Giant prolactinoma with progressive cranial settling and central herniation: a case report.

Background: Giant prolactinoma (size > 4 cm) is a rare condition and accounts for less than 1% of pituitary adenomas. In even rarer cases, these lesions may involve craniocervical structures requiring surgical intervention. The present case is the largest reported giant prolactinoma (99 × 72 × 57 mm).

A FSH-secreting pituitary adenoma discovered after ovarian hyperstimulation syndrome: a case report, illustrating pitfalls in the interpretation of serum FSH levels.

Background: Most cases of ovarian hyperstimulation syndrome (OHSS) are caused by infertility treatment using human menopausal gonadotropin (HMG) and human chorionic gonadotropin (hCG). OHSS is widely known to have a "spoke-wheel" appearance on imaging, presenting as bilateral symmetric enlargement of ovaries with multiple cysts of varying sizes. When this spoke-wheel appearance is observed in patients not undergoing infertility treatment, tumor-derived hormones such as follicle-stimulating hormone (FSH) and hCG should be measured.

Pituitary adenomas in children: surgical course and functional outcome. Lille cohort retrospective study.

Context: Pituitary Neuroendocrine Tumors are rare in children, but challenging, implying the two purposes to cure the child, and preserve pituitary function. In this paper, we describe our population of children who underwent endoscopic endonasal resection of a pituitary adenoma, in Lille University Hospital.

Patients And Methods: Between 2007 and 2021, all children undergoing EEN surgery for pituitary adenoma were included.

Incidence of postoperative cerebrospinal fluid leaks in endoscopic endonasal transsphenoidal surgery for pituitary adenomas without sellar floor reconstruction: A retrospective observational study from a low-middle-income country.

Objectives: To determine the incidence of postoperative cerebrospinal fluid (CSF) leaks after endoscopic endonasal transsphenoidal surgery (EETS) for pituitary adenomas without sellar floor reconstruction (SFR).

Methods: This retrospective observational study was conducted at Department of Neurosurgery, Punjab Institute of Neurosciences (PINS), Lahore, Pakistan from January, 2018 to December, 2022. It is a non-probability based consecutive case series.

MicroRNA networks in prolactinoma tumorigenesis: a scoping review.

Background: Prolactinoma is the leading type of pituitary adenoma. Aside from the mass-like effect of prolactinoma, its hormonal effect is the main pathological cause of endocrine dysregulation and infertility. The dopamine agonist administration and surgical resection are the current mainstream anti-neoplastic treatments for affected patients; however, tumor fibrosis, tumor invasion, dopamine agonist resistance, and gain prolactinomas are clinical challenges for treating affected patients.

Long-term outcome of childhood and adolescent patients with craniopharyngiomas: a single center retrospective experience.

Background: The treatment of craniopharyngiomas (CPs) poses challenges due to their proximity to critical neural structures, the risk of serious complications, and the impairment of quality of life after treatment. However, long-term prognostic data are still scarce. Therefore, the purpose of this retrospective study is to evaluate the long-term outcomes of patients with CPs after treatment.

Approach to the Patient: From Endocrinopathy to the Diagnosis of a Histiocytic Disorder.

Endocrinopathies are frequently the initial presentation of histiocytic neoplasms, which are rare hematologic disorders affecting multiple organ systems. Langerhans cell histiocytosis and Erdheim-Chester disease are 2 such disorders known to infiltrate the hypothalamus and/or pituitary gland, leading to arginine vasopressin deficiency (AVP-D) and anterior pituitary dysfunction (APD) in 20% to 30% of cases, often as the first manifestation. Conversely, histiocytic disorders account for a notable proportion (10-15%) of all pituitary stalk lesions.

Predictors of mortality at 3 months in patients with skull base tumor resections in a low-income setting.

Objective: Globally, skull base tumors are among the most challenging tumors to treat and are known for their significant morbidity and mortality. Hence, this study aimed to identify robust associated factors that contribute to mortality of patients following surgical resection for a variety of skull base tumors at the 3-month follow-up period. This in turn helps devise an evidence-based meticulous treatment strategy and baseline input for quality improvement work.

Modeling craniopharyngioma for drug screening reveals a neuronal mechanism for tumor growth.

Tumors occurring along the hypothalamus-pituitary axis receive axonal projection from neuroendocrine neurons, but it remains unclear whether neuroendocrine neuronal activity drives tumor expansion. Craniopharyngioma is a common suprasellar tumor with a propensity for invading the hypothalamus, leading to devastating endocrine and metabolic disorders. Here, we developed two autochthonous animal models that faithfully recapitulate the molecular pathology, clinical manifestations, and transcriptomic profiles of papillary craniopharyngioma.

Platelet rich fibrin three-layer reconstruction of the sellar floor after endoscopic endonasal transsphenoidal approach: technical note and initial experience.

Background: Cerebrospinal fluid (CSF) leakage frequently complicates endoscopic endonasal transsphenoidal pituitary resections, despite the use of lumbar drains, nasoseptal flaps, or commercial dura sealants. Managing this complication often requires revision surgery and increases the risk of infection. Platelet-rich fibrin (PRF), an affordable autologous biomaterial derived from the patient's blood through short, angulated centrifugation, contains growth factors and leukocytes embedded in a fibrin matrix.

Endoscopic Suturing of Skull Base Dura and its Effectiveness in Preventing CSF Leak.

Proper skull base repair is essential in preventing postoperative cerebrospinal fluid (CSF) leak following endonasal endoscopic skull base surgery. Direct suturing of the skull base dura is desirable but difficult. Here, we discuss the effectiveness of endoscopic suturing of skull base dura in cases of skull base lesions with intraoperative CSF leak.

A novel computational model ITHCS for enhanced prognostic risk stratification in ESCC by correcting for intratumor heterogeneity.

Intratumor heterogeneity significantly challenges the accuracy of existing prognostic models for esophageal squamous cell carcinoma (ESCC) by introducing biases related to the varied genetic and molecular landscapes within tumors. Traditional models, relying on single-sample, single-region bulk RNA sequencing, fall short of capturing the complexity of intratumor heterogeneity. To fill this gap, we developed a computational model for intratumor heterogeneity corrected signature (ITHCS) by employing both multiregion bulk and single-cell RNA sequencing to pinpoint genes that exhibit consistent expression patterns across different tumor regions but vary significantly among patients.

Automatic pituitary adenoma segmentation and identification of cavernous sinus invasion via multitask learning.

Aim: This study aimed to develop a multitask deep learning model for pituitary macroadenoma (PMA) segmentation and identification of cavernous sinus (CS) invasion.

Materials And Methods: A total of 926 patients with PMAs (n=816 from Institution 1 for model training and n=110 from Institution 2 for model validation) were included. Manual segmentation for tumor and bilateral internal carotid arteries was conducted on coronal contrast-enhanced T1-weighted imaging images using ITK-SNAP.

Advancements in Molecular Diagnosis and Pharmacotherapeutic Strategies for Invasive Pituitary Adenomas.

Background: The overwhelming majority of pituitary tumors consist of pituitary adenomas (PAs), which have recently also been termed pituitary neuroendocrine tumors (PitNETs). Clinically significant PAs occur in approximately one in every 1000 individuals, while other types of pituitary tumors, such as craniopharyngiomas and pituicytomas, are significantly less common. Although PAs are generally benign, a subset of them exhibits malignant-like biological traits.

Intravascular large B-cell lymphoma arising in the pituitary gland: A case report.

Rationale: Primary pituitary lymphoma is defined as a lymphoma that develops only in the pituitary gland without involvement of other areas.

Patient Concerns: We present the case of a 61-year-old female patient who underwent an endonasal transsphenoidal approach for the preoperative diagnosis of a pituitary macroadenoma based on radiological findings.

Diagnoses: Microscopically, the capillaries were distended by tumor cells.

Growth Hormone-Secreting Pituitary Adenoma: Dura Mater Invasion Is Not a Predictor of Acromegaly Persistence After Trans-Sphenoidal Surgery.

: In pituitary adenomas, examinations of surgical specimens have shown that dural invasion occurs in 42-85% of cases. No studies about dura mater invasion have been conducted specifically in acromegaly patients. The aim of the present study was to evaluate the relationship between histologically dural invasion and the main features of GH-secreting adenomas.

Postoperative Hemorrhage and Venous Thromboembolism in Patients with Pituitary Adenomas Under Acetylsalicylic Acid.

Postoperative hemorrhages (POHs) after pituitary adenoma surgery can have devastating consequences for patients. Many patients take acetylsalicylic acid (ASA) for the primary or secondary prevention of cardiovascular or stroke events. However, the impact of continued low-dose ASA use on the risk of postoperative hemorrhage and the frequency of thromboembolic events after discontinuing ASA in these patients remain poorly understood.

Cushing's Disease Manifestation in -Mutated Corticotropinoma May Be Mediated by Interactions Between WNT Signaling and SST Trafficking.

In the current work, we aimed to evaluate the association of clinical data of Cushing's disease (CD) patients with mutation status and to study USP8-related molecular mechanisms connected to the regulation of corticotropinoma growth and activity. 35 CD patients were enrolled; the sequencing of exon 14 in revealed variants in eighteen adenomas, two of which were described for the first time in CD. variants were more common in women (94% vs.

Mutations Associated with Cushing's Disease Alter Protein Structure Dynamics.

The adenomas in Cushing's disease frequently exhibit mutations in exon 14, within a binding motif for the regulatory protein 14-3-3 located between the catalytic domain (DUB), responsible for ubiquitin hydrolysis, and the WW-like domain that mediates autoinhibition, resulting in constantly active USP8. The exact molecular mechanism of deubiquitinase activity disruption in Cushing's disease remains unclear. To address this, Sanger sequencing of was performed to identify mutations in corticotropinomas.

The Activation of p300 Enhances the Sensitivity of Pituitary Adenomas to Dopamine Agonist Treatment by Regulating the Transcription of DRD2.

Prolactinomas are commonly treated with dopamine receptor agonists (DAs), such as bromocriptine (BRC) and cabergoline (CAB). However, 10-30% of patients exhibit resistance to DA therapies. DA resistance is largely associated with reduced dopamine D2 receptor (DRD2) expression, potentially regulated by epigenetic modifications, though the underlying mechanisms are still unclear.

Pituitary Gigantism in an Adolescent Girl With Postsurgical Residual Disease Treated With Lanreotide.

Pituitary gigantism (PG) is a rare endocrine disorder that may present with multiple pituitary hormone abnormalities in pediatric patients. A hallmark presentation is accelerated growth due to growth hormone (GH) excess. Current treatment modalities include surgery, radiation, and medical therapy.

A novel multilayered membrane repair technique for high-flow cerebrospinal fluid leaks during expanded endoscopic endonasal tumor resection.

Background: Postoperative cerebrospinal fluid (CSF) leak is a life-threatening complication following endoscopic skull base surgery. This study describes a multilayered membrane reconstruction strategy for treating high-flow intraoperative CSF leaks during expanded endoscopic endonasal tumor resection (EEA) and presents the associated outcomes, supplemented by surgical video documentation.

Methods: A retrospective review was performed on patients who underwent multilayered membrane reconstruction for high-flow CSF leaks during EEA.

Utility of F18-FDG PET/CT in the Evaluation of Pituitary Uptake.

 Pituitary adenoma is the most common disease that affects the gland and may be classified as functional/nonsecretory tumors. Inflammatory/infective causes may also affect the pituitary gland. The 18F-fluorodeoxyglucose positron emission tomography/computed tomography (F18-FDG PET/CT) may have an incremental value in assessing these lesions and in determining their clinical significance.