Marker for Pineal Tumours?

Barber, S G; Smith, J.A.; Cove, D H; Smith, Sarah C.; London, David

doi:10.1016/s0140-6736(78)92969-0

Cited by 16 publications

(2 citation statements)

References 21 publications

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“…Melatonin can be produced by the tumor (in the case of germinomas). The physiological rhythmic pattern can be maintained or secretion can be diminished due to an undifferentiated and invasive tumor (Barber et al, 1978; Grimoldi et al, 1998; Leston et al, 2009; Miles et al, 1985; Murata et al, 1998; Walker et al, 1996). Melatonin depletion can be used to confirm complete tumor and pineal gland resection (Leston et al, 2009; Murata et al, 1998; Neuwelt and Lewy, 1983).…”

Section: Introductionmentioning

confidence: 99%

Prospective Study on Salivary Evening Melatonin and Sleep before and after Pinealectomy in Humans

et al. 2015

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Melatonin is secreted systemically from the pineal gland maximally at night but is also produced locally in many tissues. Its chronobiological function is mainly exerted by pineal melatonin. It is a feedback regulator of the main circadian pacemaker in the hypothalamic suprachiasmatic nuclei and of many peripheral oscillators. Although exogenous melatonin is approved for circadian rhythm sleep disorders and old-age insomnia, research on endogenous melatonin in humans is hindered by the great interindividual variability of its amount and circadian rhythm. Single case studies on pinealectomized patients report on disrupted but also hypersomnic sleep. This is the first systematic prospective report on sleep with respect to pinealectomy due to pinealocytoma World Health Organization grade I without chemo- or radiotherapy. Before and after pinealectomy, 8 patients completed questionnaires on sleep quality and circadian rhythm (Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Morningness-Eveningness Questionnaire), 2 nights of polysomnography, salivary evening melatonin profiles, and qualitative assessment of 2 weeks of actigraphy and sleep logs. Six patients were assessed retrospectively up to 4 years after pinealectomy. Before pinealectomy, all but 1 patient showed an evening melatonin rise typical for indifferent chronotypes. After pinealectomy, evening saliva melatonin was markedly diminished, mostly below the detection limit of the assay (0.09 pg/mL). No systematic change in subjective sleep quality or standard measures of polysomnography was found. Mean pre- and postoperative sleep efficiency was 94% and 95%, and mean sleep-onset latency was 21 and 17 min, respectively. Sleep-wake rhythm during normal daily life did not change. Retrospective patients had a reduced sleep efficiency (90%) and more stage changes, although this was not significantly different from prospective patients. In conclusion, melatonin does seem to have a modulatory, not a regulatory, effect on standard measures of sleep. Study output is limited by small sample size and because only evening melatonin profiles were assessed.

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Section: Introductionmentioning

confidence: 99%

Prospective Study on Salivary Evening Melatonin and Sleep before and after Pinealectomy in Humans

et al. 2015

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“…Other markers for pineal tumours exist, including melatonin which was shown to be undetectable in our patient (Barber et al, 1978). The hCGB produced by this tumour, however, helped in the early detection of recurrence.…”

Section: Discussionmentioning

confidence: 59%

hCGβ PRODUCING PINEAL CHORIOCARCINOMA

Wass

Jones

Rees

et al. 1982

Clinical Endocrinology

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A patient is described with tumours in the region of the pineal gland and anterior hypothalamus associated with high levels of hCG beta in the serum and cerebrospinal fluid (CSF). He presented aged 19, with hypopituitarism, but persistent secondary sexual characteristics. LH immunoreactivity in serum was due to the hCG beta which probably caused the elevated level of testosterone. Following cranial irradiation the tumour became undetectable and hCG beta was eradicated from the serum and CSF. The patient later died because of an intramedullary metastasis of choriocarcinoma in the cervical spinal cord. The endocrine details of six previously reported intracranial neoplasms which have been shown to secrete hCG beta are reviewed. Only two of these involved the pineal region. Chorionic gonadotrophin production by this tumour enabled early detection of its recurrence. It is unclear how often precocious puberty is caused by tumours producing hCG beta, but patients presenting either with that problem or a pineal tumour should have circulating hCG beta measured.

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