Pituitary Gland Carcinoma

This case underscores the necessity of maintaining a high index of suspicion for acromegaly in elderly patients presenting with unexplained acral and facial changes. Comprehensive endocrine evaluation and advanced imaging are critical for achieving an accurate diagnosis and ensuring timely surgical intervention to prevent disease progression.

Our findings suggest a correlation between PTTG1 expression and lymphadenopathy at diagnosis, independent of tumor size and T stage. It may reflect biological features associated with lymphatic dissemination and requires further investigation in larger prospective studies.

This case describes a rare Pit-1 lineage pituitary macroadenoma associated with acromegaly and subclinical Cushing's disease. The discordance between ACTH hypersecretion and absent T-pit expression highlights atypical hormone regulation in plurihormonal PitNETs and underscores the limitations of current lineage-based classifications.

Key investigations include next-generation sequencing, chromosome microarray, and droplet digital polymerase chain reaction. Exploratory research-based genetic testing may help uncover new genetic causes of familial acromegaly kindreds and pituitary gigantism in people with negative results on standard testing, benefiting those being tested as well as advancing our understanding of the heritable basis of somatotropinomas.

P=N/A, N=100, Completed, Trakya University | Recruiting --> Completed | Initiation date: Apr 2024 --> Sep 2024

Additionally, IGF-I-activated MET reduces KLLN by suppressing KLLN transcription via repressing tumor protein 53 (TP53) in thyroid cells. These findings uncover that the PA-dependent IGF-I/MET/TP53/KLLN signaling axis contributes to increased proliferation and tumorigenic potential of thyroid cells, which should provide potential therapeutic targets for thyroid diseases in PA.

She was initially managed conservatively with stress-dose hydrocortisone and low-dose cabergoline under close clinical and visual monitoring...Postoperatively, she developed cerebrospinal fluid rhinorrhea that resolved with lumbar drainage, as well as transient diabetes insipidus treated with desmopressin...In hemorrhagic sellar lesions, markedly elevated prolactin may reflect either a prolactinoma or stalk effect; a rapid postoperative prolactin decline supports stalk compression as the dominant mechanism. Close observation during conservative management is essential, and clinical deterioration should prompt timely surgical decompression to optimize neurological and endocrine outcomes.

The ERK‑specific inhibitor U0126 reversed this pro-proliferative effect. To the best of our knowledge, the present study is the first to reveal that AS‑IV inhibits pituitary tumor proliferation and promotes apoptosis by targeting TUBB4B to regulate the STMN1‑ERK signaling axis, providing a novel theoretical basis and potential strategies for traditional Chinese medicine treatment and molecular targeted research on pituitary tumors.

Although current evidence is growing, these approaches are still considered in the research field but are slowly being introduced in clinical practice. In this chapter, we review the available molecular and functional markers of response to medical therapy in acromegaly and discuss how to include them in the clinical ground for advancing precision medicine in this disease.

However, benign constitutional maturation variants are the most common causes of deviations to normal growth, while overgrowth syndromes and pseudoacromegaly conditions leading to non-pituitary gigantism may be also rarely encountered. In this chapter, we aimed to provide an update overview of the causes, differential diagnosis and management of gigantism, with the main focus on GH/IGF-1-related pituitary gigantism, including isolated and familial forms.

Additionally, we discuss treatment strategies, including surgical and medical approaches, highlighting the impact of the treatment with cabergoline and somatostatin receptor ligands (SRLs) in biochemical control. The predictors of surgical and medical treatment resistance, including Knosp grade, tumor size, and baseline hormone levels, are also addressed. Understanding the unique behavior of these tumors is crucial for optimizing treatment strategies and improving patient outcomes.

Hereditary GH-secreting PitNETs can manifest as isolated tumors, such as in familial isolated pituitary adenoma (FIPA) including cases with AIP variants or GPR101 microduplications, (X- linked acrogigantism) or can be part of syndromes like multiple endocrine neoplasia type 1 or type 4, McCune-Albright syndrome, Carney complex or phaeochromocytoma/paraganglioma-pituitary adenoma association. Identifying genetic defects allows an early detection and prompt intervention, essential for preventing complications and improving the quality of life in affected individuals, as well as finding affected relatives before the clinical manifestations of the disease.