Main complications post-treatment in patients with pituitary adenoma producing growth hormone
Abstract
Pituitary adenomas are benign intracranial tumors originating in the anterior portion of the hypophysis, thus constituting the most frequent pathology of alterations of the sella turcica in 90%. This type of tumors presents a great variety of clinical manifestations that will depend on the hormonal release, among them; galactorrhea due to excess prolactin, acromegaly or gigantism due to growth hormone alteration, Cushing's disease due to ACTH, hyperthyroidism due to TSH and sex hormone disorders FSH-LH. Acromegaly is a rare endocrinological disease characterized by a metabolic disorder of growth hormone and the consequent elevation of insulin-like growth factor, it also represents a great clinical challenge for endocrinologists and surgical for neurosurgeons, however in expert hands a remission of up to 80% can be achieved. In the present research work, a descriptive, retrospective, cross- sectional study was carried out in registered patients with a diagnosis of benign pituitary tumors and acromegaly who were admitted by the endocrinology, neurosurgery and neurology service at the Teodoro Maldonado Carbo Hospital during the period January 2011-December 2019. The result was a slight female predominance with 54%, the most frequent age was 65-67 years. Within the most frequent symptoms and clinical effects were headache, acral and facial alterations, cataloging the 21 % with Hardy ID. 88% of the patients received Octeotride, 45.5% received radiosurgery treatment with a recurrence rate of 41%.Downloads
References
Donoho D., Bose N., Zada G., Carmichael J. Management of aggressive growth hormone secreting pituitary adenomas. Pituitary. 2017; 20(1): 169-178. doi:10.1007/s11102-016-0781-7
García WR., Cortes HT., Romero AF. Pituitary gigantism: a case series from Hospital de San José (Bogotá, Colombia). Arch Endocrinol Metab. 2019; 63(4): 385-393. doi:10.20945/2359-3997000000150
Gadelha M., Kasuki L., Korbonits M. The genetic background of acromegaly. Pituitary. 2017; 20(1): 10-21. doi:10.1007/s11102-017-0789-7
Briceno V., Zaidi H., Doucette J., Onomichi K., Alreshidi A., Mekary R. Efficacy of transsphenoidal surgery in achieving biochemical cure of growth hormone-secreting pituitary adenomas among patients with cavernous sinus invasion: a systematic review and meta-analysis. Neurological Research. 2017; 39(5): 387-398. doi:10.1080/01616412.2017.1296653
Melmed S., Bronstein M., Chanson P., Klibanski A., Casanueva F., Wass J. A Consensus Statement on acromegaly therapeutic outcomes. Nature Reviews; Endocrinolog. 2018; 14(9): 552-561. doi:10.1038/s41574-018-0058-5
McCabe J., Ayuk J., Sherlock M. Treatment factors that influence mortality in acromegaly. Neuroendocrinology. 2016; 103(1): 66-74. doi:1159/000375163
Jalali S., Monsalves E., Tateno T., Zadeh G. Role of mTOR inhibitors in growth hormone- Producing pituitary adenomas harboring different FGFR4 genotypes. Endocrinology. 2016; 157(9): 3577-3587. doi:10.1210/en.2016-1028
Sánchez, G. Acromegalia: epidemiología, manifestaciones clínicas, diagnóstico y tratamiento. Clínica de Endocrinología y Metabolismo, Universidad de la República, Montevideo, Uruguay. 2016. http://tuendocrinologo.com/site/images/pdfs/AC ROMEGALIA.pdf
Claessen K., Mazziotti G., Biermasz N., Giustina A. Bone and Joint Disorders in Acromegaly. Neuroendocrinology. 2016; 103(1): 86-95. doi:10.1159/000375450
Hernández J., Jorge R. Trastornos de la glandula hipofisiaria. La Habana, Cuba: ecimed. 2010
Qin L., Guo X., Gao L., Wang L., Feng C., Deng K., Lian W., Xing B. Preoperative and Postoperative Bone Mineral Density Change and Risk Factor Analysis in Patients with a GH-Secreting Pituitary Adenoma. International Journal of Endocrinology. 2019; 2019: 1-8 doi:10.1155/2019/2102616
Franck S., Gatto F., Lely A., Janssen J., Dallenga A., Nagtegaal A., Hofland L. y Neggers S. (2017). Somatostatin Receptor Expression in GH-Secreting Pituitary Adenomas Treated with Long-Acting Somatostatin Analogues in Combination with Pegvisomant. Neuroendocrinology, 105(1), 44-53. doi:10.1159/000448429
Rozman C., Cardellach F. (Ed.) Farreras-Rozman. Medicina Interna. Metabolismo y nutrición. Endocrinología. 17th Edition. ELSEVIER. 2012
Tortosa, F. Adenomas de la glándula hipofisaria: Correlaciones clínico-patológicas e inmunohistoquímicas en un centro de referencia de Portugal. Universidad Autónoma de Barcelona. 2018. Obtenido de http://hdl.handle.net/10803/665227
Endo T., Ogawa Y., Watanabe M., Tominaga T. A case of pituitary carcinoma initially diagnosed as an ectopic growth hormone producing pituitary adenoma with a High Ki-67 Labeling Index. J Neurol Surgery. 2018; 79(1): 90-95. doi:10.1055/s-0037-1600515
Mosbah H., Brue T., Chanson P. Acromégalie: améliorer la prise en charge. Annales D´Endocrilogie. 2019; 80(1): 10-18. doi:10.1016/S0003-4266(19)30112-X
Tortora F., Negro A., Grasso L., Colao A., Pivonello R., Splendiani A. Pituitary magnetic resonance imaging predictive role in the therapeutic response of growth hormone-secreting pituitary adenomas. Gland Surgery. 2019; 8(3): 150-158. doi:10.21037/gs.2019.06.04
Corica G., Ceraudo M., Campana C., Nista F., Cocchiara F., Boschetti M., Zona G., Criminelli D., Ferone D., Gatto F. Octreotide-Resistant Acromegaly: Challenges and Solutions. Therapeutics and Clinical Risk Management. 2020; 16: 379-91. doi:10.2147/TCRM.S183360
Kasuki L., Wildemberg L., Gadelha M. Management of endocrine disease: Personalized medicine in the treatment of acromegaly. Eur J Endocrinol. 2018; 178(3): R89-R100. doi:10.1530/EJE-17-1006
Colao A., Auriemma R., Pivonello P. The effects of somatostatin analogue therapy on pituitary tumor volume in patients with acromegaly. Pituitary. 2016;19(2): 210-221. doi:10.1007/s11102-015-0677-y
Shimon I., Jallad R., Fleseriu M., Yedinak C., Greenman Y., Bronstein M. Giant GH- secreting pituitary adenomas: management of rare and aggressive pituitary tumors. Eur J Endocrinol. 2015; 172(6): 707-713. doi:10.1530/EJE-14-1117
Bier G., Hempel J., Grimm F., Ernemann U., Bender B., Honegger J. Quantification of specific growth patterns and frequency of the empty sella phenomenon in growth hormone-secreting pituitary adenomas. European Journal of Radiology. 2018; 104: 79-86. doi:10.1016/j.ejrad.2018.05.009
Liu Q., Zhang J., Gao H., Yuan T., Kang J., Jin L., Gui S., Zhang Y. Role of EGFL7/EGFR-signaling pathway in migration and invasion of growth hormone- producing pituitary adenomas. Science China Life Sciences. 2018; 61: 893–901
Ding D., Mehta G., Patibandla M., Lee C., Liscak R., Kano H. Stereotactic Radiosurgery for Acromegaly: An International Multicenter Retrospective Cohort Study. Neurosurgery. 2019; 84(3): 717-725. doi:10.1093/neuros/nyy178
Loachimescu A., Handa T., Goswami N., Pappy A., Veledar E., Oyesiku N. Gender differences and temporal trends over two decades in acromegaly: a single center study in 112 patients. Endocrine. 2019; 67(2): 423-432. doi:10.1007/s12020-019-02123-4
Franco K., Burbano L. Endocrinología y Nutrición. 2016. Obtenido de: https://es.scribd.com/document/395779393/Acromegalia-Endocrinologia
Anik I., Cabuk B., Gokbel A., Selek A., Cetinarslan B., Anik Y. Endoscopic transsphenoidal approach for acromegaly with remission rates in 401 patients: 2010 consensus criteria. World Neurosurgery. 2017; 108: 278-290. doi:10.1016/j.wneu.2017.08.182
Beltrame S., Toscano M., GoldschmidtE., Garategui L., Campero A., Yampolsky C., Carrizo A. Tratamiento endoscópico de 140 tumores de hipófisis, resultados y complicaciones. Neurocirugía. 2017; 28(2): 67-74. doi:10.1016/j.ne ucir.2016.06.005
Chen C., Ironside N., Pomeraniec I., Chivukula S., Buell T., Ding D. Microsurgical versus endoscopic transsphenoidal resection for acromegaly: a systematic review of outcomes and complications. Acta Neurochir (Wien). 2017; 159(11): 2193-2207. doi:10.1007/s00701-017-3318-6
Carvalho P., Lau E., Carvalho D. Surgery induced hypopituitarism in acromegalic patients: a systematic review and meta-analysis of the results. Pituitary. 2015; 18(6): 844-860. doi:10.1007/s11102-015-0661-6
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