Download or read book Cushing s disease and aggressive pituitary tumours written by Daniel Bengtsson and published by Linköping University Electronic Press. This book was released on 2021-04-07 with total page 89 pages. Available in PDF, EPUB and Kindle. Book excerpt: This thesis focuses on clinical and epidemiological aspects of aggressive pituitary tumours/carcinomas and Cushing’s disease. Pituitary carcinomas account for only 0.1-0.2% of the tumours originating from the anterior pituitary gland and are defined solely by the event of distant metastases, whereas aggressive pituitary tumours are defined by their clinical behaviour of rapid/progressive growth despite optimal treatment with surgery, radiotherapy and medical agents. The prognosis for individuals with aggressive tumours/carcinomas has been poor with few treatment options. However, case reports indicated better outcomes after treatment with the alkylating agent temozolomide. In study I and III, we investigated 24 patients (16 aggressive tumours and 8 carcinomas) given treatment with temozolomide. We found an initial response rate (tumour regression ≥30%) in 10/21 evaluable patients, with complete regression in two carcinomas. Favourable response was associated with low tumour expression of the DNA repair protein MGMT; in responders median 9% (range 5-20%) vs non-responders median 93% (50-100%). Our results also indicated a longer survival in patients with low MGMT. Out of 11 patients with MGMT >10%, nine died with an estimated median survival of 26 months (95% CI 14-38), whereas only 1/6 patients with lower MGMT died from tumour progression during a follow-up of median 83 months (range 12-161). One of the patients in study I and III had a corticotroph pituitary carcinoma and in addition, Lynch syndrome (LS), a hereditary cancer-predisposing syndrome caused by germline mutations in DNA mismatch repair (MMR) genes and primarily associated with colon and endometrial carcinomas. In study II, we investigated the characteristics of the pituitary carcinoma and found loss of MSH2 and MSH6 protein expression, consistent with the patient’s germline mutation in MSH2. This was the first published case of a pituitary tumour associated with LS. In addition, we identified all known Swedish patients with LS (n=910) and searched for diagnostic codes consistent with a pituitary tumour in the Swedish national patient register. We found in total three patients with clinically relevant pituitary tumours, the reported prevalence in the background population is around 1:1000. The last two studies in the thesis focused on Cushing’s disease (CD), i.e. an ACTH-secreting pituitary tumour resulting in excess levels of cortisol. CD is associated with multiple comorbidities and increased mortality. The reversibility of comorbidities and mortality risk after remission of cortisol levels have been under debate. Study IV examined psychiatric consequences of CD, measured by the use of psychotropic drugs. 179 patients with CD and a quadrupled matched control group were followed from diagnosis and at 5- and 10-year follow-up. We found that use of antidepressants remained at around 25% of patients with CD, regardless of remission status, at diagnosis and follow-up, whereas drugs for somatic comorbidities decreased. Use of antidepressants, sleeping pills and anxiolytics was higher in patients with CD compared to controls at diagnosis and 5-year follow-up. A cross-sectional analysis of 76 patients in sustained biochemical remission for median 9.3 years showed that 25% were taking antidepressants, a significantly higher use than controls, OR 2.0 (95% CI 1.1-3.8). In addition, patients with CD had a higher use of psychotropic drugs, already in the 5-year period before diagnosis. Study V investigated mortality and causes of death in 371 patients with CD, compared to a quadrupled matched control group. Follow-up was median 10.6 years (IQR 5.7-18.2) after time of diagnosis. Overall mortality was increased in patients with CD, HR 2.1 (95% CI 1.5-2.8) and remained elevated for patients in remission at last follow-up (n=303), HR 1.5 (1.02-2.2). For patients not in remission (n=31), HR was 5.6 (2.7-11.6). Cardiovascular diseases (32/66) and infections (12/66) were overrepresented causes of death in patients with CD. Main conclusions of the thesis: Temozolomide improves outcome in patients with aggressive pituitary tumours/carcinomas and a low MGMT expression in the tumour predicts a favourable outcome. As additional therapies evolve, MGMT may help to tailor the treatment.Germline mutations in MMR genes may contribute to the development and clinical course of pituitary tumours and may be a novel cause of hereditary pituitary tumours.Patients with Cushing’s disease have a high use of psychotropic drugs that remains elevated despite achievement of biochemical remission, suggesting persisting negative effects on mental health and highlighting the need for long-term monitoring of psychiatric symptoms. In addition, psychiatric symptoms may be early and important signs of CD.Efforts to achieve biochemical remission are crucial to reduce mortality in CD. However, patients in remission still have an increased mortality compared to controls. This underscores the need for life-long monitoring and treatment of associated comorbidities in patients with CD.
Download or read book Management of Pituitary Tumors An Issue of Neurosurgery Clinics written by Manish K. Aghi and published by Elsevier Health Sciences. This book was released on 2012-10-28 with total page 181 pages. Available in PDF, EPUB and Kindle. Book excerpt: This issue of the Neurosurgery Clinics of North America, Guest Edited by Drs. Manish Aghi and Lewis Blevins, is devoted to Management of Pituitary Tumors. Experts in the field have assembled to provide articles on Imaging of the pituitary and parasellar region; Management of Incidentally Found Nonfunctional Pituitary Tumors; Endoscopic Surgery for Pituitary Tumors; Prolactinomas – Medical versus Surgical Management; Neurosurgery for Cushing’s Disease; Postoperative radiotherapy and stereotactic radiosurgery for pituitary tumors; Management options for persistent postoperative acromegaly; Medical management of persistent and recurrent Cushing’s disease; Management of Large Aggressive Nonfunctional Pituitary Tumors – Experimental Medical Options when Surgery and Radiation Fail; Pituitary Carcinoma; Visual Outcomes after Surgery For Nonfunctional Adenomas Causing Visual Compromise; and Hypopituitarism and Central Diabetes Insipidus: Peri-Operative Diagnosis and Management.
Download or read book Pituitary Disorders An Issue of Endocrinology and Metabolism Clinics of North America written by Niki Karavitaki and published by Elsevier Health Sciences. This book was released on 2020-09-01 with total page 241 pages. Available in PDF, EPUB and Kindle. Book excerpt: This issue of Endocrinology and Metabolism Clinics will cover Pituitary Disorders. Curated by Dr. Niki Karavitaki, this issue will explore topics in the field that are relevant for practicing clinicians. This issue is one of four selected each year by the series Consulting Editor, Adriana G. Ioachimescu. The volume will include articles on: Epidemiology of pituitary disease, Advances in the imaging of pituitary tumours, WHO 2017 classification of pituitary tumours, Cancer immunotherapy and pituitary function, Advances in the medical treatment of Cushing's disease, Nelson's syndrome, Update on genetics of pituitary tumours, Dopamine agonists for pituitary tumours: benefits and risks, Acromegaly: Update on management and long-term morbidities, Endoscopic surgery for pituitary tumours, Aggressive pituitary adenomas and carcinomas, Diabetes insipidus: an update, Management of hypothalamic obesity, and Pituitary Centers of Excellence.
Download or read book Diagnosis and Management of Pituitary Tumors written by Kamal Thapar and published by Springer Science & Business Media. This book was released on 2000-11-09 with total page 479 pages. Available in PDF, EPUB and Kindle. Book excerpt: Eminent clinicians and specialists thoroughly review in great detail every aspect of pituitary tumors. The topics covered include prolactinomas, somatotroph adenomas, corticotroph adenomas, thyrotroph adenomas, nonfunctioning tumors, pituitary tumors, invasive adenomas, and pituitary carcinomas, as well as lesions, exclusive of pituitary adenomas, that occur in the sellar region. Also discussed are the new methods in endocrine diagnosis, high resolution imaging, receptor-mediated pharmacotherapy, microsurgical techniques, improved methods of radiation delivery, and the development of a precise and physiologically meaningful classification of pituitary tumors. Much-needed and brilliantly multidisciplinary, Diagnosis and Management of Pituitary Tumors offers all those dealing with pituitary cancer patients today's most comprehensive guide to diagnosis and treatment, one whose coordinated treatment strategies have sharply improved long-term survival rates for many patients.
Download or read book Pituitary Microadenomas written by G. Faglia and published by . This book was released on 1980 with total page 588 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Pituitary Disorders An Issue of Endocrinology and Metabolism Clinics of North America written by Anat Ben-Shlomo and published by Elsevier Health Sciences. This book was released on 2015-06-03 with total page 273 pages. Available in PDF, EPUB and Kindle. Book excerpt: This issue of Endocrinology and Metabolism Clinics, edited by Drs. Anat Ben-Shlomo and Maria Fleseriu, is devoted to Pituitary Disorders. Articles in this issue include: Pathogenesis of Pituitary Tumors; Prognostic Clinicopathological Classification of Pituitary Adenomas; Familial Isolated Pituitary Adenomas (FIPA) and Mutations in the Aryl Hydrocarbon Receptor Interacting Protein (AIP) Gene; Pitfalls of IGF1 and GH Assays; Acromegaly: Pharmacotherapy; Hypothalamo-pituitary-adrenal Axis Testing; Pharmacotherapy of Cushing Disease: New Targets; Prolactinomas; Non-functioning Pituitary Tumors; Cabergoline Use for Pituitary Tumors and Valvular Disorders; Aggressive Atypical Pituitary Tumors and Carcinoma; Outcomes of Endoscopic Transsphenoidal Pituitary Surgery; Efficacy and Complications of Pituitary Irradiation; Hypopituitarism: GH and ACTH Deficiency; Hypophysitis; Hypopituitarism After Traumatic Brain Injury; Quality of Life in Pituitary Diseases; Pituitary and Bone Disease; Pituitary Tumor Management in Pregnancy; and Pituitary Apoplexy.
Download or read book Management of Pituitary Tumors an Issue of Neurosurgery Clinics written by Manish K. Aghi and published by Saunders. This book was released on 2012-10-09 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: This issue of the Neurosurgery Clinics of North America, Guest Edited by Drs. Manish Aghi and Lewis Blevins, is devoted to Management of Pituitary Tumors. Experts in the field have assembled to provide articles on Imaging of the pituitary and parasellar region; Management of Incidentally Found Nonfunctional Pituitary Tumors; Endoscopic Surgery for Pituitary Tumors; Prolactinomas - Medical versus Surgical Management; Neurosurgery for Cushing's Disease; Postoperative radiotherapy and stereotactic radiosurgery for pituitary tumors; Management options for persistent postoperative acromegaly; Medical management of persistent and recurrent Cushing's disease; Management of Large Aggressive Nonfunctional Pituitary Tumors - Experimental Medical Options when Surgery and Radiation Fail; Pituitary Carcinoma; Visual Outcomes after Surgery For Nonfunctional Adenomas Causing Visual Compromise; and Hypopituitarism and Central Diabetes Insipidus: Peri-Operative Diagnosis and Management.
Download or read book Pituitary Adenomas written by Gianluca Tamagno and published by Springer Nature. This book was released on 2022-01-31 with total page 340 pages. Available in PDF, EPUB and Kindle. Book excerpt: Stemming from the ENEA Young Researcher Committee, this didactical book comprehensively discusses all aspects of pituitary adenomas, particularly the practical aspects arising in everyday clinical practice. Offering valuable tips, it serves as a guide for young trainee endocrinologists facing their first cases of pituitary adenomas. It also includes illustrative clinical cases of acromegaly, prolactinomas, Cushing’s disease, and TSHomas. In addition, a Questions & Answers section is available online. The mix of fresh enthusiasm and well-established expertise in the field provided by the editors and the committee they belong to make the book both solid and innovative, with an appropriate balance between the traditional knowledge and the most exciting innovations from recent or ongoing research. Written and edited by young researchers active in the field of neuroendocrinology, it is a valuable resource for anyone working or interested in the field.
Download or read book The Pituitary Adenoma written by Kalmon D. Post and published by Springer Science & Business Media. This book was released on 2013-11-11 with total page 515 pages. Available in PDF, EPUB and Kindle. Book excerpt: The idea for this book developed as an outcome of a multidisciplinary sym posium entitled "Pituitary Adenoma Update" that was held at Tufts-New En gland Medical Center in April 1977. The purpose of that symposium was to put together our current knowledge of the cause of pituitary tumors and discuss the diagnostic evaluation and management that was now appropriate, in light of the rapid advances that had taken place so recently in this area. Those of our colleagues who had presented papers at the symposium, as well as a number of others, were invited to contribute to this volume, which should serve as a presentation of the "state of the art" on all aspects of pitu itary tumors. We felt that such a book would be of value to endocrinologists, neurosurgeons, neuroradiologists, and pathologists who are involved in the investigation or care of patients with pituitary disorders. For a number of reasons, a review of pituitary adenomas seems particu larly timely. Rapid advances have taken place coincidentally in the fields of neurosurgery, neuroendocrinology, neuroradiology, neuropathology, and neuropharmacology. Seven major developments in these areas have occurred independently and almost simultaneously that have virtually revolutionized our approach to pituitary adenomas.
Download or read book Treatment of Pituitary Adenomas written by Rudolf Fahlbusch and published by . This book was released on 1978 with total page 470 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book MRI of the Pituitary Gland written by Jean-François Bonneville and published by Springer. This book was released on 2016-04-26 with total page 382 pages. Available in PDF, EPUB and Kindle. Book excerpt: This clinically oriented book will familiarize the reader with all aspects of the diagnosis of tumors and other disorders of the pituitary gland by means of magnetic resonance imaging (MRI). The coverage includes acromegaly, Cushing’s disease, Rathke cleft cysts, prolactinomas, incidentalomas, nonsecreting adenomas, other lesions of the sellar area, hypophysitis, and central diabetes insipidus. Normal radiologic anatomy and the numerous normal variants are described, and guidance is also provided on difficulties, artifacts, and other pitfalls. The book combines concise text and high-quality images with a question and answer format geared toward the needs of the practitioner. MRI is today considered the cornerstone in the diagnosis of diseases of the hypophyseal-hypothalamic region but the relatively small size of the pituitary gland, its deep location, the many normal anatomic variants, and the often tiny size of lesions can hinder precise evaluation of the anatomic structures and particularly the pituitary gland itself. Radiologists and endocrinologists will find MRI of the Pituitary Gland to be full of helpful information on this essential examination, and the book will also be of interest to internists and neurosurgeons.
Download or read book Pituitary Disorders an Issue of Endocrinology and Metabolism Clinics of North America Volume 49 3 written by Niki Karavitaki and published by Elsevier. This book was released on 2020-09-28 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: This issue of Endocrinology and Metabolism Clinics will cover Pituitary Disorders. Curated by Dr. Niki Karavitaki, this issue will explore topics in the field that are relevant for practicing clinicians. This issue is one of four selected each year by the series Consulting Editor, Adriana G. Ioachimescu. The volume will include articles on: Epidemiology of pituitary disease, Advances in the imaging of pituitary tumours, WHO 2017 classification of pituitary tumours, Cancer immunotherapy and pituitary function, Advances in the medical treatment of Cushing's disease, Nelson's syndrome, Update on genetics of pituitary tumours, Dopamine agonists for pituitary tumours: benefits and risks, Acromegaly: Update on management and long-term morbidities, Endoscopic surgery for pituitary tumours, Aggressive pituitary adenomas and carcinomas, Diabetes insipidus: an update, Management of hypothalamic obesity, and Pituitary Centers of Excellence.
Download or read book Androgens in Gynecological Practice written by Leo Plouffe, Jr and published by Cambridge University Press. This book was released on 2015-06-25 with total page 261 pages. Available in PDF, EPUB and Kindle. Book excerpt: A practical approach to the field of androgen excess or deprivation in women's health. The content includes multiple viewpoints on the most common disorders in this class, such as polycystic ovary disease, hirsutism and menopausal issues. Each chapter provides a combination of long-lasting clinical principles in the diagnosis and management of these patients along with a state-of-the-art review. This text takes an innovative approach to uncommon conditions (such as congenital adrenal hyperplasia, transgender conditions). In addition to presenting clinical insights, and a review of the basic science underpinning these conditions, it focuses on key concepts that can be derived from these rare conditions to the entire field. This book is an essential addition to the library for any busy clinician who is looking for a practical reference guide but also for the sub-specialist who is looking for new and thought-provoking insights in this complex scientific area.
Download or read book Pituitary Tumors written by Jürgen Honegger and published by Elsevier. This book was released on 2021-04-14 with total page 722 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pituitary Tumors: A Comprehensive and Interdisciplinary Approach provides the latest information on preclinical issues, diagnostic procedures, treatment options and post-treatment care for patients with pituitary tumors. The book includes basic and advanced knowledge for a broad audience, including physicians, endocrinologists, neurosurgeons, neuro-radiologists, neuro-ophthalmologists, neuro-pathologists, oncologists, radiotherapists and researchers who are investigating pituitary tumors. Readers will find the latest research surrounding progress on uncoding the molecular mechanisms involved in tumor genesis. In addition, standard treatment modalities, including surgery, medical treatment and radiosurgery are explored. Provides state-of-the-art knowledge from experts who cover all specialties involved in the field of pituitary tumors Offers a comprehensive presentation of related issues to pituitary tumors Delivers a complete reference book for a broad audience, providing both basic and advanced knowledge
Download or read book Gigantism and Acromegaly written by Constantine A. Stratakis and published by Academic Press. This book was released on 2021-06-01 with total page 312 pages. Available in PDF, EPUB and Kindle. Book excerpt: Gigantism and Acromegaly brings together pituitary experts, taking readers from bench research, to genetic analysis, clinical analysis, and new therapeutic approaches. This book serves as a reference for growth hormone over-secretion and its diagnosis and treatment for endocrinologists, pediatricians, internists, and neurosurgeons, and for geneticists. Pharmaceutical companies may use it as a reference for drug development and research. Students, residents and fellows in medicine and endocrinology and genetics will also find it valuable as it provides a single up-to-date review of the molecular biology of gigantism and acromegaly as well as recommended approaches to evaluation and management. Acromegaly is a rare pituitary disorder that slowly changes its adult victim's appearance over time: larger hands and feet, bigger jaw, forehead, nose, and lips. Generally, a benign pituitary tumor is the cause and symptoms of acromegaly can vary from patient to patient, making a diagnosis difficult and prolonging suffering for years. Early detection is key in the management of acromegaly as the pathologic effects of increased growth hormone (GH) production are progressive and can be life-threatening as the result of associated cardiovascular, cerebrovascular, and respiratory disorders and malignancies. - Accessible, up-to-date overview of the characteristics, state-of-the-art diagnostic procedures, and management of acromegaly and gigantism - Provides a unique compendium of endocrinology, genetics, clinical diagnosis and therapeutics - Contains contributions from internationally known experts who have treated patients with acromegaly and gigantism
Download or read book Contemporary Diagnosis and Management of Pituitary Adenomas written by and published by . This book was released on 1991 with total page 198 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book WHO Classification of Tumours of Endocrine Organs written by Ricardo V. Lloyd and published by WHO Classification of Tumours. This book was released on 2017 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The WHO Classification of Tumours of Endocrine Organs is the 10th volume in the 4th Edition of the WHO series on histological and genetic typing of human tumours. This authoritative, concise reference provides an international standard for oncologists and pathologists and will serve as an indispensable guide for use in the design of studies evaluating response to therapy and clinical outcome. Diagnostic criteria, pathological features, and associated genetic alterations are described in a disease-oriented manner. Sections on all recognized neoplasms and their variants include new ICD-O codes, epidemiology, clinical features, pathology, genetics, prognosis, and predictive factors. The book, prepared by 166 authors from 25 countries, contains more than 700 color images and tables and more than 3100 references.
