will become one of the most promising approaches for treating pituitary adenomas.

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“…73,74 TS-IUS for localization and targeted resection of pituitary microadenomas that may not be visualized on preoperative MRI, enhances the safety of exploration, maximizes the removal of macroadenomas, and positively effects the surgical outcome at lower costs. 75,76 However, evaluation of larger series with TS-IUS, and more specific instrumentation available for transsphenoidal applications, will be essential in determining the ultimate value of this promising technique.…”

Section: Factors Increasing Surgical Successmentioning

confidence: 99%

Pitfalls in the management of Cushing’s disease

Bademci

2007

Journal of Clinical Neuroscience

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Localization of pituitary adenomas by using intraoperative ultrasoound pituitary in patients with Cushing's disease and no demonstrable tumor on magnetic resonance imaging

Abstract: The IOUS is a sensitive imaging modality when used in patients with Cushing's disease in whom findings on pituitary MR imaging are negative. The improved ability to detect and localize these tumors by using IOUS positively affects surgical outcome.

Cited by 96 publications

References 18 publications

Comparación del abordaje sublabial transesfenoidal microquirúrgico frente al abordaje endonasal transesfenoidal endoscópico: Estudio prospectivo de 50 pacientes

Comparación del abordaje sublabial transesfenoidal microquirúrgico frente al abordaje endonasal transesfenoidal endoscópico: Estudio prospectivo de 50 pacientes

Gene Therapy for Pituitary Tumors

Pitfalls in the management of Cushing’s disease

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