Pituitary Gland Carcinoma

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.

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.

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.

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.

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.

This case highlights the potential utility of IPSS in selected patients with hyperprolactinemia and bilateral pituitary tumors. This technique may be helpful in guiding surgical decision-making in prolactinoma patients with multiple sellar masses. https://thejns.org/doi/10.3171/CASE25511.

NR3C1 promotes the invasive phenotype of NIPAs by activating Wnt signalling. These findings suggest NR3C1 as a potential biomarker and therapeutic target for invasive pituitary adenomas.

P=N/A, N=25, Completed, Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta | Active, not recruiting --> Completed | Trial completion date: Feb 2028 --> May 2025 | Trial primary completion date: Feb 2028 --> May 2025

Clinical management often requires a multimodal approach including titration of DA to higher than usual doses, surgical resection or debulking, and targeted radiotherapy. Robust evidence is lacking for non-approved adjunct therapies, such as aromatase inhibitors and estrogen receptor modulators, although the somatostatin receptor ligand pasireotide may have potential in select patients.

After restricting the analysis to the gonadotroph PitNET group, tumors with an IRS of 1-2 showed significantly higher invasiveness compared with those with an IRS of 3-6 (p = 0.012). These findings suggest that mE-cad may serve as a biomarker of PitNET invasiveness, with expression varying according to TF lineage and tumor subtype.

Among pituitary adenomas, prolactin‑secreting pituitary neuroendocrine tumours (PRL‑PitNETs) are unique in that pharmacotherapy, specifically cabergoline (CAB), can be used as a first‑line treatment, and it is the recommended therapeutic option...Plasma exosomal circOMA1 levels were significantly elevated in PRL‑PitNET patients preoperatively. These findings established circOMA1 as a key mediator of CAB resistance and a potential prognostic indicator in patients with a PRL‑PitNET.