PMID: 18209869Jan 23, 2008Paper

Silent corticotroph adenomas

Arquivos brasileiros de endocrinologia e metabologia
Niki KaravitakiJohn A H Wass

Abstract

Silent corticotroph pituitary adenomas (SCA) are defined as pituitary adenomas showing positive staining for adrenocorticotrophic hormone in immunohistochemical studies, but not associated with perioperative clinical or laboratory features of hypercortisolaemia. They account for 1.1-6% of surgically removed pituitary adenomas. Currently, two distinct pathologic subtypes of SCA are recognised. Their pathogenesis remains unclear. They present with local mass effects (headache, visual deterioration, cranial nerve palsies, endocrine dysfunction). The lack of manifestations of cortisol excess has not been conclusively explained. In surgical series, most tumours are macroadenomas with suprasellar extension present in 87-100% of the cases; this is in contrast to Cushing's disease, which is mostly attributed to microadenomas. Surgery remains the main therapeutic approach. Attempts to identify predictors of recurrence have not been successful. Management and follow-up protocols should be planned taking into account their potential aggressive behaviour, particularly upon recurrence. The development of florid pituitary Cushing's syndrome and local recurrence followed by metastatic disease (occasionally outside the central nervous system) ...Continue Reading

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Citations

May 19, 2010·Endocrine Pathology·Michael E FealeyRicardo V Lloyd
Dec 3, 2011·Neurosurgical Focus·Walavan SivakumarWilliam T Couldwell
Feb 7, 2012·Best Practice & Research. Clinical Endocrinology & Metabolism·Israel B OrijaAmir H Hamrahian
Sep 23, 2011·Journal of Comparative Pathology·S GestierM Kiupel
Jun 10, 2015·Annales d'endocrinologie·Françoise GallandPhilippe Chanson
Mar 23, 2017·The Journal of Clinical Endocrinology and Metabolism·Metaxia TampourlouNiki Karavitaki
Oct 20, 2017·European Journal of Endocrinology·Gerald RaverotUNKNOWN European Society of Endocrinology
Apr 9, 2011·The Journal of Clinical Endocrinology and Metabolism·Pamela U FredaUNKNOWN Endocrine Society
Feb 27, 2020·Cancers·Jacqueline TrouillasChiara Villa

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