Endocrinology and Metabolism

Original Articles

Hypothalamus and pituitary gland
⁶⁸Ga-DOTATOC PET/CT in the Localization of Pituitary Tumors in Cushing’s Disease: Kyungwon Kim, Dongwoo Kim, Min-Ho Lee, Yae Won Park, Sung Soo Ahn, Ju Hyung Moon, Eui Hyun Kim, Sun Ho Kim, Cheol Ryong Ku, Eun Jig Lee; Endocrinol Metab. 2025;40(4):637-647. Published online March 18, 2025; DOI: https://doi.org/10.3803/EnM.2024.2249

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Background
This study aimed to determine the value of ⁶⁸Ga-DOTATOC positron emission tomography/computed tomography (PET/CT) in localizing adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas.
Methods
In this retrospective cohort study, we enrolled 30 patients with Cushing’s disease and positive ACTH immunoreactivity. All patients underwent ⁶⁸Ga-DOTATOC PET/CT and pituitary magnetic resonance imaging (MRI) before transsphenoidal adenomectomy.
Results
Twenty-five patients showed ⁶⁸Ga-DOTATOC uptake in their pituitary glands on PET/CT. Median age, pre-operative ACTH levels, pre-operative cortisol, and tumor size on MRI were comparable irrespective of DOTATOC uptake. ⁶⁸Ga-DOTATOC PET/CT showed a 77% success rate for localizing adenomas, which was not statistically different from that of MRI. The ACTH level in the successful localization group was significantly higher than that in the failed group (84.41 pg/mL vs. 37.26 pg/mL, P=0.001). The ACTH level was statistically significant predictor of successful localization using ⁶⁸Ga-DOTATOC PET/CT (P=0.013). The area under the curve was 0.932 with a cutoff of 53.86 pg/mL for ACTH levels to determine successful localization. Pre-operative ACTH levels above 53.86 pg/mL showed the best diagnostic accuracy in predicting the success of localizing adenomas (sensitivity, 91.3%; specificity, 85.7%). Mean and maximum standardized uptake value of adenoma negatively correlated to pre-operative ACTH level.
Conclusion
Plasma ACTH level is a favorable predictor for the successful localization and negative correlation with ⁶⁸Ga-DOTATOC uptake of corticotroph adenomas in ⁶⁸Ga-DOTATOC PET/CT. ⁶⁸Ga-DOTATOC PET/CT did not improve tumor localization for Cushing’s disease compared with MRI alone.

Citations

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Novel Imaging Modalities in the Evaluation of Patients with Pituitary Adenomas
Kevin A. Huynh, James MacFarlane, Waiel A. Bashari, Daniel Gillett, Mark Gurnell
Endocrinology and Metabolism Clinics of North America.2025; 54(4): 549. CrossRef
Research Progress on the Transformation Mechanism of Silent Adrenocorticotropic Hormone Cell Adenoma and Cushing’s Disease
思凡鄢
Advances in Clinical Medicine.2025; 15(11): 93. CrossRef

Hypothalamus and pituitary gland Big Data Articles (National Health Insurance Service Database)
Sex-Specific Cardiovascular Risks and Mortality in Patients with Panhypopituitarism: A Nationwide Cohort Study: Seung Shin Park, Hyunmook Jeong, Chang Ho Ahn, Min Jeong Park, Yong Hwy Kim, Kwangsoo Kim, Jung Hee Kim; Endocrinol Metab. 2025;40(3):469-483. Published online February 11, 2025; DOI: https://doi.org/10.3803/EnM.2024.2176

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Abstract PDF Supplementary Material PubReader ePub: Background
Panhypopituitarism is a condition of combined deficiency of multiple pituitary hormones, which requires lifelong hormone replacement therapy. Hormone deficiency or inadequate hormone replacement may contribute to cardiovascular disease. Here, we aimed to investigate the burden of cardiovascular, cerebrovascular diseases and mortality in patients with panhypopituitarism.
Methods
A total of 5,714 patients with panhypopituitarism were enrolled in the Korean National Health Insurance Service database from 2003 to 2020. Panhypopituitarism was defined according to the International Classification of Diseases, 10th Revision (ICD- 10) codes for hypopituitarism, pituitary adenoma, or craniopharyngioma and the continuous prescription of thyroid hormone and glucocorticoids. The risks of all-cause mortality, coronary artery disease (CAD), heart failure (HF), ischemic stroke, and intracranial hemorrhage were compared between patients with panhypopituitarism and age-, sex-, and index year-matched controls.
Results
The mean age of patients with panhypopituitarism and matched controls was 55.1 years, and men accounted for 51.5%. Patients with panhypopituitarism showed significantly higher all-cause mortality compared to matched controls after adjustment for covariates (hazard ratio [HR], 2.18; 95% confidence interval [CI], 1.95 to 2.43 in men and HR, 3.09; 95% CI, 2.78 to 3.44 in women). Additionally, there were higher risks of CAD, HF, ischemic stroke, and intracranial hemorrhage in both sexes, except for CAD in men.
Conclusion
Patients with panhypopituitarism have elevated risks of cardiovascular and cerebrovascular diseases as well as increased mortality. These risks are particularly prominent for all-cause mortality in women. Therefore, proactive monitoring for cardiovascular and cerebrovascular complications is required in patients with panhypopituitarism.

Review Article

Hypothalamus and pituitary gland
Pituitary Neuroendocrine Tumors in Multiple Endocrine Neoplasia: Sang Ouk Chin, Constance Chik, Toru Tateno; Endocrinol Metab. 2025;40(1):39-46. Published online August 30, 2024; DOI: https://doi.org/10.3803/EnM.2024.2074

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Multiple endocrine neoplasia type 1 (MEN1) is an autosomal-dominant disorder characterized by tumors of the pituitary, parathyroid, and endocrine-gastrointestinal tract. Pituitary neuroendocrine tumors (PitNETs) occur in about 40% of MEN1 cases, with 10% being the first manifestation. Recent studies show a slight female predominance, with microPitNETs (<1 cm) being more common than macroPitNETs (>1 cm). Functional PitNETs (FPitNETs) are more frequent than non-functional ones (36% to 48%), with prolactinomas being the most common FPitNETs. MEN1-associated PitNETs are often plurihormonal, larger, and more invasive compared to sporadic types, though patient age and FPitNET proportions are similar. MEN1 mutation-negative patients tend to have larger, symptomatic PitNETs at diagnosis. Six patients with MEN1 have been reported to have pituitary carcinomas, including a mutation- negative patient. Treatment approach between PitNETs in MEN1 and sporadic types appears to be similar. PitNETs also occur in MEN4, but their epidemiology is less understood. In patients with a MEN1-like phenotype and negative genetic testing, MEN4 should be considered.

Citations

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The evolution and application of multi-omic analysis for pituitary neuroendocrine tumors
Sangami Pugazenthi, Shree S. Pari, Ziyan Zhang, Julie Silverstein, Albert H. Kim, Bhuvic Patel
Frontiers in Medicine.2025;[Epub] CrossRef
The clinical challenge of MEN1 phenocopies: insights from a multicentric national retrospective study
Rosaria M. Ruggeri, Elio Benevento, Iderina Hasballa, Erika Maria Grossrubatscher, Roberta Modica, Manuela Albertelli, Bianca Golisano, Vito Guarnieri, Flavia Pugliese, Valentina Guarnotta, Simona Jaafar, Andrea Lania, Antonio Prinzi, Isabella Zanata, Mar
Journal of Endocrinological Investigation.2025;[Epub] CrossRef

Original Articles

Hypothalamus and pituitary gland
Clinical Characteristics, Diagnosis, and Treatment of Thyroid Stimulating Hormone-Secreting Pituitary Neuroendocrine Tumor (TSH PitNET): A Single-Center Experience: Jung Heo, Yeon-Lim Suh, Se Hoon Kim, Doo-Sik Kong, Do-Hyun Nam, Won-Jae Lee, Sung Tae Kim, Sang Duk Hong, Sujin Ryu, You-Bin Lee, Gyuri Kim, Sang-Man Jin, Jae Hyeon Kim, Kyu Yeon Hur; Endocrinol Metab. 2024;39(2):387-396. Published online February 5, 2024; DOI: https://doi.org/10.3803/EnM.2023.1877

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Background
Thyroid-stimulating hormone (TSH)-secreting pituitary neuroendocrine tumor (TSH PitNET) is a rare subtype of PitNET. We investigated the comprehensive characteristics and outcomes of TSH PitNET cases from a single medical center. Also, we compared diagnostic methods to determine which showed superior sensitivity.
Methods
A total of 17 patients diagnosed with TSH PitNET after surgery between 2002 and 2022 in Samsung Medical Center was retrospectively reviewed. Data on comprehensive characteristics and treatment outcomes were collected. The sensitivities of diagnostic methods were compared.
Results
Seven were male (41%), and the median age at diagnosis was 42 years (range, 21 to 65); the median follow-up duration was 37.4 months. The most common (59%) initial presentation was hyperthyroidism-related symptoms. Hormonal co-secretion was present in four (23%) patients. Elevated serum alpha-subunit (α-SU) showed the greatest diagnostic sensitivity (91%), followed by blunted response at thyrotropin-releasing hormone (TRH) stimulation (80%) and elevated sex hormone binding globulin (63%). Fourteen (82%) patients had macroadenoma, and a specimen of one patient with heavy calcification was negative for TSH. Among 15 patients who were followed up for more than 6 months, 10 (67%) achieved hormonal and structural remission within 6 months postoperatively. A case of growth hormone (GH)/TSH/prolactin (PRL) co-secreting mixed gangliocytoma-pituitary adenoma (MGPA) was discovered.
Conclusion
The majority of the TSH PitNET cases was macroadenoma, and 23% showed hormone co-secretion. A rare case of GH/TSH/PRL co-secreting MGPA was discovered. Serum α-SU and TRH stimulation tests showed great diagnostic sensitivity. Careful consideration is needed in diagnosing TSH PitNET. Achieving remission requires complete tumor resection. In case of nonremission, radiotherapy or medical therapy can improve the long-term remission rate.

Citations

Citations to this article as recorded by

Glucose metabolism in anterior pituitary adenomas
Valeria Hernández-Brito, Stephanie Lemoni Casco-Morales, Andrés Vega-Rosas
Clinica Chimica Acta.2026; 578: 120587. CrossRef
TSH-secreting pituitary adenomas and bone
Marco Losa, Alberto Vassallo, Stefano Frara, Pietro Mortini, Andrea Giustina
Pituitary.2024; 27(6): 752. CrossRef

Hypothalamus and pituitary gland
Preoperative Serum Copeptin Can Predict Delayed Hyponatremia after Pituitary Surgery in the Absence of Arginine Vasopressin Deficiency: Ho Kang, Seung Shin Park, Yoo Hyung Kim, Hwan Sub Lim, Mi-Kyeong Lee, Kyoung-Ryul Lee, Jung Hee Kim, Yong Hwy Kim; Endocrinol Metab. 2024;39(1):164-175. Published online January 3, 2024; DOI: https://doi.org/10.3803/EnM.2023.1792

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Background
Delayed postoperative hyponatremia (DPH) is the most common cause of readmission after pituitary surgery. In this study, we aimed to evaluate the cutoff values of serum copeptin and determine the optimal timing for copeptin measurement for the prediction of the occurrence of DPH in patients who undergo endoscopic transsphenoidal approach (eTSA) surgery and tumor resection.
Methods
This was a prospective observational study of 73 patients who underwent eTSA surgery for pituitary or stalk lesions. Copeptin levels were measured before surgery, 1 hour after extubation, and on postoperative days 1, 2, 7, and 90.
Results
Among 73 patients, 23 patients (31.5%) developed DPH. The baseline ratio of copeptin to serum sodium level showed the highest predictive performance (area under the curve [AUROC], 0.699), and its optimal cutoff to maximize Youden’s index was 2.5×10^–11, with a sensitivity of 91.3% and negative predictive value of 92.0%. No significant predictors were identified for patients with transient arginine vasopressin (AVP) deficiency. However, for patients without transient AVP deficiency, the copeptin-to-urine osmolarity ratio at baseline demonstrated the highest predictive performance (AUROC, 0.725). An optimal cutoff of 6.5×10^–12 maximized Youden’s index, with a sensitivity of 92.9% and a negative predictive value of 94.1%.
Conclusion
The occurrence of DPH can be predicted using baseline copeptin and its ratio with serum sodium or urine osmolarity only in patients without transient AVP deficiency after pituitary surgery.

Citations

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Incidence and risk factors of hyponatremia after transsphenoidal surgery: a systematic meta-analysis
Kevin L. Webb, Charles E. Reilly, Mickayla L. Hinkle, Yuki Shinya, Jamie J. Van Gompel, Fredric B. Meyer
Neurosurgical Review.2025;[Epub] CrossRef
Impact Factors of Blood Copeptin Levels in Health and Disease States
Yutong Wang, Shirui Wang, Siyu Liang, Xinke Zhou, Xiaoyuan Guo, Bochuan Huang, Hui Pan, Huijuan Zhu, Shi Chen
Endocrine Practice.2024; 30(12): 1197. CrossRef

Review Article

Hypothalamus and pituitary gland
Update on Current Evidence for the Diagnosis and Management of Nonfunctioning Pituitary Neuroendocrine Tumors: Elizabeth Whyte, Masahiro Nezu, Constance Chik, Toru Tateno; Endocrinol Metab. 2023;38(6):631-654. Published online November 15, 2023; DOI: https://doi.org/10.3803/EnM.2023.1838

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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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Circulating miR-20a-5p as a biomarker associated with cabergoline responsiveness in patients with hyperprolactinemia and pituitary adenomas
Yang Jong Lee, Jae Won Hong, Yongjae Kim, Jisup Kim, Chan Woo Kang, Min-Ho Lee, Ju Hyung Moon, Eui Hyun Kim, Cheol Ryong Ku, Eun Jig Lee
European Journal of Endocrinology.2025; 192(4): 335. CrossRef
Successful Volume Control of Invasive Pituitary Adenoma Tumor With Pasireotide: A New Horizon for a Challenging Disease
Tarik Elhadd, Shahd I Ibrahim, Elabbass Abdelmahmuod, Susan M Webb
JCEM Case Reports.2025;[Epub] CrossRef
A randomized controlled trial to compare the effects of sevoflurane and propofol for maintenance of anesthesia on postoperative recovery quality in patients undergoing transsphenoidal resection of pituitary adenoma
Yunying Feng, Yuelun Zhang, Wei Lian, Yang Xue, Manjiao Ma, Xuerong Yu, Xiaopeng Guo, Lulu Ma, Bing Xing, Yuguang Huang
BMC Anesthesiology.2025;[Epub] CrossRef
Systematic Cavernous Sinus Exploration Combined With Early Hormonal Assessment in Cushing Disease
Maxwell T. Laws, Ihika Rampalli, David T. Asuzu, Reinier Alvarez, Christina Hayes, Christina Tatsi, Lynnette Nieman, Prashant Chittiboina
Neurosurgery.2025;[Epub] CrossRef
Clinical, radiological, and pathological characteristics and long-term outcomes of silent corticotroph adenomas: a retrospective study
Yuhui Chen, Yang Yang, Heng Zhang, Tianshun Feng, Liangfeng Wei, Shousen Wang
BMC Endocrine Disorders.2025;[Epub] CrossRef
Biomarkers Driving Precision Medicine in Nonfunctioning Pituitary Neuroendocrine Tumors: A Systematic Review of Recent Literature
Amalina Haydar Ali Tajuddin, Nur Firdaus Isa, Mohd Hamzah Mohd Nasir
The Journal of Clinical Endocrinology & Metabolism.2025;[Epub] CrossRef
Association Between the Ki-67 Index, Tumor Size and Postoperative Structural Persistence in Non-functioning Pituitary Neuroendocrine Tumors: A Single-Center Experience
Carlos E Jimenez-Canizales, Juan S Salas-Henao , Gabriela Ballesteros-Oviedo , Rafael Parra-Medina, Edgar G Ordóñez-Rubiano, Johan E Vargas-Vargas, William Rojas
Cureus.2025;[Epub] CrossRef
Phenotype Transformation of PitNETs
Zhenwei Li, Yinzi Wu, Guannan He, Renzhi Wang, Xinjie Bao
Cancers.2024; 16(9): 1731. CrossRef
Donor–Acceptor–Donor Strategy Rouses the Photodynamic Therapy Anticancer Activity of a Bis-terpyridyl Ru(II) Complex
Zhongyu Wang, Li Wei, Junfeng Lin, Can Huang, Huitong Chen, Dong Fan, Weiyu Hu, Jing Liu, Huaiyi Huang, Zongming Wang, Xin Wang
Journal of Medicinal Chemistry.2024; 67(15): 13435. CrossRef
A Study in Pituitary Neuroendocrine Tumors (PitNETs): Real-Life Data Amid Baseline and Serial CT Scans
Mihai Costachescu, Oana-Claudia Sima, Mihaela Stanciu, Ana Valea, Mara Carsote, Claudiu Nistor, Mihai-Lucian Ciobica
Cancers.2024; 16(20): 3477. CrossRef
Editorial: Prognostic factors in pituitary tumors: clinical, biochemical, imaging, and pathological aspects
Toru Tateno, Roxana-Ioana Dumitriu Stan, Stephanie Du Four
Frontiers in Endocrinology.2024;[Epub] CrossRef
Adaptive evaluation of gross total resection rates for endoscopic endonasal approach based on preoperative MRI morphological features of pituitary adenomas
Ao Shen, Yue Min, Dongjie Zhou, Lirui Dai, Liang Lyu, Wenyi Zhan, Shu Jiang, Peizhi Zhou
Frontiers in Oncology.2024;[Epub] CrossRef

Songwon Lecture 2022

Hypothalamus and pituitary gland
Multiomics Approach to Acromegaly: Unveiling Translational Insights for Precision Medicine: Kyungwon Kim, Cheol Ryong Ku, Eun Jig Lee; Endocrinol Metab. 2023;38(5):463-471. Published online October 13, 2023; DOI: https://doi.org/10.3803/EnM.2023.1820

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The clinical characteristics and prognoses of acromegaly vary among patients. Assessment of current and novel predictors can lead to multilevel categorization of patients, allowing integration into new clinical guidelines and a reduction in the increased morbidity and mortality associated with acromegaly. Despite advances in the diagnosis and treatment of acromegaly, its pathophysiology remains unclear. Recent advancements in multiomics technologies, including genomics, transcriptomics, proteomics, metabolomics, and radiomics, have offered new opportunities to unravel the complex pathophysiology of acromegaly. This review comprehensively explores the emerging role of multiomics approaches in elucidating the molecular landscape of acromegaly. We discuss the potential implications of multiomics data integration in the development of novel diagnostic tools, identification of therapeutic targets, and the prospects of precision medicine in acromegaly management. By integrating diverse omics datasets, these approaches can provide valuable insights into disease mechanisms, facilitate the identification of diagnostic biomarkers, and identify potential therapeutic targets for precision medicine in the management of acromegaly.

Citations

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“Micromegaly”: Acromegaly with apparently normal GH, an entity on its own?
Lucio Vilar, Luciana Ansaneli Naves, Manoel Ricardo Alves Martins, Antônio Ribeiro-Oliveira Jr
Best Practice & Research Clinical Endocrinology & Metabolism.2024; 38(3): 101878. CrossRef

Special Article

Miscellaneous
Immune Checkpoint Inhibitors and Endocrine Disorders: A Position Statement from the Korean Endocrine Society: Hyemi Kwon, Eun Roh, Chang Ho Ahn, Hee Kyung Kim, Cheol Ryong Ku, Kyong Yeun Jung, Ju Hee Lee, Eun Heui Kim, Sunghwan Suh, Sangmo Hong, Jeonghoon Ha, Jun Sung Moon, Jin Hwa Kim, Mi-kyung Kim, The Committee of Clinical Practice Guideline of the Korean Endocrine Society; Endocrinol Metab. 2022;37(6):839-850. Published online December 26, 2022; DOI: https://doi.org/10.3803/EnM.2022.1627

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Immune checkpoint inhibitors (ICIs) including an anti-cytotoxic T-lymphocyte-associated antigen 4 inhibitor, anti-programmed cell death protein 1 (PD-1) inhibitors, and anti-PD-ligand 1 inhibitors are representative therapeutics for various malignancies. In oncology, the application of ICIs is currently expanding to a wider range of malignancies due to their remarkable clinical outcomes. ICIs target immune checkpoints which suppress the activity of T-cells that are specific for tumor antigens, thereby allowing tumor cells to escape the immune response. However, immune checkpoints also play a crucial role in preventing autoimmune reactions. Therefore, ICIs targeting immune checkpoints can trigger various immune-related adverse events (irAEs), especially in endocrine organs. Considering the endocrine organs that are frequently involved, irAEs associated endocrinopathies are frequently life-threatening and have unfavorable clinical implications for patients. However, there are very limited data from large clinical trials that would inform the development of clinical guidelines for patients with irAEs associated endocrinopathies. Considering the current clinical situation, in which the scope and scale of the application of ICIs are increasing, position statements from clinical specialists play an essential role in providing the appropriate recommendations based on both medical evidence and clinical experience. As endocrinologists, we would like to present precautions and recommendations for the management of immune-related endocrine disorders, especially those involving the adrenal, thyroid, and pituitary glands caused by ICIs.

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Clinical manifestations and risk factors of immune-related thyroid adverse events in patients treated with PD-1 inhibitors: a case-control study
Pengfei Zhao, Jia Li, Lihong Yu, Wenming Ma, Ting Zhao
Frontiers in Immunology.2025;[Epub] CrossRef
Immune Checkpoint Inhibitor-Related Hypophysitis: A Call for Vigilance
Ju Hee Lee
Endocrinology and Metabolism.2025; 40(3): 391. CrossRef
Panhypopituitarism Presenting as Myxedema Coma Unveiling Sheehan’s Syndrome
Mennaallah Eid, Daniel Joseph Toft, Kalyani Sen
Case Reports in Endocrinology.2025;[Epub] CrossRef
Patterns of hormonal changes in hypophysitis by immune checkpoint inhibitor
Hyunji Sang, Yun Kyung Cho, Sang-hyeok Go, Hwa Jung Kim, Eun Hee Koh
The Korean Journal of Internal Medicine.2024; 39(5): 801. CrossRef
Pembrolizumab plus lenvatinib for radically unresectable or metastatic renal cell carcinoma in the Japanese population
Ryo Fujiwara, Takeshi yuasa, kenichi kobayashi, tetsuya yoshida, susumu kageyama
Expert Review of Anticancer Therapy.2023; 23(5): 461. CrossRef
Incidence of Endocrine-Related Dysfunction in Patients Treated with New Immune Checkpoint Inhibitors: A Meta-Analysis and Comprehensive Review
Won Sang Yoo, Eu Jeong Ku, Eun Kyung Lee, Hwa Young Ahn
Endocrinology and Metabolism.2023; 38(6): 750. CrossRef

Review Articles

Hypothalamus and Pituitary Gland
Independent Skeletal Actions of Pituitary Hormones: Se-Min Kim, Farhath Sultana, Funda Korkmaz, Daria Lizneva, Tony Yuen, Mone Zaidi; Endocrinol Metab. 2022;37(5):719-731. Published online September 28, 2022; DOI: https://doi.org/10.3803/EnM.2022.1573

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Over the past years, pituitary hormones and their receptors have been shown to have non-traditional actions that allow them to bypass the hypothalamus-pituitary-effector glands axis. Bone cells—osteoblasts and osteoclasts—express receptors for growth hormone, follicle stimulating hormone (FSH), thyroid stimulating hormone (TSH), adrenocorticotrophic hormone (ACTH), prolactin, oxytocin, and vasopressin. Independent skeletal actions of pituitary hormones on bone have been studied using genetically modified mice with haploinsufficiency and by activating or inactivating the receptors pharmacologically, without altering systemic effector hormone levels. On another front, the discovery of a TSH variant (TSH-βv) in immune cells in the bone marrow and skeletal action of FSHβ through tumor necrosis factor α provides new insights underscoring the integrated physiology of bone-immune-endocrine axis. Here we discuss the interaction of each pituitary hormone with bone and the potential it holds in understanding bone physiology and as a therapeutic target.

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Plasma proteomic profiles reveal proteins and three characteristic patterns associated with osteoporosis: A prospective cohort study
Yi Zheng, Jincheng Li, Yucan Li, Jiacheng Wang, Chen Suo, Yanfeng Jiang, Li Jin, Kelin Xu, Xingdong Chen
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Fracture risks in patients aged 50 years and older with panhypopituitarism: a nationwide cohort study
Seung Shin Park, Hyunmook Jeong, Chang Ho Ahn, Min Jeong Park, Sung Hye Kong, Sang Wan Kim, Chan Soo Shin, Yong Hwy Kim, Kwangsoo Kim, Jung Hee Kim
Osteoporosis International.2025; 36(10): 1951. CrossRef
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Aleksandra Zdrojowy-Wełna, Barbara Stachowska, Marek Bolanowski
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Skeletal fragility in pituitary disease: how can we predict fracture risk?
Fabio Bioletto, Alessandro Maria Berton, Marco Barale, Luigi Simone Aversa, Lorenzo Sauro, Michela Presti, Francesca Mocellini, Noemi Sagone, Ezio Ghigo, Massimo Procopio, Silvia Grottoli
Pituitary.2024; 27(6): 789. CrossRef
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Tianming Wang, Jianya Ye, Yongqiang Zhang, Jiayi Li, Tianxiao Yang, Yufeng Wang, Xiao Jiang, Qingqiang Yao
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Modern approach to bone comorbidity in prolactinoma
Meliha Melin Uygur, Sara Menotti, Simona Santoro, Andrea Giustina
Pituitary.2024; 27(6): 802. CrossRef
New tools for bone health assessment in secreting pituitary adenomas
Meliha Melin Uygur, Stefano Frara, Luigi di Filippo, Andrea Giustina
Trends in Endocrinology & Metabolism.2023; 34(4): 231. CrossRef
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Dongjin Lee, Moon Ahn
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The mechanism of oxytocin and its receptors in regulating cells in bone metabolism
Liu Feixiang, Feng Yanchen, Li Xiang, Zhang Yunke, Miao Jinxin, Wang Jianru, Lin Zixuan
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Scientific Reports.2023;[Epub] CrossRef

Hypothalamus and Pituitary Gland
Advances in Pituitary Surgery: Yoon Hwan Byun, Ho Kang, Yong Hwy Kim; Endocrinol Metab. 2022;37(4):608-616. Published online August 19, 2022; DOI: https://doi.org/10.3803/EnM.2022.1546

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Pituitary surgery has advanced considerably in recent years with the exploration and development of various endoscopic approaches and techniques. Different endoscopic skull base approaches are being applied to access sellar tumors in different locations. Moreover, extracapsular dissection and cavernous sinus exploration have enabled gross total resection of sellar tumors where it could not have been achieved in the past. Techniques for skull base reconstruction have also progressed, allowing surgeons to remove larger and more complicated tumors than before. This review article discusses different endoscopic skull base approaches, surgical techniques for removing pituitary adenomas, and reconstruction methods for repairing postoperative low-flow and high-flow cerebrospinal fluid leakage.

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Gage A. Guerra, Apurva Prasad, Ishan Shah, David J. Cote, David Gomez, Racheal Peterson, Mark Shiroishi, John Carmichael, Robert G. Briggs, Gabriel Zada
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Plastic and Reconstructive Surgery - Global Open.2025; 13(6): e6834. CrossRef
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Carlos F. Nicolas-Cruz, J. Tomás Moncada-Habib, Marco Antonio Munuzuri-Camacho, Jorge F Aragón-Arreola, Juan Luis Gomez Amador
Surgical Neurology International.2025; 16: 421. CrossRef
U vùng tuyến yên và trên yên: đánh giá kết quả phẫu thuật lấy u bằng đường nội soi qua xoang bướm
Mai Hoàng Vũ, Chu Tấn Sĩ, Đặng Bảo Ngọc, Huỳnh Trí Dũng, Lê Xuân Sang, Phan Vân Đình, Phan Duy Quang
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Original Article

Hypothalamus and Pituitary Gland
Metabolic Impacts of Discontinuation and Resumption of Recombinant Human Growth Hormone Treatment during the Transition Period in Patients with Childhood-Onset Growth Hormone Deficiency: Yun Jeong Lee, Yunha Choi, Han-Wook Yoo, Young Ah Lee, Choong Ho Shin, Han Saem Choi, Ho-Seong Kim, Jae Hyun Kim, Jung Eun Moon, Cheol Woo Ko, Moon Bae Ahn, Byung-Kyu Suh, Jin-Ho Choi; Endocrinol Metab. 2022;37(2):359-368. Published online April 25, 2022; DOI: https://doi.org/10.3803/EnM.2021.1384

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Background
Discontinuing growth hormone (GH) treatment during the transition to adulthood has been associated with adverse health outcomes in patients with childhood-onset growth hormone deficiency (CO-GHD). This study investigated the metabolic changes associated with interrupting GH treatment in adolescents with CO-GHD during the transition period.
Methods
This study included 187 patients with CO-GHD who were confirmed to have adult GHD and were treated at six academic centers in Korea. Data on clinical parameters, including anthropometric measurements, metabolic profiles, and bone mineral density (BMD) at the end of childhood GH treatment, were collected at the time of re-evaluation for GHD and 1 year after treatment resumption.
Results
Most patients (n=182, 97.3%) had organic GHD. The median age at treatment discontinuation and re-evaluation was 15.6 and 18.7 years, respectively. The median duration of treatment interruption was 2.8 years. During treatment discontinuation, body mass index Z-scores and total cholesterol, low-density lipoprotein, and non-high-density lipoprotein (HDL) cholesterol levels increased, whereas fasting glucose levels decreased. One year after GH treatment resumption, fasting glucose levels, HDL cholesterol levels, and femoral neck BMD increased significantly. Longer GH interruption (>2 years, 60.4%) resulted in worse lipid profiles at re-evaluation. The duration of interruption was positively correlated with fasting glucose and non-HDL cholesterol levels after adjusting for covariates.
Conclusion
GH treatment interruption during the transition period resulted in worse metabolic parameters, and a longer interruption period was correlated with poorer outcomes. GH treatment should be resumed early in patients with CO-GHD during the transition period.

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Special Article

Miscellaneous
COVID-19 Vaccination for Endocrine Patients: A Position Statement from the Korean Endocrine Society: Cheol Ryong Ku, Kyong Yeun Jung, Chang Ho Ahn, Jun Sung Moon, Ju Hee Lee, Eun Heui Kim, Hyemi Kwon, Hee Kyung Kim, Sunghwan Suh, Sangmo Hong, Jeonghoon Ha, Eun Roh, Jin Hwa Kim, Mi-kyung Kim, the Committee of Clinical Practice Guideline of the Korean Endocrine Society; Endocrinol Metab. 2021;36(4):757-765. Published online August 17, 2021; DOI: https://doi.org/10.3803/EnM.2021.404

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Since the first outbreak of coronavirus disease 2019 (COVID-19), ongoing efforts have been made to discover an efficacious vaccine against COVID-19 to combat the pandemic. In most countries, both mRNA and DNA vaccines have been administered, and their side effects have also been reported. The clinical course of COVID-19 and the effects of vaccination against COVID-19 are both influenced by patients’ health status and involve a systemic physiological response. In view of the systemic function of endocrine hormones, endocrine disorders themselves and the therapeutics used to treat them can influence the outcomes of vaccination for COVID-19. However, there are very limited data to support the development of clinical guidelines for patients with specific medical backgrounds based on large clinical trials. In the current severe circumstances of the COVID-19 pandemic, position statements made by clinical specialists are essential to provide appropriate recommendations based on both medical evidence and clinical experiences. As endocrinologists, we would like to present the medical background of COVID-19 vaccination, as well as precautions to prevent the side effects of COVID-19 vaccination in patients with specific endocrine disorders, including adrenal insufficiency, diabetes mellitus, osteoporosis, autoimmune thyroid disease, hypogonadism, and pituitary disorders.

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Original Articles

Hypothalamus and Pituitary Gland Big Data Articles (National Health Insurance Service Database)
Descriptive Epidemiology and Survival Analysis of Prolactinomas and Cushing’s Disease in Korea: Jin Sun Park, Soo Jin Yun, Jung Kuk Lee, So Young Park, Sang Ouk Chin; Endocrinol Metab. 2021;36(3):688-696. Published online June 28, 2021; DOI: https://doi.org/10.3803/EnM.2021.1000

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Background
Only a few studies have established the epidemiology of prolactinoma and Cushing’s disease in Korea. Furthermore, the incidence of these disease are increasing than before associated with the development of technologies. This study was designed to evaluate the epidemiology of prolactinoma and Cushing’s disease and their survival analysis according to treatment.
Methods
The nationwide, population-based study evaluated incidence and prevalence of prolactinoma and Cushing’s disease using de-identified claims data in The Korean Health Insurance Review and Assessment Service database between 2013 and 2017. The survival analysis investigated regarding treatment over a period of 6 years. A log-rank test and Cox proportional hazard regression analysis were used.
Results
The 6,056 patients with newly diagnosed prolactinoma and 584 patients with Cushing’s disease were recorded between 2013 and 2017. The annual incidence of prolactinoma was 23.5 cases per million, and its prevalence was 82.5 cases per million, and 2.3 cases per million/year and 9.8 cases per million for Cushing’s disease. The survival benefit was insignificant in prolactinoma according to treatment, but treatment of Cushing’s disease ameliorated the survival rate significantly.
Conclusion
Overall, the incidence of prolactinoma and Cushing’s disease was similar with those found previously, but the prevalence of two diseases were inconsistent when compared with the early studies. The present study also proposed necessity of treatment in Cushing’s disease for improving the survival rate.

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Meng Wang, Xueting Sun, Shiwei Li, Xin Li, Jingqiu Cui
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Kyungwon Kim, Dongwoo Kim, Min-Ho Lee, Yae Won Park, Sung Soo Ahn, Ju Hyung Moon, Eui Hyun Kim, Sun Ho Kim, Cheol Ryong Ku, Eun Jig Lee
Endocrinology and Metabolism.2025; 40(4): 637. CrossRef
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Min-Ho Lee, Jae Won Hong, Kyungwon Kim, Cheol Ryong Ku, Eun Jig Lee
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Big Data Research in the Field of Endocrine Diseases Using the Korean National Health Information Database
Sun Wook Cho, Jung Hee Kim, Han Seok Choi, Hwa Young Ahn, Mee Kyoung Kim, Eun Jung Rhee
Endocrinology and Metabolism.2023; 38(1): 10. CrossRef
Cushing Syndrome
Martin Reincke, Maria Fleseriu
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Shlomo Melmed, Ursula B Kaiser, M Beatriz Lopes, Jerome Bertherat, Luis V Syro, Gerald Raverot, Martin Reincke, Gudmundur Johannsson, Albert Beckers, Maria Fleseriu, Andrea Giustina, John A H Wass, Ken K Y Ho
Endocrine Reviews.2022; 43(6): 1003. CrossRef

Hypothalamus and Pituitary Gland
Heart Rate Variability in Postoperative Patients with Nonfunctioning Pituitary Adenoma: Jeonghoon Ha, Hansang Baek, Chaiho Jeong, Minsoo Yeo, Seung-Hwan Lee, Jae Hyoung Cho, Ki-Hyun Baek, Moo Il Kang, Dong-Jun Lim; Endocrinol Metab. 2021;36(3):678-687. Published online June 10, 2021; DOI: https://doi.org/10.3803/EnM.2021.978

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Background
Decreased heart rate variability (HRV) has been reported to be associated with cardiac autonomic dysfunction. Hypopituitarism in nonfunctioning pituitary adenoma (NFPA) is often linked to increased cardiovascular mortality. We therefore hypothesized that postoperative NFPA patients with hormone deficiency have an elevated risk of HRV alterations indicating cardiac autonomic dysfunction.
Methods
A total of 22 patients with NFPA were enrolled in the study. Between 3 and 6 months after surgery, a combined pituitary function test (CPFT) was performed, and HRV was measured. The period of sleep before the CPFT was deemed the most stable period, and the hypoglycemic period that occurred during the CPFT was defined as the most unstable period. Changes in HRV parameters in stable and unstable periods were observed and compared depending on the status of hormone deficiencies.
Results
In patients with adrenocorticotropic hormone (ACTH) deficiency with other pituitary hormone deficiencies, the low frequency to high frequency ratio, which represents overall autonomic function and is increased in the disease state, was higher (P=0.005). Additionally, the standard deviation of the normal-to-normal interval, which decreases in the autonomic dysfunction state, was lower (P=0.030) during the hypoglycemic period. In panhypopituitarism, the low frequency to high frequency ratio during the hypoglycemic period was increased (P=0.007).
Conclusion
HRV analysis during CPFT enables estimation of cardiac autonomic dysfunction in patients with NFPA who develop ACTH deficiency with other pituitary hormone deficiencies or panhypopituitarism after surgery. These patients may require a preemptive assessment of cardiovascular risk.

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Review Article

Hypothalamus and Pituitary gland
Best Achievements in Pituitary and Adrenal Diseases in 2020: Chang Ho Ahn, Jung Hee Kim; Endocrinol Metab. 2021;36(1):51-56. Published online February 24, 2021; DOI: https://doi.org/10.3803/EnM.2021.108

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Significant progress in pituitary and adrenal diseases was made in 2020. This review presents major translational and clinical advances in research on pituitary and adrenal diseases, encompassing their epidemiology, pathogenesis, diagnosis, and clinical management. We address the controversy regarding the nomenclature of pituitary neuroendocrine tumors, omics-based molecular classification of pituitary adenomas, and novel drugs for Cushing’s disease in the field of pituitary diseases. In the field of adrenal diseases, we cover big data-driven epidemiology of adrenal tumors, steroid profiling as a new diagnostic tool, and the utility of scoring systems in the decision-making process of managing primary aldosteronism. This brief article will broaden readers’ understanding of pituitary and adrenal diseases.

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Special Article

Miscellaneous
Diagnosis and Treatment of Growth Hormone Deficiency: A Position Statement from Korean Endocrine Society and Korean Society of Pediatric Endocrinology: Jung Hee Kim, Hyun Wook Chae, Sang Ouk Chin, Cheol Ryong Ku, Kyeong Hye Park, Dong Jun Lim, Kwang Joon Kim, Jung Soo Lim, Gyuri Kim, Yun Mi Choi, Seong Hee Ahn, Min Ji Jeon, Yul Hwangbo, Ju Hee Lee, Bu Kyung Kim, Yong Jun Choi, Kyung Ae Lee, Seong-Su Moon, Hwa Young Ahn, Hoon Sung Choi, Sang Mo Hong, Dong Yeob Shin, Ji A Seo, Se Hwa Kim, Seungjoon Oh, Sung Hoon Yu, Byung Joon Kim, Choong Ho Shin, Sung-Woon Kim, Chong Hwa Kim, Eun Jig Lee; Endocrinol Metab. 2020;35(2):272-287. Published online June 24, 2020; DOI: https://doi.org/10.3803/EnM.2020.35.2.272

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Growth hormone (GH) deficiency is caused by congenital or acquired causes and occurs in childhood or adulthood. GH replacement therapy brings benefits to body composition, exercise capacity, skeletal health, cardiovascular outcomes, and quality of life. Before initiating GH replacement, GH deficiency should be confirmed through proper stimulation tests, and in cases with proven genetic causes or structural lesions, repeated GH stimulation testing is not necessary. The dosing regimen of GH replacement therapy should be individualized, with the goal of minimizing side effects and maximizing clinical improvements. The Korean Endocrine Society and the Korean Society of Pediatric Endocrinology have developed a position statement on the diagnosis and treatment of GH deficiency. This position statement is based on a systematic review of evidence and expert opinions.

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Review Articles

Hypothalamus and Pituitary gland
Epidemiology of Functioning Pituitary Adenomas: Sang Ouk Chin; Endocrinol Metab. 2020;35(2):237-242. Published online June 24, 2020; DOI: https://doi.org/10.3803/EnM.2020.35.2.237

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Pituitary adenomas (PAs) are defined as benign monoclonal tumors in the pituitary gland that cause symptoms due to either hormonal hypersecretion or a space-occupying effect, and are classified as functioning or non-functioning. Because of their rarity and slow-growing with symptomless nature in most cases, it has been challenging to investigate the epidemiology of PAs. Considering their public health impact and association with increased morbidity and mortality, however, it is essential to understand the prevalence and incidence of PAs in order to improve patient outcomes and to minimize the resultant burden on the health care system. Fortunately, developments in imaging modalities and easier access to large-scale population data have enabled investigators to analyze the epidemiology of PAs more accurately. This review summarizes previously reported epidemiologic data on functioning PAs in Korea and other countries.

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Non-recurrent mutations and copy number changes predominate pituitary adenoma genomes
Dipika R Mohan, Ticiana Paes, Jacobo Buelvas Mebarak, David M Meredith, Beatriz Soares, Victor Vaz, Rona S Carroll, Ursula B Kaiser, Timothy R Smith, Wenya L Bi, Antonio M Lerario, Ana Paula Abreu
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Spontaneous Cerebrospinal Fluid Rhinorrhea in Pre-operative Pituitary Adenoma: A Report of Two Cases
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Surgical effect of the medial wall resection of the cavernous sinus for functional pituitary adenomas
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Transcriptome of GH-producing pituitary neuroendocrine tumours and models are significantly affected by somatostatin analogues
Rihards Saksis, Olesja Rogoza, Helvijs Niedra, Kaspars Megnis, Ilona Mandrika, Inga Balcere, Liva Steina, Janis Stukens, Austra Breiksa, Jurijs Nazarovs, Jelizaveta Sokolovska, Ilze Konrade, Raitis Peculis, Vita Rovite
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Prognostic Models in Growth-Hormone- and Prolactin-Secreting Pituitary Neuroendocrine Tumors: A Systematic Review
Roxana-Ioana Dumitriu-Stan, Iulia-Florentina Burcea, Teodor Salmen, Catalina Poiana
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Salivary microbiome profiles for different clinical phenotypes of pituitary adenomas by single-molecular long-read sequencing
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Microbiology Spectrum.2023;[Epub] CrossRef
Endoscopic endonasal surgical management of giant pituitary adenomas with extension into ventricle system
Mykola O. Guk, Oleksii V. Ukrainets
Ukrainian Neurosurgical Journal.2023; 29(4): 13. CrossRef
Uso de resonancia magnética nuclear intraoperatoria en la resección transesfenoidal de adenomas hipofisiarios: ¿qué resultados se han obtenido?
María Laura Boschetti Saer, Levino Roberto Boschetti, Jose Pastor Linarez Veloz, Michael Ortega-Sierra
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Single Cell Metabolic Landscape of Pituitary Neuroendocrine Tumor Subgroups and Lineages
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Luz E. Castellanos, Catherine Gutierrez, Timothy Smith, Edward R. Laws, J. Bryan Iorgulescu
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The kinome, cyclins and cyclin-dependent kinases of pituitary adenomas, a look into the gene expression profile among tumors from different lineages
Keiko Taniguchi-Ponciano, Lesly A. Portocarrero-Ortiz, Gerardo Guinto, Sergio Moreno-Jimenez, Erick Gomez-Apo, Laura Chavez-Macias, Eduardo Peña-Martínez, Gloria Silva-Román, Sandra Vela-Patiño, Jesús Ordoñez-García, Sergio Andonegui-Elguera, Aldo Ferreir
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IL-10 Gene Rs1800871, Rs1800872, and Rs1800896 Polymorphisms and IL-10 Serum Levels Association with Pituitary Adenoma
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Genome wide analysis of circulating miRNAs in growth hormone secreting pituitary neuroendocrine tumor patients’ plasma
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Surgery is a safe, effective first-line treatment modality for noninvasive prolactinomas
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Hypothalamus and Pituitary gland
Precision Therapy in Acromegaly Caused by Pituitary Tumors: How Close Is It to Reality?: Cheol Ryong Ku, Vladimir Melnikov, Zhaoyun Zhang, Eun Jig Lee; Endocrinol Metab. 2020;35(2):206-216. Published online June 24, 2020; DOI: https://doi.org/10.3803/EnM.2020.35.2.206

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Acromegaly presents with an enigmatic range of symptoms and comorbidities caused by chronic and progressive growth hormone elevations, commonly due to endocrinologic hypersecretion from a pituitary gland tumor. Comprehensive national acromegaly databases have been appearing over the years, allowing for international comparisons of data, although still presenting varying prevalence and incidence rates. Lack of large-scale analysis in geographical and ethnic differences in clinical presentation and management requires further research. Assessment of current and novel predictors of responsiveness to distinct therapy can lead to multilevel categorization of patients, allowing integration into new clinical guidelines and reduction of increased morbidity and mortality associated with acromegaly. This review compares current data from epidemiological studies and assesses the present-day application of prognostic factors in medical practice, the reality of precision therapy, as well as its future prospects in acromegaly, with a special focus on its relevance to the South Korean population.

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Risk of Neurodegenerative Diseases in Patients With Acromegaly
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Machine Learning-based Prediction Model for Treatment of Acromegaly With First-generation Somatostatin Receptor Ligands
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Miscellaneous
Machine Learning Applications in Endocrinology and Metabolism Research: An Overview: Namki Hong, Heajeong Park, Yumie Rhee; Endocrinol Metab. 2020;35(1):71-84. Published online March 19, 2020; DOI: https://doi.org/10.3803/EnM.2020.35.1.71

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Machine learning (ML) applications have received extensive attention in endocrinology research during the last decade. This review summarizes the basic concepts of ML and certain research topics in endocrinology and metabolism where ML principles have been actively deployed. Relevant studies are discussed to provide an overview of the methodology, main findings, and limitations of ML, with the goal of stimulating insights into future research directions. Clear, testable study hypotheses stem from unmet clinical needs, and the management of data quality (beyond a focus on quantity alone), open collaboration between clinical experts and ML engineers, the development of interpretable high-performance ML models beyond the black-box nature of some algorithms, and a creative environment are the core prerequisites for the foreseeable changes expected to be brought about by ML and artificial intelligence in the field of endocrinology and metabolism, with actual improvements in clinical practice beyond hype. Of note, endocrinologists will continue to play a central role in these developments as domain experts who can properly generate, refine, analyze, and interpret data with a combination of clinical expertise and scientific rigor.

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Original Articles

Endocrine Research
Therapeutic Effect of a Novel Chimeric Molecule Targeting Both Somatostatin and Dopamine Receptors on Growth Hormone-Secreting Pituitary Adenomas: Jean Kim, Ju Hun Oh, Heather Harlem, Michael D. Culler, Cheol Ryong Ku, Eun Jig Lee; Endocrinol Metab. 2020;35(1):177-187. Published online March 19, 2020; DOI: https://doi.org/10.3803/EnM.2020.35.1.177

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Background

Acromegaly is a rare disease primarily caused by growth hormone (GH)-secreting pituitary adenomas, and its treatment is costly. Moreover, some patients are unresponsive to treatment. Hence, there are increasing efforts to develop new drugs with improved effectiveness for this disease. BIM23B065 is a novel chimeric molecule that acts on both somatostatin and dopamine receptors. This study aimed to investigate the effects of BIM23B065 compared with those of a somatostatin receptor analog and a dopamine agonist.

Methods

The effects of BIM23B065 on the proliferation, GH and insulin-like growth factor-1 (IGF-1) levels, and extracellular signal-regulated kinase (ERK) 1/2 and cyclic AMP response element binding (CREB) phosphorylation of GH3 cells were investigated with MTS assay, enzyme-linked immunosorbent assay, and Western blotting, respectively. The dosage and treatment duration of BIM23B065 were tested in animal models of GH-secreting pituitary adenoma. The effect of BIM23B065 (3 mg/kg/day) on changes in IGF-1 levels before and after treatment was further investigated.

Results

In vitro, BIM23B065 treatment decreased GH release in the culture media and downregulated ERK 1/2 and CREB phosphorylation to 22% and 26%, respectively. In vivo, IGF-1 expression decreased to 50 % after 4 weeks of treatment with BIM23B065 using an osmotic pump implant. Moreover, magnetic resonance imaging results showed that the tumor size decreased significantly following treatment with BIM23B065 for 4 weeks.

Conclusion

The novel chimeric molecule was effective in decreasing IGF-1 and GH levels and may serve as an effective therapeutic agent for acromegaly.

Citations

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Pituitary Tumorigenesis—Implications for Management
Rodanthi Vamvoukaki, Maria Chrysoulaki, Grigoria Betsi, Paraskevi Xekouki
Medicina.2023; 59(4): 812. CrossRef
Current and Emerging Medical Therapies in Pituitary Tumors
Nicolas Sahakian, Frédéric Castinetti, Thierry Brue, Thomas Cuny
Journal of Clinical Medicine.2022; 11(4): 955. CrossRef
Characterization of the ability of a, second-generation SST-DA chimeric molecule, TBR-065, to suppress GH secretion from human GH-secreting adenoma cells
Thomas Cuny, Thomas Graillon, Célines Defilles, Rakesh Datta, Shengwen Zhang, Dominique Figarella-Branger, Henry Dufour, Grégory Mougel, Thierry Brue, Tanya Landsman, Heather A. Halem, Michael D. Culler, Anne Barlier, Alexandru Saveanu
Pituitary.2021; 24(3): 351. CrossRef
Efficacy of a Novel Second-Generation Somatostatin-Dopamine Chimera (TBR-065) in Human Medullary Thyroid Cancer: A Preclinical Study
Alessandra Dicitore, Maria Celeste Cantone, Germano Gaudenzi, Davide Saronni, Silvia Carra, Maria Orietta Borghi, Manuela Albertelli, Diego Ferone, Leo J. Hofland, Luca Persani, Giovanni Vitale
Neuroendocrinology.2021; 111(10): 937. CrossRef
Emerging drugs for the treatment of acromegaly
Claudia Campana, Giuliana Corica, Federica Nista, Francesco Cocchiara, Giulia Graziani, Keyvan Khorrami, Marta Franco, Mara Boschetti, Diego Ferone, Federico Gatto
Expert Opinion on Emerging Drugs.2020; 25(4): 409. CrossRef

Pituitary Stalk Transection Syndrome.: Yong Hwan Cho, Jae Hoon Shin; J Korean Endocr Soc. 1996;11(3):324-329. Published online November 7, 2019

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Abstract PDF: We experienced one case of severe pituitary dwarfism in a 16 years old male boy that magnetic resonance image(MRI) revealed transection of the pituitary stalk with the ectopic location of posterior pituitary gland and hypoplastic anterior pituitary gland. The serum growth horrnone(GH) response to clonidine and L-dopa revealed severe GH deficiency. The patient revealed normal response in TSH, prolactin and LH, FSH to TRH and LHRH respectively. So far, the primary cause of idiopathic pituitary dwarfism in many patients was due to hypoxic injury to hypothalmus by perinatal insults. In this patients, there was no history of perinatal insults and postnatal head trauma. We report a case of severe dwarfism due to hypogenesis of anterior pituitary gland.

A Clinical Study on Hypopitutiarism: Significance of Combined Pituitary Stimulation Test.: Bo Youn Cho, Hong Gyu Lee, Chang Soon Koh, Hyung Kyu Park, Sook Kyung Kim, Chan Soo Shin, Seong Yeon Kim, Jae Seok Chun, Kyung Soo Park, Hyeon Kyu Kim, Sun Wook Kim; J Korean Endocr Soc. 1996;11(3):268-276. Published online November 7, 2019

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Abstract PDF: Background
Hypopituitarism can be caused by various diseases. Its clinical manifestations vary, depending on the extent and severity of the pituitary hormone deficiency. And some patients may initially present with SIADH-like features. Combined pituitary stimulation test has been used for the diagnosis of hypopituitarism and subsequent hormone replacement therapy. However, the test is laborious, expensive and uncomfortable to the patients, So we performed this study to know whether combined pituitary stimulation test can be replaced with clinical features and simple basal hormone concentrations. Methods: Fifty-four patients who were diagnosed as hypopituitarism by combined pituitary stimulation test were included in this study. Clinical features and basal hormone data were compared with the results of combined pituitary stimulation test for the evaluation of pituitary-gonadal, pituitary-thyroid, and pituitary-adrenal axes, using X2 test. Results: 1) In pituitary-gonadal axis, the evaluation of clinical features and basal gonad hormone concentrations were significantly consistent with stimulation test(p<0.05), 2) In pituitary-thyroid axis, the evaluation of basal thyroid hormone concentrations were more helpful than stimulation test though results of the two tests were not consistent. 3) In pituitary-adrenal axis, all patients whose basal cortisol concentrations were low showed inadequate responses to stimulation test. However, stimulation test revealed adrenal insufficiency in some patients with normal basal cortisol concentrations. 4) 9 patients who presented with SIADH-like features were older than the others and had all corticotropin deficiency. Conclusion: In patients with suspected hypopituitarism, the evaluation of clinical features and basal hormone concentrations can be sufficient for the diagnosis of hypopituitarism and hormone replacement therapy. However, stimulation test is necessary to investigate adrenal function in patients with normal basal cortisol concentrations. And hypopituitarism should be considered in old patients who present with SIADH-like features.

Case Reports

A Case of Pituitary Feedback Adenoma Caused by Primary Hypothyroidism.: Soon Jib Yoo, Sang A Chang, Yoo Bae Ahn, Hyun Sik Son, Kun Ho Yoon, Moo Il Kang, Bong Yun Cha, Kwang Woo Lee, Ho Young Son, Sung Koo Kang, Myung Hee Chung; J Korean Endocr Soc. 1996;11(2):199-206. Published online November 7, 2019

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Abstract PDF: A 14-year-old girl presented with severe headache and grand mal seizure. A magnetic resonance imaging(MRI) of brain showed a pituitary mass(1.0X1.5X1.3cm) incidentally during seizure evaluation. On physical examination, nodular goiter was detected on her anterior neck. The hormone study showed markdly increased basal thyroid stimulating hormone(TSH) level compared to thyroid hormone level, hyperprolactinemia and decreased basal growth hormone level. TSH and prolactin showed exaggerated response to thyrotropin releasing hormone(TRH) and the growth hormone showed delayed and blunted response to insulin-induced hypoglycemia. With the results of thyroid autoantibody and thyroid scan, the diagnosis of Hashimoto's thyroiditis was possible. Thyroid hormone and anticonvulsant drug were started with close observation of clinical status under the impression of pituitary feedback adenoma caused by hypothyroidism. After 3 months replacement therapy of levothyroxine sodium, she achieved euthyroid state with disappearance of headache and nodular goiter. After continuous replacement therapy for 9 months more, the pituitary mass was successfully regressed on follow up MRI with normalization of basal prolactin level. Grand mal seizure was developed after withholding anticonvulsant drug even though continuous admmistration of thyroid hormone. Because of similarity among pituitary adenoma discovered incidentally, careful hormonal study and high index of suspicion should be maintained to achieve correct diagnosis in order to avoid unnecessary pituitary surgery in these patients.

A Case of True Precocious Puberty Associated with Pituitary Microadenoma Treated with LHRH Agonist.: In Kyu Lee, Soon Woo Kim, Heung Sik Kim, Chin Moo Kang; J Korean Endocr Soc. 1994;9(3):244-250. Published online November 6, 2019

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Abstract PDF: Recently Brain CT and MRI have greatly contributed to the discovery of intracranial tumors including cysts which cause precocious puberty. Among many precocious pubetry patients that had previously been diagnosed as idopathic, a number of cases turn out the true precocious puberty caused by intracranial lesion.Authors experienced a case of true precocious puberty in a seven year old female whose vaginal bleeding appeared at age of five and she also had breast enlargement on admission. Pituitary microadenoma was found on her brain MRI and the microadenoma turned to be nonfunctional on hormonal tests.Following three does of decapety1-CR(LHRH Agonist), the vaginal bleeding was ceased and the deceleration of breast enlargement was noted. Her growth velocity was also affected but the further observation for final height would be warranted.

Original Article

Endocrinological and Morphological Characteristics of Clinically Nonfunctioning Pituitary Adenoma.: Jae Wha Jo, Moon Suk Nam, Hyun Chul Lee, Tae Seung Kim, Kyu Chang Lee, Hyun Joo Jung; J Korean Endocr Soc. 1994;9(3):200-212. Published online November 6, 2019

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Abstract PDF: Forth-nine patients with clinically nonfunctioning pituitary adenomas were evaluated clinically, endocrinologically and morphologically in this study.The results obtained were as follows.1) The mean age was 47.1 years(range 23 to 76 years), and 22 were male(44.9%) and 27(55.1%) female.2) The major clinical manifestations of male patients were visual disturbance(72.7%), headache(54.5%), loss of libido(45.5%), but those of female visual disturbance(59.6%), headache(48.1%), amenorrhea(48.1%), loss of body hair(25.9%), and galactorrhea(22.2%).3) All were macroadenomas evaluated by CT scan, and in the male patients 16(72.7%) were grade III and 6(27.3%) grade IV by Hardy classification, and in the female patients 6(22.2%) were grade II, 12(44.4%) grade III, and 9(33.3%) grade IV.4) The elevation of serum prolactin were observed 7(31.8%) out of male, and 24(88.9%) of female.5) Combined stimulation test revealed that GH insufficiency was 89.6%, ACTH 58.9%, LH 58.7%, FSH 51.1 %, and TSH 50.0% and hormone insufficiency more than 4 pituitary hormone was 54.2%.6) Prolactin response to TRH decreased in 12(70.6%) of 17 patients with normal basal prolactin, and 19(76.0%) of 25 with elevated prolactin.7) Immunohistochemistry revealed that null cell adenoma was 57.1%, gonadotrope adenoma 26.5%, plurihormonal adenoma 8.0%, silent corticotrope adenoma 4.0%, thyrotrope adenoma(2.0%), and lactotrope adenoma(2.0%).8) The ultrastructural characteristics examined by electron-microscopy were similar despite of immunohistochemical differences.In summary, the prevalance of clinically nonfunctioning pituitary adenoma was middle aged men and women, and their main symptoms were visual disturbance and headache. Hyperprolactinemia and pituitary hormone insufficiency more than 4 hormone were observed commonly. Most of them were null cell adenoma and gonadotrope adenoma examined by immunohistochemistry. Further study using modern techniques: cell culture, subunit-immunostaining. And Northern blot analysis of mRNA for pituitary hormone or subunit, will be needed to clarify null cell adenomas.

Case Report

A Case of Thyrotropin - Secreting Pituitary Adenoma.: Seong Yeon Kim, Bo Youn Cho, Hong Kyu Lee, Chang Soon Koh, Woon Bae Kim, Hye Young Park, Jin Sung Kim; J Korean Endocr Soc. 1994;10(2):153-160. Published online November 6, 2019

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Abstract PDF: thyrotropin-secreting(TSH) pituitary adenoma is extremely rare condition causing hyperthyroidism by uncontrolled secretion of thyrotropin. Among total pituitary adenomas, less than 1 percent are thyrotropin-secreting type, and only about 150 cases have been reported till now. However, increasing numbers of cases are being found due to the availability of ultra-sensitive TSH assay. We report here a patient with thyrotropin-secreting pituitay adenoma secreting TSH with production of lutenizing hormone(LH), follicle stimulating hormone(FSH), growth hormone(GH), prolactin(PRL) and free alpha-subunit.A 21-years old man visited thyroid clinic because of palpitation and dyspnea on exertion. He had diffuse goiter and features of mild thyrotoxicosis, and his thyroid function test showed increased T3, T4 and normal TSH. Serum free alpha-subunit concentration was 7420.5pg/ml(24.7mIU/ml) and the molar ratio of free alpha-subunit to TSH was 15.9. Basal pituitary hormone levels except TSH and the response to combined pituitary stimulation test were normal. A large sellar mass extending into frontal lobe was found on sellar MRI, so it was removed surgically leaving residual tumor mass due to the extensive nature of tumor. In immunohistochemical study the tumor tissue was stained with antibodies to TSH, LH, FSH, GH and PRL. His hyperthyroidism and goiter disappeared after partial removal of tumor. Somatostatin analogue(octreotide acetate) were given continuously via subcutaneous route(150 ug/day) using infusion pump to reduce the size of residual tumor. After 4 months of octreotide infusion, the size of tumor decreased slightly, and he is under treatment without any side effect.

Review Article

10 Years Prospective Study for the Surgical Total Removal of Pituitary Tumor; Preliminary Report - 2, 5 Years Follow Up.: Eun Jig Lee, Sung Kil Lim, Kap Bum Huh, Sun Ho Kim, Dong Ik Kim, Byung Hee Lee, Ju Heon Yoon, Su Yeon Choi, Joong Uhn Choi, Sang Seop Chung, Kyu Chang Lee; J Korean Endocr Soc. 1994;10(2):85-94. Published online November 6, 2019

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Abstract PDF: The goal of the pituitary tumor surgery is restoration of the normal endocrine function and releaving the pressure effects of the tumor mass on the adjacent neural structures. The authors had proceeded with the 10 years prospective follow-up study for the endocrine function and recurrence of pituitary tumor in the patients who received the complete total resection of tumor mass by the means of total capsulectomy.The authors will discuss the preliminary result of 2.5 years follow-up of this study.

Original Articles

Cushing's Disease Due to ACTH Producing Pituitary Carcinoma.: Young Kee Shong, Joong Yeol Park, Ghi Su Kim, Won Kyoung Cho, Jung Kyo Lee, Ghee Young Choe, Mun Ho Lee, Ki Up Lee; J Korean Endocr Soc. 1994;9(2):136-140. Published online November 6, 2019

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Abstract PDF: Primary carcinoma of the pituitary is only rarely reported. About half of the reported cases are nonfunctional. It is generally agreed that the presence of distant metastasis is required to clearly establish the diagnosis of pituitary carcinoma. We have experienced a case of ACTH-producing pituitary carcinoma causing Cushing's syndrome which could be diagnosed by histologic features only without evidence of distant metastasis. A 35-year-old female with Cushingoid appearance was diagnosed as Cushing's disease after biochemical and neuroradiological evaluation. Near total removal of the pituitary tumor was performed. By histopathologic examination, the tumor revealed evidences of histological malignancy such as prominent nuclear pleomorphism, frequent mitoses and extensive tumor necrosis. Pseudosarcomatous components were also noted. By immunohistochemical studies, the tumor cells expressed ACTH. However, there was no evidence of distant metastasis at the initial operation. She was diagnosed as having ACTH producing pituitary carcinoma by histologic feature only. One month later, she complained progressive nausea and vomiting, and follow-up brain MRI revealed regrowing pituitary mass. She was reoperated and near total tumor bulk was removed again followed by radiotherapy with 5580 rads. Four month after the second operation, she developed generalized tonic clonic seizure. Brain CT showed multiple enhancing nodules on left temporal and frontal lobes, and around falx cerebri. She refused further treatment and was managed only with anticonvalsants. About month after discharge she died at home.

In Situ Hybridization Analysis of Human Growth Hormone and Prolactin Secreting Pitultary Adenomas.: Jae Wha Jo, Eun Jig Lee, Moon Suk Nam, Kyung Rae Kim, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh, Tae Seung Kim, Sun Ho Kim, Joong Uhn Choi, Kyu Chang Lee, Hyun Joo Jung, Sang Seop Chung; J Korean Endocr Soc. 1994;9(2):82-92. Published online November 6, 2019

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Abstract PDF: A non-isotopic in situ hybridization method with biotin-labelled oligonucleotide probes was used to examine growth hormone(GH) and prolactin(PRL) gene expression in 32 patients with pituitary adenomas; 13 were prolactinomas, 8 GH secreting adenomas, and 11 mixed GH and PRL secreting adenomas.Positive immunostaining for GH was found in all patients with GH secreting adenomas, and mixed GH and PRL secreting adenomas. Positive immunostaining for PRL was found in all patients with prolactinomas and 9(81.8%) of 11 mixed GH and PRL secreting adenomas, 5(62.5%) of 8 GH secreting adenomas. Immunohistochemistry revealed that 13 were lactotrope adenomas, 5 somatotrope adenomas, and 14 GH and PRL cell adenomas.In situ hybridization revealed that GH mRNA expression was found in all the patients with somatotrope adenomas and GH and PRL cell adenomas, and 6(46.1%) of 13 lactotrope adenomas. PRL mRNA expression was 100% in lactotrope and GH and PRL cell adenomas, and 4(80.0%) of 5 somatotrope adenomas.The patients with a clinical diagnosis of acromegaly had detectable PRL mRNA in their neoplasm and it is suggested that the PRL cells in the adenomas did not result from dedifferentiation, but from the neoplastic stimulus for some mixed tumors probably occurred in cells previously committed to produce PRL and GH. In lactotrope adenomas, the PRL cells of the patients without expression of GH mRNA may be arised from cells programmed to secrete PRL or precussor PRL cells rather than from mixed GH-PRL cells. The finding that some patients produced mRNA detectable by in situ hybridization, but no hormone detectable by immunohistochemistry within tumor was suggested of a silent adenoma.These observations indicated that in situ hybridization studies may improve the classification of pituitary adenomas and may provide a precise knowledge of the biology of these neoplasms.

Case Report

A Case of Giant Cell Granuloma of The Pituitary Gland.: Eun Jig Lee, Young Duk Song, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh, Tae Seung Kim, Sun Ho Kim, Bong Soo Cha, Dong Hun Choi, Jeong Il Jeong; J Korean Endocr Soc. 1994;10(3):284-288. Published online November 6, 2019

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Abstract PDF: Granulomatous disease of the pituitary gland are uncommon disorders which are rarely diagnosed in patients presenting for hypophysectomy. The majority of reported cases come from neuropsy material and include infectious and systemic disease such as tuberculosis, sarcoidosis, syphilis and fungal infections. We experienced giant cell granuloma of the pituitary gland in a 47 years-old woman. The patient suffered from headache, polyuria and polydipsia. MR images of brain demonstrated a hyposignaled mass. The fibrous tissues were removed by transsphenoidal approach. The clinical and histopathological features of this rare entity are reviewed.

Original Articles

Endocrine Research
Transcriptome Analysis Identifies an Attenuated Local Immune Response in Invasive Nonfunctioning Pituitary Adenomas: Yong Hwy Kim, Jung Hee Kim; Endocrinol Metab. 2019;34(3):314-322. Published online September 26, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.3.314; Correction in: Endocrinol Metab 2020;35(4):965

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Background

Invasive nonfunctioning pituitary adenomas (NFPAs) remain challenging due to their high complication rate and poor prognosis. We aimed to identify the distinctive molecular signatures of invasive NFPAs, compared with noninvasive NFPAs, using gene expression profiling by RNA sequencing.

Methods

We obtained frozen fresh tissue samples from 14 patients with NFPAs who underwent primary transsphenoidal surgery. Three non-invasive and 11 invasive NFPAs were used for RNA sequencing. The bioinformatics analysis included differential gene expression, gene ontology analysis, and pathway analysis.

Results

A total of 700 genes were differentially expressed (59 up-regulated and 641 down-regulated genes) between invasive and non-invasive NFPAs (false discovery rate <0.1, and |fold change| ≥2). Using the down-regulated genes in invasive NFPAs, gene ontology enrichment analyses and pathway analyses demonstrated that the local immune response was attenuated and that transforming growth factor-β (TGF-β) RII-initiated TGF-β signaling was down-regulated in invasive NFPAs. The overexpression of claudin-9 (CLDN9) and the down-regulation of insulin-like growth factor-binding protein 5 (IGFBP5), death-associated protein kinase 1 (DAPK1), and tissue inhibitor of metalloproteinase-3 (TIMP3) may be related with invasiveness in NFPAs.

Conclusion

Invasive NFPAs harbor different gene expression profiles relative to noninvasive NFPAs. In particular, local suppression of the immune response and TGF-β signaling can make PAs prone to invasiveness.

Citations

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Whole genome sequencing and single-cell transcriptomics identify KMT2D inactivation as a potential new driver for pituitary tumors: a case report
Maxime Brunner, Jenny Meylan-Merlini, Maude Muriset, Sergey Oreshkov, Andrea Messina, Mahmoud Messerer, Roy Daniel, Ekkehard Hewer, Jean Phillipe Brouland, Federico Santoni
BJC Reports.2025;[Epub] CrossRef
Research status and prospects of pituitary adenomas in conjunction with neurological and psychiatric disorders and the tumor microenvironment
Siyuan Cui, Sainan Chen, Xuechao Wu, Qing Wang
Frontiers in Neuroscience.2024;[Epub] CrossRef
Immune landscape and progress in immunotherapy for pituitary neuroendocrine tumors
Xiaopeng Guo, Yiying Yang, Zhihong Qian, Mengqi Chang, Yuanli Zhao, Wenbin Ma, Yu Wang, Bing Xing
Cancer Letters.2024; 592: 216908. CrossRef
Advancements in Molecular Diagnosis and Pharmacotherapeutic Strategies for Invasive Pituitary Adenomas
Dingkai Xu, Ling Wang, Maohua Zheng
Immunity, Inflammation and Disease.2024;[Epub] CrossRef
Transcriptome of GH-producing pituitary neuroendocrine tumours and models are significantly affected by somatostatin analogues
Rihards Saksis, Olesja Rogoza, Helvijs Niedra, Kaspars Megnis, Ilona Mandrika, Inga Balcere, Liva Steina, Janis Stukens, Austra Breiksa, Jurijs Nazarovs, Jelizaveta Sokolovska, Ilze Konrade, Raitis Peculis, Vita Rovite
Cancer Cell International.2023;[Epub] CrossRef
PD-L1 Expression in Pituitary Neuroendocrine Tumors/Pituitary Adenomas
Giulia Cossu, Stefano La Rosa, Jean Philippe Brouland, Nelly Pitteloud, Ethan Harel, Federico Santoni, Maxime Brunner, Roy Thomas Daniel, Mahmoud Messerer
Cancers.2023; 15(18): 4471. CrossRef
Aggressive PitNETs and Potential Target Therapies: A Systematic Review of Molecular and Genetic Pathways
Simona Serioli, Ludovico Agostini, Alberto Pietrantoni, Federico Valeri, Flavia Costanza, Sabrina Chiloiro, Barbara Buffoli, Amedeo Piazza, Pietro Luigi Poliani, Maria Peris-Celda, Federica Iavarone, Simona Gaudino, Marco Gessi, Giovanni Schinzari, Pier P
International Journal of Molecular Sciences.2023; 24(21): 15719. CrossRef
Muti-omics integration analysis revealed molecular network alterations in human nonfunctional pituitary neuroendocrine tumors in the framework of 3P medicine
Siqi Wen, Chunling Li, Xianquan Zhan
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A systematic review of molecular alterations in invasive non-functioning pituitary adenoma
Nazanin Hosseinkhan, Maryam Honardoost, Zahra Emami, Sara Cheraghi, Nahid Hashemi-Madani, Mohammad E. Khamseh
Endocrine.2022; 77(3): 500. CrossRef
Medication for Acromegaly Reduces Expression of MUC16, MACC1 and GRHL2 in Pituitary Neuroendocrine Tumour Tissue
Rihards Saksis, Ivars Silamikelis, Pola Laksa, Kaspars Megnis, Raitis Peculis, Ilona Mandrika, Olesja Rogoza, Ramona Petrovska, Inga Balcere, Ilze Konrade, Liva Steina, Janis Stukens, Austra Breiksa, Jurijs Nazarovs, Jelizaveta Sokolovska, Valdis Pirags,
Frontiers in Oncology.2021;[Epub] CrossRef
Large Scale Molecular Studies of Pituitary Neuroendocrine Tumors: Novel Markers, Mechanisms and Translational Perspectives
Raitis Peculis, Helvijs Niedra, Vita Rovite
Cancers.2021; 13(6): 1395. CrossRef
Nkx3-1 and Fech genes might be switch genes involved in pituitary non-functioning adenoma invasiveness
Nasibeh Khayer, Maryam Jalessi, Amin Jahanbakhshi, Alireza Tabib khooei, Mehdi Mirzaie
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The tumour microenvironment of pituitary neuroendocrine tumours
Pedro Marques, Ashley B. Grossman, Márta Korbonits
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The Progress of Immunotherapy in Refractory Pituitary Adenomas and Pituitary Carcinomas
Congxin Dai, Siyu Liang, Bowen Sun, Jun Kang
Frontiers in Endocrinology.2020;[Epub] CrossRef

Endocrine Research
Effects of Oxytocin on Cell Proliferation in a Corticotroph Adenoma Cell Line: Jung Soo Lim, Young Woo Eom, Eun Soo Lee, Hyeong Ju Kwon, Ja-Young Kwon, Junjeong Choi, Choon Hee Chung, Young Suk Jo, Eun Jig Lee; Endocrinol Metab. 2019;34(3):302-313. Published online September 26, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.3.302

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Background

Oxytocin (OXT) has been reported to act as a growth regulator in various tumor cells. However, there is a paucity of data on the influence of OXT on cell proliferation of corticotroph adenomas. This study aimed to examine whether OXT affects cell growth in pituitary tumor cell lines (AtT20 and GH3 cells) with a focus on corticotroph adenoma cells.

Methods

Reverse transcription polymerase chain reaction and enzyme-linked immunosorbent assay were conducted with AtT20 cells to confirm the effects of OXT on hormonal activity; flow cytometry was used to assess changes in the cell cycle after OXT treatment. Moreover, the impact of OXT on proliferating cell nuclear antigen (PCNA), nuclear factor κB, and mitogen-activated protein kinase signaling pathway was analyzed by Western blot.

Results

OXT treatment of 50 nM changed the gene expression of OXT receptor and pro-opiomelanocortin within a short time. In addition, OXT significantly reduced adrenocorticotropic hormone secretion within 1 hour. S and G2/M populations of AtT20 cells treated with OXT for 24 hours were significantly decreased compared to the control. Furthermore, OXT treatment decreased the protein levels of PCNA and phosphorylated extracellular-signal-regulated kinase (P-ERK) in AtT20 cells.

Conclusion

Although the cytotoxic effect of OXT in AtT20 cells was not definite, OXT may blunt cell proliferation of corticotroph adenomas by altering the cell cycle or reducing PCNA and P-ERK levels. Further research is required to investigate the role of OXT as a potential therapeutic target in corticotroph adenomas.

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Increased proliferation and neuronal fate in prairie vole brain progenitor cells cultured in vitro: effects by social exposure and sexual dimorphism
Daniela Ávila-González, Italo Romero-Morales, Lizette Caro, Alejandro Martínez-Juárez, Larry J. Young, Francisco Camacho-Barrios, Omar Martínez-Alarcón, Analía E. Castro, Raúl G. Paredes, Néstor F. Díaz, Wendy Portillo
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Review Article

Recent Progress in the Medical Therapy of Pituitary Tumors: Fabienne Langlois, Shirley McCartney, Maria Fleseriu; Endocrinol Metab. 2017;32(2):162-170. Published online May 19, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.2.162

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Management of pituitary tumors is multidisciplinary, with medical therapy playing an increasingly important role. With the exception of prolactin-secreting tumors, surgery is still considered the first-line treatment for the majority of pituitary adenomas. However, medical/pharmacological therapy plays an important role in controlling hormone-producing pituitary adenomas, especially for patients with acromegaly and Cushing disease (CD). In the case of non-functioning pituitary adenomas (NFAs), pharmacological therapy plays a minor role, the main objective of which is to reduce tumor growth, but this role requires further studies. For pituitary carcinomas and atypical adenomas, medical therapy, including chemotherapy, acts as an adjuvant to surgery and radiation therapy, which is often required to control these aggressive tumors. In the last decade, knowledge about the pathophysiological mechanisms of various pituitary adenomas has increased, thus novel medical therapies that target specific pathways implicated in tumor synthesis and hormonal over secretion are now available. Advancement in patient selection and determination of prognostic factors has also helped to individualize therapy for patients with pituitary tumors. Improvements in biochemical and “tumor mass” disease control can positively affect patient quality of life, comorbidities and overall survival. In this review, the medical armamentarium for treating CD, acromegaly, prolactinomas, NFA, and carcinomas/aggressive atypical adenomas will be presented. Pharmacological therapies, including doses, mode of administration, efficacy, adverse effects, and use in special circumstances are provided. Medical therapies currently under clinical investigation are also briefly discussed.

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Original Article

Clinical Study
The Recovery of Hypothalamic-Pituitary-Adrenal Axis Is Rapid in Subclinical Cushing Syndrome: Hee Kyung Kim, Jee Hee Yoon, Yun Ah Jeong, Ho-Cheol Kang; Endocrinol Metab. 2016;31(4):592-597. Published online December 20, 2016; DOI: https://doi.org/10.3803/EnM.2016.31.4.592

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Background

In subclinical Cushing syndrome (SC), it is assumed that glucocorticoid production is insufficient to cause a clinically recognizable syndrome. Differences in hormonal levels or recovery time of the hypothalamic-pituitary-adrenocortical (HPA) axis after adrenalectomy between patients with overt Cushing syndrome (OC) and SC remain unknown.

Methods

Thirty-six patients (10 with OC and 26 with SC) with adrenal Cushing syndrome who underwent adrenalectomy from 2004 to 2014 were reviewed retrospectively. Patients were treated with glucocorticoid after adrenalectomy and were reevaluated every 1 to 6 months using a rapid adrenocorticotropic hormone (ACTH) stimulation test.

Results

Levels of basal 24-hour urine free cortisol (UFC), serum cortisol after an overnight dexamethasone suppression test (DST), and serum cortisol and 24-hour UFC after low-dose DST and high-dose DST were all significantly lower in patients with SC compared with OC. Basal ACTH levels showed significantly higher in patients with SC compared with OC. The probability of recovering adrenal function during follow-up differed significantly between patients with OC and SC (P=0.001), with significant correlations with the degree of preoperative cortisol excess. Patients with OC required a longer duration of glucocorticoid replacement to recover a normal ACTH stimulation test compared with patients with SC (median 17.0 months vs. 4.0 months, P<0.001).

Conclusion

The HPA axis recovery time after adrenalectomy in patients with SC is rapid and is dependent on the degree of cortisol excess. More precise definition of SC is necessary to achieve a better management of patients and to avoid the risk of under- or over-treatment of SC patients.

Citations

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Review Article

Adrenal gland
Clinical Guidelines for the Diagnosis and Treatment of Cushing's Disease in Korea: Kyu Yeon Hur, Jung Hee Kim, Byung Joon Kim, Min-Seon Kim, Eun Jig Lee, Sung-Woon Kim; Endocrinol Metab. 2015;30(1):7-18. Published online March 27, 2015; DOI: https://doi.org/10.3803/EnM.2015.30.1.7

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Cushing's disease (CD) is a rare disorder characterized by the overproduction of adrenocorticotropic hormone due to a pituitary adenoma that ultimately stimulates excessive cortisol secretion from the adrenal glands. Prior to the detection of pituitary adenomas, various clinical signs of CD such as central obesity, moon face, hirsutism, and facial plethora are usually already present. Uncontrolled hypercortisolism is associated with metabolic, cardiovascular, and psychological disorders that result in increased mortality. Hence, the early detection and treatment of CD are not only important but mandatory. Because its clinical manifestations vary from patient to patient and are common in other obesity-related conditions, the precise diagnosis of CD can be problematic. Thus, the present set of guidelines was compiled by Korean experts in this field to assist clinicians with the screening, diagnoses, and treatment of patients with CD using currently available tests and treatment modalities.

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Original Articles

Adrenal gland
Clinical Characteristics, Management, and Outcome of 22 Cases of Primary Hypophysitis: Sun Mi Park, Ji Cheol Bae, Ji Young Joung, Yoon Young Cho, Tae Hun Kim, Sang-Man Jin, Sunghwan Suh, Kyu Yeon Hur, Kwang-Won Kim; Endocrinol Metab. 2014;29(4):470-478. Published online December 29, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.4.470

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Background

Primary hypophysitis causes varying degrees of endocrine dysfunction and mass effect. The natural course and best treatment have not been well established.

Methods

Medical records of 22 patients who had been diagnosed with primary hypophysitis between January 2001 and March 2013 were retrospectively reviewed. Based on the anatomical location, we classified the cases as adenohypophysitis (AH), infundibuloneurohypophysitis (INH), and panhypophysitis (PH). Clinical presentation, endocrine function, pathologic findings, magnetic resonance imaging findings, and treatment courses were reviewed.

Results

Among 22 patients with primary hypophysitis, 81.8% (18/22) had involvement of the posterior pituitary lobe. Two patients of the AH (2/3, 66.6%) and three patients of the PH (3/10, 30%) groups initially underwent surgical mass reduction. Five patients, including three of the PH (3/10, 33.3%) group and one from each of the AH (1/3, 33.3%) and INH (1/9, 11.1%) groups, initially received high-dose glucocorticoid treatment. Nearly all of the patients treated with surgery or high-dose steroid treatment (9/11, 82%) required continuous hormone replacement during the follow-up period. Twelve patients received no treatment for mass reduction due to the absence of acute symptoms and signs related to a compressive mass effect. Most of them (11/12, 92%) did not show disease progression, and three patients recovered partially from hormone deficiency.

Conclusion

Deficits of the posterior pituitary were the most common features in our cases of primary hypophysitis. Pituitary endocrine defects responded less favorably to glucocorticoid treatment and surgery. In the absence of symptoms related to mass effect and with the mild defect of endocrine function, it may not require treatment to reduce mass except hormone replacement.

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Salma Salhi, Ibtissem Oueslati, Yasmine Mouelhi, Alia Zehani, Nidhameddine Kchir, Elyes Kamoun, Meriem Yazidi, Melika Chihaoui
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Sabrina Chiloiro, Alessandra Vicari, Ginevra Mongelli, Flavia Costanza, Antonella Giampietro, Pier Paolo Mattogno, Liverana Lauretti, Alessandro Olivi, Laura De Marinis, Francesco Doglietto, Antonio Bianchi, Alfredo Pontecorvi
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Mineral, Bone & Muscle
Testosterone Replacement and Bone Mineral Density in Male Pituitary Tumor Patients: Min Jeong Lee, Hyoung Kyu Ryu, So-Yeon An, Ja Young Jeon, Ji In Lee, Yoon-Sok Chung; Endocrinol Metab. 2014;29(1):48-53. Published online March 14, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.1.48

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Background

Hypopituitarism is associated with osteoporosis and osteopenia especially when hypogonadotropic hypogonadism is present. Despite hypopituitarism being an important cause of secondary osteoporosis, osteoporosis in patients receiving surgery for pituitary tumors in Korea has not been studied. In this study, we evaluated the effects of testosterone replacement therapy (TRT) on bone mineral density (BMD) in postoperative hypogonadal patients with pituitary tumors.

Methods

To examine the effect of TRT on BMD, we performed a retrospective observational study in 21 postoperative male patients who underwent pituitary tumor surgery between 2003 and 2012 at the Ajou University Hospital. Testosterone was replaced in postoperative hypogonadal patients by regular intramuscular injection, daily oral medication, or application of transdermal gel. BMD (g/cm²) measurements of central skeletal sites (lumbar spine, femoral neck, and total femur) were obtained using dual-energy X-ray absorptiometry (GE Lunar). For lumbar spine BMD, L1 to L4 values were chosen for analysis. Femur neck and total femur were also analyzed.

Results

During the follow-up period (mean, 56 months; range, 12 to 99 months) serum testosterone levels increased with the administration of TRT (P=0.007). There was significant improvement (4.56%±9.81%) in the lumbar spine BMD compared to baseline BMD. There were no significant changes in the femur neck BMD or total femur BMD. We did not find any statistically significant relationships between changes in testosterone levels and BMD using Spearman correlation analysis.

Conclusion

Our results indicated that TRT used in the postoperative period for hypogonadal pituitary tumor surgery patients may have beneficial effects on the BMD of the spine.

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Testosterone Replacement Therapy and Bone Mineral Density in Men with Hypogonadism
Se Hwa Kim
Endocrinology and Metabolism.2014; 29(1): 30. CrossRef

Review Articles

Adrenal gland
The Molecular Pathogenesis of Pituitary Adenomas: An Update: Xiaobing Jiang, Xun Zhang; Endocrinol Metab. 2013;28(4):245-254. Published online December 12, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.4.245

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Pituitary tumors represent the most common intracranial neoplasms accompanying serious morbidity through mass effects and inappropriate secretion of pituitary hormones. Understanding the etiology of pituitary tumorigenesis will facilitate the development of satisfactory treatment for pituitary adenomas. Although the pathogenesis of pituitary adenomas is largely unknown, considerable evidence indicates that the pituitary tumorigenesis is a complex process involving multiple factors, including genetic and epigenetic changes. This review summarized the recent progress in the study of pituitary tumorigenesis, focusing on the role of tumor suppressor genes, oncogenes and microRNAs.

Citations

Citations to this article as recorded by

PD-L1 expression in PitNETs: Correlations with the 2022 WHO classification
Ethan Harel, Ekkehard Hewer, Stefano La Rosa, Jean Philippe Brouland, Nelly Pitteloud, Federico Santoni, Maxime Brunner, Roy Thomas Daniel, Mahmoud Messerer, Giulia Cossu
Brain and Spine.2025; 5: 104171. CrossRef
Insights into FGFR4 (rs351855 and rs7708357) Gene Variants, Ki-67 and p53 in Pituitary Adenoma Pathophysiology
Martyna Juskiene, Monika Duseikaite, Alvita Vilkeviciute, Egle Karinauske, Ieva Baikstiene, Jurgita Makstiene, Lina Poskiene, Arimantas Tamasauskas, Rasa Liutkeviciene, Rasa Verkauskiene, Birute Zilaitiene
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Plurihormonal Pituitary Neuroendocrine Tumors: Clinical Relevance of Immunohistochemical Analysis
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Pituitary Adenoma: SSTR2 rs2236750, SSTR5 rs34037914, and AIP rs267606574 Genetic Variants, Serum Levels, and Ki-67 Labeling Index Associations
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Single-Cell RNA Sequencing and Its Applications in Pituitary Research
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Neuroendocrinology.2024; 114(10): 875. CrossRef
The expression of VDACs and Bcl2 family genes in pituitary adenomas: clinical correlations and postsurgical outcomes
AN Facundo, M Magalhães, GC Nascimento, RS Azulay, RM Santos, LA Freitas, AGPAC Nascimento, VP Rodrigues, WC Santos, AMGS Beckman, JMF Abreu, RP Silva, EL Carneiro, CP Oliveira Neto, RM Gil da Costa, R Corcoy, E Mato, MS Faria
Frontiers in Endocrinology.2024;[Epub] CrossRef
Signal Transducer and Activator of Transcription 4 (STAT4) Association with Pituitary Adenoma
Greta Gedvilaite-Vaicechauskiene, Loresa Kriauciuniene, Rasa Liutkeviciene
Medicina.2024; 60(11): 1871. CrossRef
LncRNA MYMLR promotes pituitary adenoma development by upregulating carbonyl reductase 1 via sponging miR-197-3p
Tuo Wang, Ping Mao, Yan Zhang, Bo Cui, Mao-De Wang, Ya Li, Ke Gao
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Transcriptomic Profiles of Normal Pituitary Cells and Pituitary Neuroendocrine Tumor Cells
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EMT-Related Markers in Serum Exosomes are Potential Diagnostic Biomarkers for Invasive Pituitary Adenomas
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Neuropsychiatric Disease and Treatment.2021; Volume 17: 3769. CrossRef
The Role of Long Noncoding RNAs in the Biology of Pituitary Adenomas
Ozal Beylerli, Ilgiz Gareev, Valentin Pavlov, Xin Chen, Shiguang Zhao
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Sellar Tumors
Katherine E. Schwetye, Sonika M. Dahiya
Surgical Pathology Clinics.2020; 13(2): 305. CrossRef
Genomic and molecular characterization of pituitary adenoma pathogenesis: review and translational opportunities
Mazin Elsarrag, Parantap D. Patel, Ajay Chatrath, Davis Taylor, John A. Jane
Neurosurgical Focus.2020; 48(6): E11. CrossRef
Metabolic profiling reveals distinct metabolic alterations in different subtypes of pituitary adenomas and confers therapeutic targets
Jie Feng, Hua Gao, Qi Zhang, Yang Zhou, Chuzhong Li, Sida Zhao, Lichuan Hong, Jinjin Yang, Shuyu Hao, Wan Hong, Zhengping Zhuang, Guowang Xu, Yazhuo Zhang
Journal of Translational Medicine.2019;[Epub] CrossRef
Quantitative Analysis of Proteome in Non-functional Pituitary Adenomas: Clinical Relevance and Potential Benefits for the Patients
Tingting Cheng, Ya Wang, Miaolong Lu, Xiaohan Zhan, Tian Zhou, Biao Li, Xianquan Zhan
Frontiers in Endocrinology.2019;[Epub] CrossRef
circOMA1-Mediated miR-145-5p Suppresses Tumor Growth of Nonfunctioning Pituitary Adenomas by Targeting TPT1
Qiu Du, Bin Hu, Yajuan Feng, Zongming Wang, Xin Wang, Dimin Zhu, Yonghong Zhu, Xiaobing Jiang, Haijun Wang
The Journal of Clinical Endocrinology & Metabolism.2019; 104(6): 2419. CrossRef
Differential Expression of HMGA1 and HMGA2 in pituitary neuroendocrine tumors
Sérgio Portovedo, Nadja Gaido, Bruno de Almeida Nunes, Ana Giselia Nascimento, Allysson Rocha, Marcelo Magalhães, Gilvan Cortes Nascimento, Denise Pires de Carvalho, Paula Soares, Christina Takiya, Manuel dos Santos Faria, Leandro Miranda-Alves
Molecular and Cellular Endocrinology.2019; 490: 80. CrossRef
Double Pituitary Adenomas with Synchronous Somatotroph and Corticotroph Clinical Presentation of Acromegaly and Cushing's Disease
Naomi Collazo-Gutiérrez, Orlando de Jesús, Maria Villamil-Jarauta, Milliette Alvarado, Loida González, Margarita Ramírez, Victor J. Carlo-Chevere
World Neurosurgery.2019; 132: 161. CrossRef
Association of ApoE haplotype with clinical evidence of pituitary adenoma
Agne Sidaraite, Alvita Vilkeviciute, Brigita Glebauskiene, Loresa Kriauciuniene, Dalia Zaliuniene, Rasa Liutkeviciene
Gene.2019; 706: 154. CrossRef
Next-generation sequencing of microRNAs reveals a unique expression pattern in different types of pituitary adenomas
Zongze He, Longyi Chen, Xiao Hu, Jian Tang, Linfu He, Junting Hu, Fan Fei, Qi Wang
Endocrine Journal.2019; 66(8): 709. CrossRef
Growth hormone and prolactin-staining tumors causing acromegaly: a retrospective review of clinical presentations and surgical outcomes
Jonathan Rick, Arman Jahangiri, Patrick M. Flanigan, Ankush Chandra, Sandeep Kunwar, Lewis Blevins, Manish K. Aghi
Journal of Neurosurgery.2019; 131(1): 147. CrossRef
Study of major genetic factors involved in pituitary tumorigenesis and their impact on clinical and biological characteristics of sporadic somatotropinomas and non-functioning pituitary adenomas
R.K. Foltran, P.V.G.H. Amorim, F.H. Duarte, I.P.P. Grande, A.C.T.B. Freire, F.P. Frassetto, J.B. Dettoni, V.A. Alves, I. Castro, E.B. Trarbach, M.D. Bronstein, R.S. Jallad
Brazilian Journal of Medical and Biological Research.2018;[Epub] CrossRef
Detection of circulating tumor cells in patients with pituitary tumors
Gao Hua, He Yanjiao, Liu Qian, Wang Jichao, Zhang Yazhuo
BMC Cancer.2018;[Epub] CrossRef
Plurihormonal ACTH-GH Pituitary Adenoma: Case Report and Systematic Literature Review
Elena Roca, Pier Paolo Mattogno, Teresa Porcelli, Luigi Poliani, Francesco Belotti, Alberto Schreiber, Filippo Maffezzoni, Marco Maria Fontanella, Francesco Doglietto
World Neurosurgery.2018; 114: e158. CrossRef
The role of galectin-3 in the tumorigenesis and progression of pituitary tumors
Bo Diao, Ying Liu, Guo‑Zheng Xu, Yi Zhang, Jun Xie, Jie Gong
Oncology Letters.2018;[Epub] CrossRef
Programmed cell senescence: role of IL-6 in the pituitary
Melanie Sapochnik, Mariana Fuertes, Eduardo Arzt
Journal of Molecular Endocrinology.2017; 58(4): R241. CrossRef
Selective molecular biomarkers to predict biologic behavior in pituitary tumors
Aydin Sav, Fabio Rotondo, Luis V. Syro, Meric A. Altinoz, Kalman Kovacs
Expert Review of Endocrinology & Metabolism.2017; 12(3): 177. CrossRef
MicroRNA-200b inhibits pituitary tumor cell proliferation and invasion by targeting PKCα
Yuanchuan Wang, Xiaohong Yin, Long Zhao, Shun Li, Jie Duan, Renzhao Kuang, Junwei Duan
Experimental and Therapeutic Medicine.2017; 14(2): 1706. CrossRef
Increased expression of the microRNA 106b~25 cluster and its host gene MCM7 in corticotroph pituitary adenomas is associated with tumor invasion and Crooke’s cell morphology
Filip Garbicz, Dawid Mehlich, Beata Rak, Emir Sajjad, Maria Maksymowicz, Wiktor Paskal, Grzegorz Zieliński, Paweł K. Włodarski
Pituitary.2017; 20(4): 450. CrossRef
Bromocriptine Induces Autophagy-Dependent Cell Death in Pituitary Adenomas
Xin Geng, Lixin Ma, Zefu Li, Zhenzhu Li, Jianmin Li, Meng Li, Qingbo Wang, Zheng Chen, Qikai Sun
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Biomarkers of pituitary carcinomas
Aydin Sav, Fabio Rotondo, Luis V. Syro, Antonio Di Ieva, Michael D. Cusimano, Kalman Kovacs
Expert Review of Endocrinology & Metabolism.2016; 11(3): 253. CrossRef
MicroRNAs in the pituitary
Erica Gentilin, Ettore degli Uberti, Maria Chiara Zatelli
Best Practice & Research Clinical Endocrinology & Metabolism.2016; 30(5): 629. CrossRef
Molecular markers in pituitary tumors
Asha M. Robertson, Anthony P. Heaney
Current Opinion in Endocrinology, Diabetes & Obesity.2016; 23(4): 324. CrossRef
MicroRNA-106b promotes pituitary tumor cell proliferation and invasion through PI3K/AKT signaling pathway by targeting PTEN
Kai Zhou, Tingrong Zhang, YanDong Fan, Serick, Guojia Du, Pengfei Wu, Dangmurenjiafu Geng
Tumor Biology.2016; 37(10): 13469. CrossRef
Isolated double adrenocorticotropic hormone-secreting pituitary adenomas: A case report and review of the literature
JIUJUN PU, ZHIMING WANG, HUI ZHOU, AILING ZHONG, KAI JIN, LUNLIANG RUAN, GANG YANG
Oncology Letters.2016; 12(1): 585. CrossRef
Progress in Endocrine Neoplasia
Samuel A. Wells
Clinical Cancer Research.2016; 22(20): 4981. CrossRef
Pituitary adenomas: historical perspective, surgical management and future directions
Debebe Theodros, Mira Patel, Jacob Ruzevick, Michael Lim, Chetan Bettegowda
CNS Oncology.2015; 4(6): 411. CrossRef
Epidrug mediated re-expression of miRNA targeting the HMGA transcripts in pituitary cells
Mark O. Kitchen, Kiren Yacqub-Usman, Richard D. Emes, Alan Richardson, Richard N. Clayton, William E. Farrell
Pituitary.2015; 18(5): 674. CrossRef
Pituitary Adenoma and the Chemokine Network: A Systemic View
Fabio Grizzi, Elena Monica Borroni, Alessandro Vacchini, Dorina Qehajaj, Manuela Liguori, Sanja Stifter, Maurizio Chiriva-Internati, Antonio Di Ieva
Frontiers in Endocrinology.2015;[Epub] CrossRef
MiR-132, miR-15a and miR-16 synergistically inhibit pituitary tumor cell proliferation, invasion and migration by targeting Sox5
Wang Renjie, Liang Haiqian
Cancer Letters.2015; 356(2): 568. CrossRef
Brief Review of Articles in 'Endocrinology and Metabolism' in 2013
Won-Young Lee
Endocrinology and Metabolism.2014; 29(3): 251. CrossRef
Epigenetics of pituitary tumours
William E. Farrell
Current Opinion in Endocrinology, Diabetes & Obesity.2014; 21(4): 299. CrossRef
The Role of Genetic and Epigenetic Changes in Pituitary Tumorigenesis
Hidenori FUKUOKA, Yutaka TAKAHASHI
Neurologia medico-chirurgica.2014; 54(12): 943. CrossRef

Adrenal gland
Characteristics of Acromegaly in Korea with a Literature Review: Jae Won Hong, Cheol Ryong Ku, Sun Ho Kim, Eun Jig Lee; Endocrinol Metab. 2013;28(3):164-168. Published online September 13, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.3.164

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Acromegaly is a slowly progressive disease caused by excessive growth hormone (GH), which is related to a GH secreting pituitary tumor in most cases. Herein, we describe the epidemiology, clinical characteristics, and treatment of acromegaly in Korea with a literature review. The average annual incidence of acromegaly in Korea was 3.9 cases per million people, which was within the range of previous Western studies. The primary treatment for acromegaly was also transsphenoidal adenomectomy, which accounted for 90.4% of patients whose primary therapeutic options were known. The overall surgical remission rates were 89%, 87%, 64%, 70%, and 50% for modified Hardy classification I, II, IIIA, IIIB, and IV, respectively. An updated and larger study regarding the treatment outcome of medical/radiotherapy in Korean acromegalic patients is needed.

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Risk of depression in patients with acromegaly in Korea (2006-2016): a nationwide population-based study
Shinje Moon, Sangmo Hong, Kyungdo Han, Cheol-Young Park
European Journal of Endocrinology.2023; 189(3): 363. CrossRef
Increased Risk of Hip Fracture in Patients with Acromegaly: A Nationwide Cohort Study in Korea
Jiwon Kim, Namki Hong, Jimi Choi, Ju Hyung Moon, Eui Hyun Kim, Eun Jig Lee, Sin Gon Kim, Cheol Ryong Ku
Endocrinology and Metabolism.2023; 38(6): 690. CrossRef
Selective screening of patients with associated somatic diseases as a method of early detection of acromegaly
M. B. Antsiferov, V. S. Pronin, T. M. Alekseeva, O. A. Ionova, E. Y. Martynova, Yu. E. Poteshkin, N. A. Chubrova, K. Y. Zherebchikova
Problems of Endocrinology.2021; 67(1): 20. CrossRef
Precision Therapy in Acromegaly Caused by Pituitary Tumors: How Close Is It to Reality?
Cheol Ryong Ku, Vladimir Melnikov, Zhaoyun Zhang, Eun Jig Lee
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Patient Characteristics, Diagnostic Delays, Treatment Patterns, Treatment Outcomes, Comorbidities, and Treatment Costs of Acromegaly in China: A Nationwide Study
Xiaopeng Guo, Kailu Wang, Siyue Yu, Lu Gao, Zihao Wang, Huijuan Zhu, Bing Xing, Shuyang Zhang, Dong Dong
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Case Reports

A Case of Pituitary Adenoma with Simultaneous Secretion of TSH and GH.: Eun Young Lee, Cheol Ryong Ku, Hyun Min Kim, Woo Kyoung Lee, Jung Soo Lim, Sena Hwang, Do Hwan Kim, Dong Yeob Shin, Eun Jig Lee; Endocrinol Metab. 2011;26(2):160-165. Published online June 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.2.160

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Abstract PDF

Thyrotropin (TSH)-secreting pituitary adenoma is a very rare disease. In one-quarter of patients suffering from this disease, the pituitary tumor secretes other anterior pituitary hormones. Herein, we report a case of pituitary adenoma with simultaneous secretion of TSH and growth hormone (GH). A 34-year-old female visitied local hospital complaining of sweating, intermittent palpitation, and weight loss of 8 kg within 1 year. The patient had undergone trans-sphenoidal surgery 3 years prior for resolution of a TSH and GH co-secreting pituitary adenoma. She had been administered somatostatin analogue prior to visiting our hospital. The patient's GH levels were suppressed to below 1 ng/mL on the 75 g oral glucose tolerance test, and her basal insulin-like growth factor-I (IGF-I) level was within normal range. Thyroid function tests demonstrated increased levels of both free thyroxine and TSH. Sella-MRI revealed pituitary adenoma at the floor of the pituitary fossa, approximately 2 cm in height. Therefore, she was diagnosed with residual TSH-secreting pituitary adenoma. The patient again underwent trans-sphenoidal surgery and entered complete remission, based on hormone levels and MRI findings.

Citations

Citations to this article as recorded by

Endoscopic Transsphenoidal Surgery of Pituitary Adenomas: Preliminary Results of the Neurosurgery Service of Hospital Cristo Redentor
Gerson Perondi, Afonso Mariante, Fernando Azambuja, Gabriel Frizon Greggianin, Wanderson William dos Santos Dias, Giulia Pinzetta
Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery.2023; 42(02): e89. CrossRef
A case of a co-secreting TSH and growth hormone pituitary adenoma presenting with a thyroid nodule
Laura Hamilton Adams, Derick Adams
Endocrinology, Diabetes & Metabolism Case Reports.2018;[Epub] CrossRef

A Case of Pituitary Abscess that was Difficult to Diagnose due to Repeated Symptomatic Responses to Every Corticosteroid Administration.: Jin Sun Jang, Jae Seung Yun, Jung Ah Shin, Min Hee Kim, Dong Jun Lim, Jae Hyung Cho, Kun Ho Yoon, Moo Il Kang, Bong Yun Cha, Ho Young Son, Yong Kil Hong; Endocrinol Metab. 2011;26(1):72-77. Published online March 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.1.72

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Abstract PDF: Pituitary abscess is a rare pathology, but it is a potentially life-threatening condition. Therefore, timely intervention, including antibiotics and an operation, can prevent the morbidity and mortality in such cases. A 31-year-old woman, who was 16 months after her second delivery, presented with intermittent headache for 3 months. Amenorrhea, polyuria and polydipsia were noticed and the endocrinological hormone studies were compatible with panhypopituitarism and diabetes insipidus. Pituitary MRI demonstrated a 2.3 cm sized cystic mass with an upper small nodular lesion. Her symptoms such as headache and fever were repeatedly improved whenever corticosteroid was administered, which led us to suspect the diagnosis of an inflammatory condition like lymphocytic hypophysitis. During the hormone replacement therapy, her cystic pituitary mass had grown and her symptoms progressively worsened for another two months. The patient underwent trans-sphenoidal exploration and she turned out to have a pituitary abscess. At the 3-month follow-up, amenorrhea was noticed and her residual function of the pituitary was tested by a combined pituitary stimulation test. The results were compatible with panhypopituitarism. She received levothyroxine 100 microg, prednisolone 5 mg and desmopressin spray and she is being observed at the out-patient clinic. The authors experienced a patient with primary pituitary abscess that was confirmed pathologically and we report on its clinical course with a literature review.

Original Article

Clinical Characteristics of Langerhans Cell Histiocytosis with Hypothalamo-Pituitary Involvement.: Eun Shil Hong, Jung Hun Ohn, Jung Hee Kim, Yul Hwang-Bo, Jin Joo Kim, Jung Hee Kwon, Jung Won Lee, Se Youn Choi, Eun Kyung Lee, Sun Wook Cho, Chan Soo Shin, Kyong Soo Park, Hak Chul Jang, Bo Youn Cho, Hong Kyu Lee, Choong Ho Shin, Sei Won Yang, Seong Yeon Kim; Endocrinol Metab. 2011;26(1):38-43. Published online March 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.1.38

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Abstract PDF

BACKGROUND
Langerhans cell histiocytosis (LCH) is a rare disease that involves a clonal proliferation of Langerhans cells. LCH has a predilection for hypothalamo-pituitary axis (HPA) dysfunction, and this leads to diabetes insipidus (DI) and/or anterior pituitary dysfunction. Here, we describe the endocrine dysfunction and clinical characteristics of adult patients with LCH and we analyzed the differences between an adult-onset type and a childhood-onset type. METHODS: The data was obtained from a retrospective chart review of the patients with LCH that involved the HPA and who attended Seoul National University Hospital. The patients were classified into the adult-onset type (age at the time of diagnosis > or = 16) and the childhood-onset type (age at the time of diagnosis < or = 15). RESULTS: Ten patients (9 males and 1 female) were diagnosed with LCH involving the HPA. Five patients were classified as an adultonset type and the other five patients were classified as a childhood-onset type. The median follow-up duration was 6 (3-12) years for the adult-onset type and 16 (15-22) years for the childhood-onset type. All the patients presented with DI as the initial manifestation of HPA involvement. Four adult-onset patients and three childhood-onset patients had a multi-system disease. Panhypopituitarism developed in three adult-onset patients and in one childhood-onset patient. The pituitary lesion of the three adult-onset patients had spread to the brain during the follow-up duration. In contrast, the pituitary lesion of the other two adult-onset patients without panhypopituitarism and all the childhood-onset patients had not changed. CONCLUSION: DI was the initial presentation symptom of HPA involvement. Anterior pituitary hormone deficiency followed in some patients. Compared with the childhood-onset patients, the adult-onset patients were more likely to have panhypopituitarism and a poor prognosis.

Citations

Citations to this article as recorded by

Pulmonary Langerhans Cell Histiocytosis in an Adult Male Presenting with Central Diabetes Insipidus and Diabetes Mellitus: A Case Report
Yeun Seoung Choi, Jung Soo Lim, Woocheol Kwon, Soon-Hee Jung, Il Hwan Park, Myoung Kyu Lee, Won Yeon Lee, Suk Joong Yong, Seok Jeong Lee, Ye-Ryung Jung, Jiwon Choi, Ji Sun Choi, Joon Taek Jeong, Jin Sae Yoo, Sang-Ha Kim
Tuberculosis and Respiratory Diseases.2015; 78(4): 463. CrossRef
Adult Multisystem Langerhans Cell Histiocytosis Presenting with Central Diabetes Insipidus Successfully Treated with Chemotherapy
Jung-Eun Choi, Hae Ri Lee, Jung Hun Ohn, Min Kyong Moon, Juri Park, Seong Jin Lee, Moon-Gi Choi, Hyung Joon Yoo, Jung Han Kim, Eun-Gyoung Hong
Endocrinology and Metabolism.2014; 29(3): 394. CrossRef

Case Report

The Effect of Octreotide LAR on GH and TSH Co-Secreting Pituitary Adenoma.: Nam Keong Kim, Yu Jin Hah, Ho Young Lee, Sang Jin Kim, Mi Kyung Kim, Keun Gyu Park, Ealmaan Kim, Hyukwon Chang, Hye Soon Kim; Endocrinol Metab. 2010;25(4):378-381. Published online December 1, 2010; DOI: https://doi.org/10.3803/EnM.2010.25.4.378

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Abstract PDF: Growth hormone (GH) and thyroid stimulating hormone (TSH)-secreting pituitary adenomas are very rare and they account for only 0.5% for all pituitary adenomas. These adenomas are usually treated with surgery, but this surgery is not easy because the tumor is usually huge and invasive. We reported here on a case of a GH-TSH-secreting adenoma in a 23-year-old male patient who was initially treated with octreotide LAR. He presented with symptoms of headache, palpitation and a visual defect that he had for the 3 months. He had hypertrophy of the frontal bone and enlargement of both the hands and feet. The visual field test showed bitemporal hemianopsia. The laboratory examinations showed high serum levels of free T4, TSH and free alpha-subunit. Additionally, the serum levels of GH and insulin-like growth factor-I (IGF-I) were increased. GH was not suppressed below 1microg/L by an oral 75g glucose loading test, and TSH was not stimulated by thyrotropin-releasing hormone (TRH). Because sellar MRI showed invasive macroadenoma encasing the vessels, we initially tried octreotide LAR for treatment. A year later, the IGF-I and thyroid function tests were normalized and the size of the tumor was reduced with cystic change. The symptoms of palpitation and headache were improved without a change of the visual field defect.

Original Articles

Clinical Characteristics of 16 Patients with Pituitary Tumor Incidentally Detected by 18F-Fluorodeoxyglucose PET-CT (18F-FDG PET-CT).: Hyung Jin Kim, Gi Jeong Cheon, A Ra Cho, Chang Hoon Lee, Sang Min Youn, Se jin Ahn, Sang Eon Jang, Jung Min Kim, Yun Yong Lee, Ka Hee Yi; Endocrinol Metab. 2010;25(4):321-325. Published online December 1, 2010; DOI: https://doi.org/10.3803/EnM.2010.25.4.321

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Abstract PDF: BACKGROUND
It is uncommon to unexpectedly discover pituitary tumor as a hypermetabolic lesion on an 18F-FDG PET-CT scan for the evaluation of an unrelated disease when the patient does not show neurological or endocrine signs and symptoms. METHODS: We retrospectively analyzed the medical records of 16 patients with pituitary tumor that was detected incidentally on 18FFDG PET-CT at the Korea Cancer Center Hospital from January 2002 to September 2009. We analyzed their clinical features in detail. RESULTS: On 35,505 18F-FDG PET-CT scans, 16 (0.045%) patients were diagnosed with pituitary incidentaloma. They underwent 18FFDG PET-CT for the evaluation of the state of malignancy. All of them had no signs and symptoms related to pituitary tumor. The average age of the patients was 63.3 +/- 12.0 years (49-85 years). Eleven patients were men and 5 were women. The mean diameter of the tumor was 17.9 +/- 5.7 mm. Most of the pituitary incidentalomas were macroadenoma. The result of tumor morphologic evaluation by the Hardy classification was as follows: 6 grade IV, 1 grade III, 3 grade II and 1 grade I. The mean standardized uptake value of the tumor was 10.6 +/- 6.7. Ten patients had endocrine evaluation and they showed a normal hormone level. Among 16 patients, 4 patients received TSA and they were diagnosed with pituitary adenoma. CONCLUSION: This study showed that pituitary incidentaloma discovered on 18F-FDG PET-CT was extremely rare. It was almost all non-functioning macroadenoma and this showed relatively high FDG uptake.

Correlation between Pituitary Insufficiency and Magnetic Resonance Imaging Finding in Non-Functioning Pituitary Adenomas.: Hyun Min Kim, Cheol Ryong Ku, Eun Young Lee, Woo Kyung Lee, Jung Soo Lim, Sena Hwang, Mi Jung Lee, Seung Ku Lee, Sun Ho Kim, Eun Jig Lee; Endocrinol Metab. 2010;25(4):310-315. Published online December 1, 2010; DOI: https://doi.org/10.3803/EnM.2010.25.4.310

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Abstract PDF

BACKGROUND
Non-functioning pituitary adenomas (NFPAs) are characterized by the absence of clinical and biochemical evidence of pituitary hormone hypersecretion, and these tumors constitute approximately one third of all the tumors of the anterior pituitary. Recently, hormonal deficiencies have gradually evolved to become the leading presenting signs and symptoms in patients with NFPAs. We investigated pituitary hormonal insufficiencies according to the magnetic resonance imaging (MRI) findings in patients with NFPA. METHODS: We evaluated the patients who were newly diagnosed with NFPA from 1997 through 2009. Among them, we analyzed 387 patients who were tested for their combined pituitary function and who underwent MRI. The severity of the hypopituitarism was determined by the number of deficient axes of the pituitary hormones. On the MRI study, the maximal diameter of the tumor, Hardy's classification, the thickness of the pituitary gland and the presence of stalk compression were evaluated. RESULTS: The mean age was 46.85 +/- 12.93 years (range: 15-86) and 186 patients (48.1%) were male. As assessed on MRI, the tumor diameter was 27.87 +/- 9.93 mm, the thickness of the normal pituitary gland was 1.42 +/- 2.07 mm and stalk compression was observed in 201 patients (51.9%). Hypopituitarism was observed in 333 patients (86.0%). Deficiency for each pituitary hormone was most severe in the patients with Hardy type IIIA. Hypopituitarism was severe in the older age patients (P = 0.001) and the patients with a bigger tumor size (P < 0.001) and the presence of stalk compression (P < 0.001). However, the patients who had a thicker pituitary gland showed less severe hypopituitarism (P < 0.001). Multivariate analysis showed that age, tumor diameter and the thickness of pituitary gland were important determinants for pituitary deficiency (P = 0.004, P < 0.001, P = 0.022, respectively). CONCLUSION: The results suggest that the hormonal deficiencies in patient with NFPA were correlated with the MRI findings, and especially the tumor diameter and preservation of the pituitary gland.

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Clinical Parameters to Distinguish Silent Corticotroph Adenomas from Other Nonfunctioning Pituitary Adenomas
Daham Kim, Cheol Ryong Ku, Se Hee Park, Ju Hyung Moon, Eui Hyun Kim, Sun Ho Kim, Eun Jig Lee
World Neurosurgery.2018; 115: e464. CrossRef

Case Report

Secondary Pituitary Hyperplasia Induced by Hashimoto's Thyroiditis Related Hypothyroidism: A Case Report.: Kwang Joon Kim, Hyun min Kim, Obin Kwon, Eun Young Park, Yong ho Lee, Jae Won Hong, Jin Wi, Eun Jig Lee; J Korean Endocr Soc. 2010;25(1):72-77. Published online March 1, 2010; DOI: https://doi.org/10.3803/jkes.2010.25.1.72

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Abstract PDF

Pituitary hyperplasia associated with untreated primary hypothyroidism in children is a rare condition. There are only a few reports on this condition in children, and especially when pituitary hyperplasia is accompanied with Hashimoto thyroiditis and growth arrest. Here, we describe an unusual association of pituitary hyperplasia with hypothyroidism and growth retardation, and this was all caused by Hashimoto thyroiditis. Hormonal testing showed a low thyroxine level and a high thyroid stimulating hormone level, elevated anti-thyroglobulin, low growth hormone levels and prepubertal levels of gonadotropins. A large intrasellar mass expanding beyond the sella turcica was detected on magnetic resonance imaging (MRI). Homogeneous contrast enhancement of mass highly suggested that it was a pituitary hyperplasia rather than a pituitary tumor. Therapy with L-thyroxine resulted in rapid improvement of the clinical signs, including renewed growth, normalization of the hormone levels and resolution of the pituitary hyperplasia on MRI within 90 days. In children, prolonged unrecognized primary hypothyroidism might be accompanied by growth deficiency and pubertal disharmony. Physicians must be aware of pituitary hyperplasia in these cases.

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Pituitary macroadenoma secondary to Hashimoto’s thyroiditis: inadvertent diagnosis in a pre-pubertal girl
Deepanjan Bhattacharya, Rakesh Kumar, Jaivinder Yadav
Tropical Doctor.2020; 50(3): 240. CrossRef
Pituitary Hyperplasia Secondary to Hypothyroidism Caused by Hashimoto's Thyroiditis in a Female Adolescent
Jeoung Suk Kim, Min Sun Kim, Sun Jun Kim, Gyung Ho Chung, Pyoung Han Hwang, Dae-Yeol Lee
Journal of Korean Society of Pediatric Endocrinology.2011; 16(3): 185. CrossRef

Original Articles

Pituitary Apoplexy in Korea - Characteristics, Treatment Options and Outcomes.: Jung Ah Lim, Jin Taek Kim, Min Joo Kim, Tae Hyuk Kim, Yenna Lee, Hwa Young Cho, Chan Soo Shin, Kyong Soo Park, Hak Chul Jang, Bo Youn Cho, Hong Kyu Lee, Seong Yeon Kim; J Korean Endocr Soc. 2009;24(4):247-253. Published online December 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.4.247

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Abstract PDF

BACKGROUND
Reports on pituitary apoplexy in Korea are limited. There are two treatment options for pituitary apoplexy - surgical decompression and conservative management. In this study, we examined clinical presentation and outcomes following different therapies in Korean patients with pituitary apoplexy. METHODS: Clinical data and treatment outcomes from 52 patients with pituitary apoplexy who visited Seoul National University Hospital between January 1992 and June 2008 were reviewed retrospectively. Patients were divided into 2 groups according to management options (a surgery group vs. a conservative management group) and their outcomes were compared. For patients who underwent surgery due to neurological symptoms, outcomes were compared between early and late surgery groups. RESULTS: Headache (73.1%) was the most common presenting symptom, and more than half of the patients were reported to have visual symptoms. The most common type of pathology was a nonfunctioning pituitary adenoma (67.3%). Nine patients received conservative management and 43 underwent surgical decompression. Their recovery from neurological and endocrinological abnormalities were similar. Among patients who showed neurological symptoms, 9 underwent surgery within 1 week of symptom onset and 24 underwent surgery after 1 week. There was no significant difference between outcomes of early and late surgery groups except recovery from impaired visual deficit was greater in the late surgery group. CONCLUSION: Patients with pituitary apoplexy in Korea show similar clinical features as similar patients in other countries. In our study, there was no significant difference between clinical outcomes of the surgery group and the conservative treatment group.

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The Outcomes of Pituitary Apoplexy with Conservative Treatment: Experiences at a Single Institution
Youngbeom Seo, Yong Hwy Kim, Yun-Sik Dho, Jung Hee Kim, Jin Wook Kim, Chul-Kee Park, Dong Gyu Kim
World Neurosurgery.2018; 115: e703. CrossRef
Characteristics and Treatment Options of Pituitary Apoplexy
Dong-Sun Kim
Journal of Korean Endocrine Society.2009; 24(4): 237. CrossRef

Pituitary Hormonal Changes after Transsphenoidal Tumor Removal in Non-Functioning Pituitary Adenoma.: Min Suk Lee, Seung Jin Han, Eun Kyung Kim, Joo An Hwang, Yoon Sok Chung, Se Hyuk Kim, Kyung Gi Cho, Nae Jung Rim, Ho Sung Kim; J Korean Endocr Soc. 2009;24(3):181-188. Published online September 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.3.181

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BACKGROUND
The present study investigated the rates and the potential predictors of either new pituitary loss or recovery of hormonal function after transsphenoidal removal of a non-functioning pituitary adenoma. METHODS: Patients who underwent transsphenoidal removal of a non-functioning pituitary adenoma from January 2003 to December 2007 at Ajou University Medical Center were included in this retrospective analysis. Patients were excluded if they had a history of previous pituitary tumor surgery, or did not have preoperative pituitary hormonal data. RESULTS: Of 42 patients included in the analysis, 36 patients had hypopituitarism, 21 patients had "stalk compression" hyperprolactinemia, and 2 patients had normal pituitary function. At long term follow-up (longer than 6 months), 13 patients showed postoperative pituitary hormonal recovery in at least 1 hormonal axis, while 6 patients had developed postoperative hormonal loss in at least 1 hormonal axis. On analysis, neither preoperative serum prolactin level nor tumor size was related to postoperative pituitary hormonal changes. CONCLUSION: More than 1/3 of patients who underwent transsphenoidal surgery showed postoperative pituitary hormonal recovery.

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Childhood Onset Pituitary Adenoma: Clinical Presentations and Outcomes of 24 Cases
Hwa Young Kim, Hae Woon Jung, Jieun Lee, Ju Young Yoon, Young Ah Lee, Choong Ho Shin, Sei Won Yang
Annals of Pediatric Endocrinology & Metabolism.2012; 17(2): 82. CrossRef

Case Report

Non-functional Pituitary Adenoma Detected on (18)F-fluorodeoxyglucose Positron Emission Tomography ((18)F-FDG-PET) in a Patient with Mucosa-associated Lymphoid Tissue Lymphoma.: Jin Ha Lee, Seung Jin Han, Se Eun Park, Mi Ae Cho, June Won Cheong, Mijin Yun, Yumie Rhee, Eun Jig Lee, Sung Kil Lim; J Korean Endocr Soc. 2008;23(2):137-141. Published online April 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.2.137

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Abstract PDF

Magnetic resonance imaging (MRI) is the modality of choice for the detection and characterization of a pituitary adenoma. Uptake of (18)F-fluorodeoxyglucose (FDG) by intrasellar tumors, including pituitary adenomas, has been reported in several previous studies. We report a case where a pituitary adenoma was detected on FDG-positron emission tomography (PET), but the tumor was not detected with the use of sellar MRI. A 31-year-old woman was referred to the clinic due to a focal increase of FDG uptake at the pituitary fossa seen on whole body FDG-PET. The patient was receiving chemotherapy due to a recurred B-cell lymphoma of the mucosa-associated lymphoid tissue type. Subsequently, sellar MRI was performed, and images showed a small non-enhancing heterogenous cystic lesion in the midline of the pituitary gland, radiologically suggestive of a Rathke's cleft cyst. However, sellar MRI failed to identify a lesion consistent with a pituitary tumor that corresponded to the site of increased FDG uptake detected by the use of PET, despite the inclusion of a dynamic contrast enhanced sequence. Despite the negative findings of the MRI examination, basal and stimulated levels of the GnRH free alpha-subunit were profoundly increased. Therefore, we suspected the presence of a non-functional pituitary tumor in addition to a Rathke's cleft cyst, rather than pituitary involvement of a lymphoma, based on the hormone levels and PET scan findings.

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Clinical Characteristics of 16 Patients with Pituitary Tumor Incidentally Detected by18F-Fluorodeoxyglucose PET-CT (18F-FDG PET-CT)
Hyung Jin Kim, Gi Jeong Cheon, A Ra Cho, Chang Hoon Lee, Sang Min Youn, Se jin Ahn, Sang Eon Jang, Jung Min Kim, Yun Yong Lee, Ka Hee Yi
Endocrinology and Metabolism.2010; 25(4): 321. CrossRef

Original Article

Characteristics and Natural Course of Pituitary Incidentaloma in Korea.: You Jin Lee, Sun Wook Cho, Sang Wan Kim, Chan Soo Shin, Kyong Soo Park, Bo Youn Cho, Hong Kyu Lee, Seong Yeon Kim; J Korean Endocr Soc. 2008;23(2):111-116. Published online April 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.2.111

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Abstract PDF

BACKGROUND
A pituitary incidentaloma is a pituitary mass discovered incidentally by computed tomography (CT) or magnetic resonance (MRI) of the brain performed for evaluation of an unrelated disease, and when the patient did not show neurological or endocrine signs and symptoms. Despite of increasing incidence, only a few studies have reported on characteristics, natural history, treatment, or follow-up strategy. Moreover no epidemiologic data exist on pituitary incidentaloma in Korean. METHODS: We retrospectively enrolled subjects diagnosed as pituitary incidentaloma in Seoul National University Hospital from January 1992 to August 2006. We reviewed baseline demographic findings and the results of basal hormone tests, visual field test, and MRI (or CT) at baseline and during follow-up. RESULTS: Among 1310 patients with pituitary adenoma, 161 subjects were diagnosed with incidentaloma. The subject age at diagnosis was 49.7 +/- 15.5 years, with 84 males. Macroadenoma was more frequent (n = 110, 68.3%). with microadenomas and Rathke's cleft cysts found in 21 and 30 cases, respectively. The mean diameter of the tumor was 1.75 cm. Functional incidentalomas such as prolactinoma or acromegaly were found in 31 cases (19.3%) although there were no symptoms or visual field defects. Of 61 incidentaloma patients who did not undergo surgery or other treatment over one year, only 3 patient showed an increase in tumor size during the mean 38.0 +/- 24.9 months follow-up. CONCLUSION: Pituitary incidentaloma generally showed a benign course despite the high prevalence of macroadenoma (68.3%). However, as about 20% of the patients had functioning tumors, pituitary hormonal evaluation at diagnosis is mandatory. Furthermore, as we experienced 3 cases with increased tumor size during follow up, including a case of pituitary microadenoma, long-term careful follow-up of pituitary incidentaloma seems necessary. A long-term, prospective study with more patients would reveal the characteristics and the natural history of pituitary incidentalomas in Korea.

Citations

Citations to this article as recorded by

Sellar Masses: An Epidemiological Study
Khaled Al-Dahmani, Syed Mohammad, Fatima Imran, Chris Theriault, Steve Doucette, Deborah Zwicker, Churn-Ern Yip, David B. Clarke, Syed Ali Imran
Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.2016; 43(2): 291. CrossRef
Optimal Surgical Approaches for Rathke Cleft Cyst With Consideration of Endocrine Function
Jeong Kyung Park, Eun Jig Lee, Sun Ho Kim
Operative Neurosurgery.2012; 70: ons250. CrossRef
Clinical Characteristics of 16 Patients with Pituitary Tumor Incidentally Detected by18F-Fluorodeoxyglucose PET-CT (18F-FDG PET-CT)
Hyung Jin Kim, Gi Jeong Cheon, A Ra Cho, Chang Hoon Lee, Sang Min Youn, Se jin Ahn, Sang Eon Jang, Jung Min Kim, Yun Yong Lee, Ka Hee Yi
Endocrinology and Metabolism.2010; 25(4): 321. CrossRef

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