Treatment of Pituitary Carcinomas and Atypical Pituitary Adenomas: A Review
نویسندگان
چکیده
Atypical pituitary adenomas (APAs) are aggressive tumors, harboring a Ki-67 (MIB-1) staining index of 3% or more, and positive immunohistochemical staining for p53 protein, according to the World Health Organization (WHO) classification in 2004. Pituitary carcinomas (PC) usually develop from progressive APAs and predominantly consist of hormone-generating tumors, defined by the presence of disseminations in the cerebrospinal system or systemic metastases. Most of the cases with these malignant pituitary adenomas underwent surgeries, irradiations and adjuvant medical treatments, nevertheless, the therapies are mainly palliative. Recently, the efficacy of temozolomide (TMZ), an orally administered alkylating agent, has been reported as an alternative medical treatment. However, some recent studies have demonstrated a significant recurrence rate after effective response to TMZ. Further clinical and pathological researches of malignant pituitary adenomas will be required to improve the outcome of patients with these tumors.
منابع مشابه
Management of Pituitary Adenomas: Mononostril Endoscopic Transsphenoidal Surgery
Introduction: The endoscopic transsphenoidal approach for pituitary adenomas and other sellar lesions is quickly becoming the procedure of choice in their surgical management. The most common approach is binostril three-hand technique which requires a large exposure and subjects both nasal cavities to potential trauma. To reduce nasal morbidity, we employ a mononostril two-hand technique with t...
متن کاملEndoscopic Endonasal Transsphenoidal Approach for Pituitary Adenomas: a Prospective Review of Our Early Experience
Background & Aim: Pituitary adenomas are a part of a dissimilar group of benign neoplasms. The development of endoscopic techniques for surgery of paranasal sinuses has increased the opportunity for an endoscopic approach with regard to the pituitary gland. Minimally invasive endoscopic pituitary surgery, in turn, permits a more thorough tumor resection and fewer associated surgical complicatio...
متن کاملRecent Progress in the Medical Therapy of Pituitary Tumors
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 patient...
متن کاملMicroscopic Transsphenoidal Surgery for Pituitary Adenomas in Children and Adolescents
Background & Aim: We described the presentation, management and subsequent treatment outcomes of children and adolescents diagnosed with a pituitary adenoma in a joint neuroendocrine setting followed up by a single service as well as assessing long-term outcomes in terms of endocrine status and neurology symptoms. Methods & Materials/Patients: A total of 21 participants with histologically v...
متن کاملبررسی ایمونوهیستوشیمی آدنومهای هیپوفیز و مقایسه آن با تظاهرات بالینی در 102 نمونه بلوک پارافینی
Routine classification of pituitary adenomas is not appropriate for diagnosis of adenoma type and in some cases there is inconcordance between clinical presentation and histological type of adenoma. The aim of this study was to determine the type of adenoma secretion based on immunohistochemical staining. 102 paraffin blocked specimens of pituitary adenoma were stained with hormone ...
متن کامل