Pituitary最新文献

{"title":"Baseline testosterone levels as a predictor of hypogonadism resolution in male patients with isolated hyperprolactinemia.","authors":"Angelo Milioto, Cristian Petolicchio, Lorenzo Mattioli, Claudia Campana, Anna Arecco, Diego Ferone, Francesco Cocchiara, Federico Gatto","doi":"10.1007/s11102-025-01548-7","DOIUrl":"10.1007/s11102-025-01548-7","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the prevalence and the timing of gonadal axis restoration in men with hypogonadism secondary to hyperprolactinemia after prolactin (PRL) normalization, and to identify factors associated with testosterone (TT) recovery to normal values.</p><p><strong>Methods: </strong>We retrospectively analyzed clinical records of male patients with central hypogonadism and successfully treated isolated hyperprolactinemia. Data on PRL, TT, gonadotropins levels were retrieved for different time points: diagnosis, PRL normalization, gonadal axis restoration (if achieved) and last follow-up. Testosterone replacement therapy within 6 months of PRL normalization was an exclusion criterion.</p><p><strong>Results: </strong>Twenty-nine patients, median age 50 years (IQR 41-58), were included. The etiology of hyperprolactinemia included: prolactinoma (n = 23, 79%), non-functioning pituitary adenoma causing stalk effect (n = 5, 17%) and idiopathic cause (n = 1, 4%). After successful treatment of hyperprolactinemia, 20 patients (69%) spontaneously recovered the gonadal axis, achieving normal TT levels. Ten patients normalized PRL and TT values concurrently, while the other 10 exhibited a median delay of 6.5 months (4-9.25) after PRL normalization; the former group showed lower baseline PRL levels at diagnosis compared to the latter (p = 0.007). Patients who recovered the gonadal axis had higher baseline TT values compared to those with persistent hypogonadism (p = 0.02). At ROC curve analysis, baseline TT was a good predictor of spontaneous gonadal axis recovery after PRL normalization (AUC 0.869, p = 0.002).</p><p><strong>Conclusion: </strong>In patients with hypogonadism secondary to isolated hyperprolactinemia, gonadal axis recovery occurs frequently, particularly in those with higher baseline TT. Lower PRL levels at diagnosis are associated with a faster recovery of gonadal axis.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"28 4","pages":"75"},"PeriodicalIF":3.3,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of growth hormone deficiency: searching for Consensus along life.","authors":"Flavia Prodam, Pietro Maffei","doi":"10.1007/s11102-025-01546-9","DOIUrl":"https://doi.org/10.1007/s11102-025-01546-9","url":null,"abstract":"","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"28 4","pages":"73"},"PeriodicalIF":3.3,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: Pituitary hyperplasia causing visual symptoms in a young woman planning pregnancy.","authors":"Frédérick Rault, Julia Morera, Thomas Gaberel","doi":"10.1007/s11102-025-01532-1","DOIUrl":"https://doi.org/10.1007/s11102-025-01532-1","url":null,"abstract":"","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"28 4","pages":"72"},"PeriodicalIF":3.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of antineoplastic drug therapies on carcinoma and aggressive pituitary tumors: a systematic review and meta-analysis.","authors":"Ana Beatriz Ribeiro Cardoso, Amanda Cristina Zimmermann, Gerald Raverot, Vania Dos Santos Nunes-Nogueira","doi":"10.1007/s11102-025-01541-0","DOIUrl":"10.1007/s11102-025-01541-0","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review aims to evaluate tumor control outcomes associated with antineoplastic drug therapies used for aggressive pituitary tumors (APTs) and pituitary carcinomas (PCs).</p><p><strong>Methods: </strong>We included studies on patients with PC or APT who received one of the following therapies: temozolomide (TMZ), peptide receptor radionuclide therapy (PRRT), everolimus, immune checkpoint inhibitors (ICIs), lapatinib, bevacizumab, capecitabine plus temozolomide (CAPTEM). Search strategies were applied to MEDLINE, EMBASE, LILACS and CENTRAL. Two independent reviewers selected studies, assessed the risk of bias, and extracted data. Proportional meta-analyses were used to calculate overall frequencies of complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD).</p><p><strong>Results: </strong>Seventy eight studies were included. TMZ was the most commonly used therapy, followed by ICIs, bevacizumab, PRRT, CAPTEM, lapatinib, and everolimus. Among 434 patients treated with TMZ in studies involving three or more participants, CR occurred in 4% (95% confidence interval [95% CI], 1-13), PR in 33% (95% CI, 28-37), SD in 32% (95% CI, 28-36), and PD in 29% (95% CI, 25-34). For ICIs, PR occurred in 24% (95% CI, 11-44), SD in 12% (95% CI, 4-31), and PD in 67% (95% CI, 24-93).</p><p><strong>Conclusion: </strong>TMZ was the most frequently reported therapy, with PR as the predominant outcome. However, the limited data on ICIs, PRRT, bevacizumab, lapatinib, and everolimus yielded imprecise results, highlighting the need for further research with the aim of gaining more insights into treatment effects of antineoplastic drug therapies for APTs and PCs.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"28 3","pages":"70"},"PeriodicalIF":3.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impulse control disorders in pituitary adenoma: What do we know and what we still don't know in almost two decades?","authors":"P Kadioglu, A Glezer","doi":"10.1007/s11102-025-01533-0","DOIUrl":"10.1007/s11102-025-01533-0","url":null,"abstract":"","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"28 3","pages":"71"},"PeriodicalIF":3.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing diagnostic tools for vasopressin deficiency: insights from a single-center cohort study.","authors":"Alessandro Mondin, Giulia Bovo, Giorgia Antonelli, Diego Faggian, Pierluigi Mazzeo, Alessandro Bavaresco, Filippo Ceccato, Mattia Barbot","doi":"10.1007/s11102-025-01538-9","DOIUrl":"10.1007/s11102-025-01538-9","url":null,"abstract":"<p><strong>Context: </strong>A recent multicenter trial confirmed that hypertonic saline-stimulated copeptin is superior to the arginine stimulation test (AST) for diagnosing vasopressin deficiency (AVP-D). The latter, though less accurate, is cheaper, better tolerated, and easier to perform. We aimed to improve AST diagnostic accuracy by incorporating additional parameters alongside copeptin.</p><p><strong>Methods: </strong>We retrospectively analysed ASTs from patients evaluated for suspected AVP-D. Final diagnosis was defined based on clinical, biochemical, radiological and follow-up data. We evaluated the test diagnostic accuracy based on either literature reported or ROC-based thresholds of several variables even in combination.</p><p><strong>Results: </strong>Nineteen patients were included and 8 were diagnosed with AVP-D. Copeptin response to AST was flat in AVP-D compared to primary polydipsia (PP) but showed limited discriminatory power with the maximal accuracy for copeptin-based parameters reaching 73.7%. AVP-D patients had lower urinary osmolarity (UOsm) and higher plasma osmolarity and serum sodium (Na) at AST end. Na at AST end was the best predictor of AVP-D (≥ 141 mmol/L: sensitivity 87.5%, specificity 100%, accuracy 94.7%, AUC 0.989). A multistep approach initially assessing Na at AST end and, in dubious cases (140-142 mmol/l), also either copeptin peak (≤ 4.1 pmol/L), UOsm (≤ 428 mOsm/kg), or absent posterior pituitary hyperintense signal achieved 100% diagnostic accuracy. Logistic regression using Na at AST end values combined with any of these aforementioned additional variables also reached complete discrimination between AVP-D and PP.</p><p><strong>Discussion: </strong>Combining multiple parameters after AST improved diagnostic accuracy, even without measuring copeptin. Despite the study's retrospective design, small sample, and absence of hypertonic saline testing, findings support the potential utility of a multivariable approach to AST interpretation.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"28 3","pages":"65"},"PeriodicalIF":3.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in acromegaly: Why, when and how.","authors":"Alessandro Giustina, Andrea Giustina","doi":"10.1007/s11102-025-01534-z","DOIUrl":"10.1007/s11102-025-01534-z","url":null,"abstract":"","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"28 3","pages":"66"},"PeriodicalIF":3.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of stereotactic radiosurgery for pituitary metastases: an international multi-institutional study.","authors":"Hussam Abou-Al-Shaar, Ibrahem Albalkhi, Rimsha K Shariff, Arka N Mallela, Pouneh K Fazeli, Salem M Tos, Georgios Mantziaris, Ying Meng, Kenneth Bernstein, Tehila Kaisman-Elbaz, Hanan Abofani, Yen-Yu Lin, Cheng-Chia Lee, Manjul Tripathi, Rituraj Upadhyay, Joshua D Palmer, Ahmed M Nabeel, Wael A Reda, Sameh R Tawadros, Khaled Abdelkarim, Amr M N El-Shehaby, Reem M Emad, Selcuk Peker, Yavuz Samanci, Rodney E Wegner, Matthew J Shepard, Roman Liscak, Gabriela Simonova, Timoteo Almeida, Carolina Benjamin, Douglas Kondziolka, Jason P Sheehan, Ajay Niranjan, Constantinos G Hadjipanayis, L Dade Lunsford","doi":"10.1007/s11102-025-01542-z","DOIUrl":"10.1007/s11102-025-01542-z","url":null,"abstract":"<p><strong>Background: </strong>Pituitary metastases (PM) account for 0.4% of all intracranial metastases and typically present with visual and endocrinological deficits. Stereotactic radiosurgery (SRS) has shown excellent tumor control and safety profile in the management of intracranial metastases. However, its role and safety in managing metastases to the pituitary gland are not well-characterized. This study aims to evaluate SRS outcomes and safety profile in the management of PM in a multicenter international cohort.</p><p><strong>Methods: </strong>The authors retrospectively analyzed data from 63 patients with PM treated with SRS across 12 institutions, assessing clinical and radiological outcomes, including survival rates, tumor control, visual and endocrinological outcomes, and post-treatment complications.</p><p><strong>Results: </strong>Among 63 patients included in the study (median tumor volume: 1.5 cc), SRS demonstrated a local tumor control rate of 93.1% at 12 months. The median survival was 25.4 months and overall survival rates of 77.6%, 65.9%, and 55.1% at 6, 12, and 18 months, respectively. In multivariate analysis, a margin dose for PM > 10 Gy emerged as an independent predictor across progression-free survival (HR: 0.20, p < 0.01), distant metastasis-free survival (HR: 0.30, p = 0.01), and overall survival. (HR: 0.15, p < 0.01). Following SRS, most patients showed stable or improved visual function (n = 17/18). A small percentage of patients experienced complications: developed new visual deficits (n = 1/63), experienced new anterior pituitary hormone deficiency (n = 5/63), and developed arginine vasopressin (AVP)-deficiency post-treatment (n = 2/63).</p><p><strong>Conclusion: </strong>SRS is an important modality in the management of PM, offering excellent local tumor control and survival outcomes with minimal morbidity. These findings support the incorporation of SRS into the multidisciplinary management for treating patients with PM.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"28 3","pages":"69"},"PeriodicalIF":3.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Muscle dysfunction is associated with poor quality of life in long-term controlled patients with acromegaly.","authors":"Luciana Martel-Duguech, Helena Bascuñana, Jordi Cuartero, Susan M Webb, Elena Valassi","doi":"10.1007/s11102-025-01539-8","DOIUrl":"10.1007/s11102-025-01539-8","url":null,"abstract":"<p><strong>Purpose: </strong>Acromegaly (ACRO) leads to significant physical and psychological morbidity. Although patients often report persistent muscle dysfunction and impaired quality of life (QoL) after hormone control, the relationship between these two factors remains largely underexplored. Our objective was to investigate the association between muscle function parameters and QoL in long-term controlled ACRO patients.</p><p><strong>Methods: </strong>We studied 36 patients with ACRO (14 males, 22 females; mean age 54 ± 8 years) with controlled GH/IGF-I excess, defined as normalized IGF-I levels and suppressed GH concentrations after an OGTT, during a mean (± SD) of 8 (4) years. Muscle function was assessed using gait speed (GS), timed up and go (TUG), handgrip strength (HGS), and the 30-second chair-to-stand test. QoL was evaluated using the AcroQoL and SF-36 questionnaires.</p><p><strong>Results: </strong>Poor muscle performance, particularly on GS and TUG, was significantly associated with reduced QoL scores on physical, psychological, and social domains of AcroQoL and SF-36 questionnaires. In women, mobility limitations were linked to impaired self-image and physical functioning. In men, reduced muscle strength and mobility were associated with broad QoL alterations on physical and emotional dimensions. These findings highlight the significant impact of muscle dysfunction on both physical performance perception and psychosocial well-being in ACRO patients.</p><p><strong>Conclusion: </strong>Muscle dysfunction in long-term controlled ACRO patients negatively affects QoL, underscoring the need for routine functional assessments and targeted rehabilitation strategies.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"28 3","pages":"68"},"PeriodicalIF":3.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diagnosis of GH deficiency in adult β-thalassemic patients: are two different stimulation tests necessary to improve specificity?","authors":"Daniele Sola, Mirna Solange Barrio Lower Daniele, Leila Danesi, Emanuela D'Angelo, Nadia Mirra, Giovanna Graziadei, Elena Cassinerio, Riccardo Pasquali, Massimo Scacchi","doi":"10.1007/s11102-025-01540-1","DOIUrl":"10.1007/s11102-025-01540-1","url":null,"abstract":"<p><strong>Purpose: </strong>β-thalassemia major (βTM) frequently leads to endocrinological complications of chronic transfusion-induced iron overload, including growth hormone deficiency (GHD). With contrasting data on GHD in adult βTM populations, our study aimed to reevaluate the diagnosis of GHD using multiple tests and its progression over time.</p><p><strong>Methods: </strong>Two experimental studies were conducted in adult βTM patients to assess GH secretory status. The first study reevaluated GH secretion after two years using a GHRH plus arginine test performed initially and during follow-up. The second study applied a glucagon stimulation test to those initially diagnosed with severe GHD, comparing the results with those of a GHRH plus arginine test.</p><p><strong>Results: </strong>The first study involved 80 patients: 67 patients had normal GH secretion at the first test, confirmed in 57 of them. Of the 13 initially diagnosed with GHD, only 3 were confirmed at the second test. The second study included 91 patients: 18 of the initially identified as having severe GHD, were tested with another challenge, but only 6 confirmed severe GHD, suggesting a possible risk of overdiagnosis in initial evaluations.</p><p><strong>Conclusions: </strong>The marked variability in GHD diagnoses among adult patients with βTM highlights the need for multiple diagnostic tests to improve accuracy and avoid unnecessary interventions. Our findings highlight the importance of reassessing GH secretory reserves with multiple tests at multiple time points, supporting a cautious approach to hormone replacement therapy, suggesting to start it only when clearly indicated.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"28 3","pages":"67"},"PeriodicalIF":3.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}