Predictors of neoplastic disease in children with isolated pituitary stalk thickening

Robison, Nathan; Prabhu, Sanjay P.; Sun, Pengling; Susan, N.; Kieran, Mark W.; Manley, Peter; Cohen, Laurie E.; Goumnerova, Liliana; Smith, Edward R.; Scott, R. Michael; London, Wendy B.; Ullrich, Nicole J.

doi:10.1002/pbc.24577

Cited by 35 publications

(21 citation statements)

References 24 publications

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“…In our cohort, the average age of PST patients was 27.6 years and 43.4% of the patients were aged under This result is to some extent in agreement with the evidences shown in a number of previous reports [9][10][11], which stated that patients with PST were mostly between 7 and 13 years old.…”

Section: Discussionsupporting

confidence: 93%

“…Since the publication of this report, our decision-making process of treating PST patients was biased in favor of the Hamilton's conclusions. More specifically, we strategically [11]. Our results showed that two-third of polydipsia and polyuria patients were confirmed as diabetes insipidus and about half of the patients were reported to have at least 1 anterior pituitary dysfunction who took the evaluation.…”

Section: Discussionmentioning

confidence: 90%

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Clinical features of patients with pituitary stalk thickening: a review of 159 cases from one medical center

et al. 2017

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Background: Pituitary stalk thickening (PST) used as an imaging diagnosis plays a major role in diagnosis and treatment of the hypothalamus and pituitary disease at an early stage. Up until now, several lines of systematic investigations have been conducted among adolescents, and the results indicated that PST is possibly one of the principal early manifestations of sellar region tumor. To characterize the major clinical features of PST and to identify the most effective treatments we conducted this study. Methods: This was a retrospective review of patients with PST evaluated at Huashan Hospital over an eight-year period between 2007 and 2014. One hundred fifty nine patients who were diagnosed PST were included. The data including demographics, clinical presentations, imaging examinations, laboratory results and surgery were thoroughly reviewed and carefully analyzed. According to their clinical presentations and examinations, relevant treatments were adopted and different prognosis were observed.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 90%

Clinical features of patients with pituitary stalk thickening: a review of 159 cases from one medical center

et al. 2017

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“…49 In children with isolated DI and a thickened pituitary stalk, the most likely diagnoses are LCH, germ cell tumor, or lymphoma. 50 LCH is frequently a diagnosis of exclusion with normal germ cell markers and normal CSF cytology. Due to risks of pituitary biopsy, in such patients it is reasonable to initiate LCH therapy empirically and monitor for early response by MRI.…”

Section: Brain Mri For Patient With Cns-risk Lesionsmentioning

confidence: 99%

How I treat Langerhans cell histiocytosis

Allen

Ladisch

McClain

2015

Blood

190

170

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“Langerhans cell histiocytosis” (LCH) describes a spectrum of clinical presentations ranging from a single bone lesion or trivial skin rash to an explosive disseminated disease. Regardless of clinical severity, LCH lesions share the common histology of CD1a+/CD207+ dendritic cells with characteristic morphology among an inflammatory infiltrate. Despite historical uncertainty defining LCH as inflammatory vs neoplastic and incomplete understanding of mechanisms of pathogenesis, clinical outcomes have improved markedly over the past decades through cooperative randomized clinical trials based on empiric therapeutic strategies. Significant advances include recognition of high- and low-risk clinical groups defined by hematopoietic and/or hepatic involvement, and of the importance of optimal intensity and of duration of chemotherapy. Nevertheless, mortality of high-risk patients, disease recurrence, lack of robustly tested salvage strategies, and significant disease morbidity of both high- and low-risk patients remain challenges. Recent discovery of recurrent somatic mutations in mitogen-activated protein kinase pathway genes at critical stages of myeloid hematopoietic differentiation in LCH patients supports redefinition of the disease as a myeloproliferative disorder and provides opportunities to develop novel approaches to diagnosis and therapy.

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“…Varan et al 19 reported that 69.8% of patients presenting with central DI had the diagnosis of LCH. Infundibular thickening and absence of posterior pituitary intensity were the most common MRI findings 20,21 . We had three patients with DI at the time of diagnosis of MS LCH.…”

Section: Multisystem Lch (Ms-lch) (N:11)mentioning

confidence: 99%

Pediatric langerhans cell histiocytosis: single center experience over a 17-year period

İnce¹,

Demirağ²,

Özek³

et al. 2016

Turk J Pediatr

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Predictors of neoplastic disease in children with isolated pituitary stalk thickening

Abstract: Patients with PST without DI are unlikely to have a neoplastic process. Among patients with DI, APD or progressive stalk increase over time are predictive of neoplasia.

Cited by 35 publications

References 24 publications

Clinical features of patients with pituitary stalk thickening: a review of 159 cases from one medical center

Clinical features of patients with pituitary stalk thickening: a review of 159 cases from one medical center

How I treat Langerhans cell histiocytosis

Pediatric langerhans cell histiocytosis: single center experience over a 17-year period

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