Expression of Tumor Necrosis Factor-α and Interleukin-6 in Invasive Pituitary Adenoma / 中国康复理论与实践

@#Objective To study the tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) expressed in invasive pituitary adenomas (IPA). Methods The expression of TNF-α and IL-6 were observed with immunohistochemstry (SP approach) in tissue from 40 cases of non-invasive pituitary adenomas (NIPA) and 40 cases of IPA. Results The expression of both TNF-α and IL-6 was significantly increased in the IPA tissues compared with those of NIPA (P<0.05). Conclusion TNF-α and IL-6 may play a role in the occurrence and development of IPA.

Expression of Tumor Necrosis Factor-αand Interleukin-6 in Invasive Pituitary Adenoma / 中国康复理论与实践

Objective To study the tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) expressed in invasive pituitary adenomas (IPA). Methods The expression of TNF-α and IL-6 were observed with immunohistochemstry (SP approach) in tissue from 40 cases of non-invasive pituitary adenomas (NIPA) and 40 cases of IPA. Results The expression of both TNF-αand IL-6 was significantly increased in the IPA tissues compared with those of NIPA (P<0.05). Conclusion TNF-αand IL-6 may play a role in the occurrence and development of IPA.

Analysis of misdiagnosis and MR findings of atypical invasive pituitary adenoma / 实用放射学杂志

Objective To investigate MR findings and analysis of misdiagnosis of atypical invasive pituitary adenoma.Methods The MR findings of twenty cases of atypical invasive pituity adenomas confirmed by pathology were reviewed ,which were misdiag-nosed as chordomas or meningiomas.Results All the twenty cases showed iso-or slightly hypo-signal on T1 WI,iso-or slightly hy-per-signal on T2 WI;Enhanced scan displayed heterogeneous enhancement.The dynamic enhancement curve showed rapid enhance-ment phase.The bilateral cavernous sinuswere infringed in nine cases,in which the pituity and pituity stalk were not well seen. Among the twenty cases,twelve cases with suprasellar and anterior cranial fossa extension were misdiagnosed as meningiomas;eight cases with clival destruction were misdiagnosed as chordomas.Conclusion The MR features of atypical invasive pituity adenomas are various.In order to avoid misdiagnosis,a comprehensive analysis should be based on a variety of signs.

Strategy for Management of Giant Invasive Pituitary Adenoma

OBJECTIVE: Giant invasive pituitary adenoma looks histologically benign, but these tumors have an aggressive clinical course. The authors review 10 cases and discuss the results obtained and the strategy to use for the management of giant invasive pituitary adenoma. METHODS: Out of a series of 155 pituitary adenomas treated surgically between 1994 and 2002, ten patients with giant invasive pituitary adenoma were selected and their clinical problems, radiologic findings, extent and invasiveness, hormonal and histologic findings and surgical results were analyzed retrospectively. RESULTS: There were 4 male and 6 female patients, with an average age of 47 years and an average follow-up period of 42 months. The average size of tumor was 50.7mm. These tumors revealed severe invasions into surrounding structures. 8 patients underwent transsphenoidal approach(TSA) operations, 1 patient with transcranial operation and 1 patient with combined TSA and transcranial operation. In all cases, subtotal resection was performed. The histologic findings were 2 prolactinomas and 8 hormonal non-function adenomas. The therapies administered after surgical removal consisted of conventional fractionated radiotherapy (2 patients), treatment with dopamine agonists to control hyperprolactinemia (2 patients), and treatment with hormone replacement (2 patients). CONCLUSION: Giant invasive pituitary adenomas are characterized by different forms of expansion and invasiveness and variable clinical problems. Because of their aggressive expansion and invasiveness, there are many different strategies which can be considered for their management. The authors obtain good results by choosing conservative surgical removal and multidisciplinary treatments with serial radiological and hormonal follow-up.

Transcavernous Approach for Invasive Pituitary Adenoma

OBJECTIVE: Surgical management of invasive pituitary tumor is challengeable with conventional transsphenoidal approach(TSA) or pterional intradural approach alone. Gross total resection of pituitary adenoma influences its prognosis favorably, so transcavernous approach(TCA) is essential in invasive pituitary tumor. This study is performed to evaluate and analyze the surgical results of TCA in cases of invasive pituitary adenoma. METHODS: From November 1995 to May 2002, nine cases of invasive pituitary adenoma were treated. The authors reviewed medical records and radiological findings. Pterional transzygomatic or orbitozygomatic transcavernous approach was selected for tumors extended below or above the third ventricle floor respectively and intradural removal of tumor with suprasellar extension was combined. Surgical results including hormonal function, recurrence, completeness of tumor resection, and postoperative complications were evaluated and analyzed. RESULTS: Eight patients were treated with TSA followed by TCA and one with TCA alone. Total resection was achieved in seven cases, subtotal resection in one, and partial resection in one. Postoperative complications included temporary third nerve palsy in four cases and facial paresthesia in two. There was no recurrence during follow-up period. CONCLUSION: Transcavernous approach alone or combined with TSA is essential surgical procedure for total removal of invasive pituitary adenomas with acceptable morbidities.

Clinical significance of molecular genetic changes in sporadic invasive pituitary adenomas

Several molecular and genetic changes have been found in pituitary adenomas. We looked for correlations between these changes and the degree of invasiveness of the tumors. The invasiveness of 11 pituitary adenomas was graded by Hardy classification. We examined the retinoblastoma gene (RB1.20 on chromosome 13q) and the region around the MEN1 locus (chromosome 11q13.1-5) for loss of heterozygosity. Also examined are p53 mutations using single strain conformation polymorphism, p53 protein overexpression using immuno cytochemistry, homozygous deletions of p15 and p16 by polymerase chain reaction, and cellular proliferative activity using MIB-1 antibody. Six tumors (54.5%) had an LOH at either RB1.20 or the MEN1 locus. LOHs were found more frequently in Grade 4 and stage E tumors (72% and 67%) than in Grade 3 and stage D tumors (25% and 40%). However, no mutation or overexpression of p53 was found. No homozygous deletions of p15 or p16 were identified. The cell proliferative index ranged from 0 to 3%. LOH at 11q13 and 13q may be valuable in predicting the invasiveness of pituitary adenomas.

Research and treatment of invasive pituitary adenomas: current status and future expectation / 第二军医大学学报

Invasive pituitary adenoma is a common pituitary adenoma invading nearby structures such as the sphenoidal sinus, ethmoidal sinus,upper clivus,sellar floor dura and bone. With the development of diagnosis neuroradiology, endocrinology,pathology and microsurgery,dramatic progress has been made on the pathogenesis, pre operative diagnosis and therapy of invasive pituitary adenoma.The development of pathology,molecular biological and medication and surgical therapy of invasive pituitary adenoma in the past few years is discussed in this paper.