The clinicopathological PANOMEN-3 classification predicts pituitary adenoma prognosis: a real-world retrospective single center study of a surgically treated cohort.

Introduction: Pituitary adenomas (PAs) are generally benign neoplasms, though in rare cases may exhibit aggressive behavior. In 2024, the PANOMEN-3 workshop released a new clinical-pathological classification. The objective of this study was to examine the potential of the PANOMEN-3 classification to predict prognosis of PAs and guide treatment in our single center cohort of patients with PAs.

Artificial Intelligence for Individualized Radiological Dialogue: The Impact of RadioBot on Precision-Driven Medical Practices.

Radiology often presents communication challenges due to its technical complexity, particularly for patients, trainees, and non-specialist clinicians. This study aims to evaluate the effectiveness of RadioBot, an AI-powered chatbot developed on the Botpress platform, in enhancing radiological communication through natural language processing (NLP). RadioBot was designed to provide context-sensitive responses based on guidelines from the American College of Radiology (ACR) and the Radiological Society of North America (RSNA).

Consensus on acromegaly therapeutic outcomes: an update.

The 15th Acromegaly Consensus Conference in September 2023 updated recommendations on therapeutic outcomes for acromegaly. Since the publication of medical management guidelines in 2018, new pharmacological agents and new treatment approaches have been developed. Fifty-two experts in the management of acromegaly reviewed the current literature and assessed changes in drug approvals, clinical practice standards and management.

Tumor-infiltrating immune cells predict the response to somatostatin receptor ligands only in somatotropinomas naïve to medical therapy.

Tumor-infiltrating immune cells (TICs) are important components of the tumor microenvironment (TME). They regulate somatotroph adenoma treatment responses to therapy with somatostatin receptor ligands (SRLs), mediated by soluble factors and cytokines. In this study, we assessed the effect of SRLs treatment on TICs.

Cerebrospinal fluid and serum biomarkers in idiopathic intracranial hypertension: A systematic review.

Objective: This study aimed to systematically review the literature on soluble biomarkers in adults with idiopathic intracranial hypertension (IIH).

Background: Idiopathic intracranial hypertension is a multifactorial disorder marked by elevated intracranial pressure without a clear cause. Although it primarily affects overweight women of reproductive age, its pathogenesis remains incompletely understood.

The Combination Therapy of Pasireotide LAR Plus Pegvisomant and Cabergoline Relieved Acromegaly-Related Headache in a Female Patient with AIP-Mutated Acromegaly: A Case Report.

Introduction: Acromegaly is a rare condition characterized by excessive exposure to GH and IGF-1 due to a pituitary adenoma in most cases. The disease is associated with numerous symptoms, including headaches, which are frequently difficult to manage.

Case Presentation: We report the clinical history of an 11-year-old female patient with an AIP mutation and acromegaly, who was unresponsive to treatment with somatostatin receptor ligands and diagnosed with chronic, disabling headaches resistant to multiple treatments, such as indomethacin, cyclooxygenase-2 inhibitors, gabapentin, melatonin, topiramate, galcanezumab, and verapamil.

Impact of pasireotide on lipid and glucose metabolism in patients with acromegaly: a systematic review and meta-analysis.

Background: Pasireotide long-acting release (PasiLAR), a somatostatin multireceptor ligand, is effective in achieving biochemical control but can increase the risk of hyperglycemia in acromegaly. However, the impact of PasiLAR on lipid and glucose metabolism in patients with acromegaly has not been systematically studied. This systematic review aimed at synthesizing evidence on PasiLAR effects (as monotherapy or combination therapy with pegvisomant) on lipid and glucose metabolism in patients with acromegaly.

Lights or shadows, a promising future for positron emission tomography in pituitary tumors: a systematic review.

The diagnosis of pituitary adenomas (PAs), also called pituitary tumors or neuroendocrine tumors (PitNETs) currently involves assessment of blood/plasma hormone levels and traditional neuroradiological techniques, with magnetic resonance imaging (MRI) being of particular significance. However, Positron Emission Tomography- computerized tomography (PET-CT) has been gaining a more substantial role both for the diagnosis and management of PAs. The present systematic review analyzes the most widely used radiopharmaceuticals in the evaluation of pituitary disorders.

Genes of the "regulation of lymphocyte activation" pathway may influence immune cells infiltration in growth hormone secreting pituitary tumors.

Purpose: The tumor microenvironment (TME) may provide a useful framework for understanding the heterogeneous behavior of growth hormone (GH) secreting pituitary adenomas. Although the interest in TME in somatotropinomas has increased exponentially over the last few decades, there is limited elucidation of its mechanisms, particularly in relation to genes expression involved in its regulation.

Methods: A retrospective, observational, single-center study was conducted on 85 subjects: 46 patients diagnosed with acromegaly and 39 controls.

Upfront Oxaliplatin-Fluoropyrimidine Chemotherapy and Somatostatin Analogues in Advanced Well-Differentiated Gastro-Entero-Pancreatic Neuroendocrine Tumors.

(1) Background: GEP-NETs are frequently diagnosed at advanced stage. For well-differentiated somatostatin receptor-positive (SSTR+) NETs, SSA are the preferred first-line therapy. However, in newly diagnosed patients with G2/G3 and a high tumor burden, SSA alone might not be enough; (2) Methods: We conducted a retrospective analysis to assess the effectiveness of combining oxaliplatin-fluoropyrimidine chemotherapy with SSA as an upfront strategy in newly diagnosed metastatic G2/G3 GEP-NET patients treated with oxaliplatin-fluoropyrimidine-based chemotherapy; (3) Results: Between March 2017 and October 2023, 32 pts (19 males, 13 females; M:F = 1.

Tumor features in adult papillary and adamantinomatous craniopharyngioma: neuroradiological evaluation of pituitary-hypothalamic-axis dysfunction and outcome prediction.

Purpose: To identify radiological features distinguishing adamantinomatous craniopharyngioma (ACP) from papillary craniopharyngioma (PCP) and assess their impact on pituitary-hypothalamic-axis dysfunction and post-surgery recurrence.

Methods: MRIs of 80 patients (48 with ACP, 32 with PCP) were analyzed for tumor topography, size, cystic-solid composition, peritumoral edema, signal intensity, and CT for calcification patterns. Volumes, normalized signal intensity minimum (nT2) and maximum (nT1) values were measured from T2 and T1-weighted images, respectively.

Cancer screening in patients with acromegaly: a plea for a personalized approach and international registries.

Acromegaly is a rare condition, and often diagnosis is delayed by several years, for most patients. Acromegaly is characterized by short and long-term respiratory, cardiovascular and metabolic comorbidities, with possible impact on mortality. In the last two decades, life expectancy has progressively increased in part due to a reduction in biochemically active disease, multidisciplinary treatment approaches and a reduction in complications, and the availability of new drugs.

Cytokines and chemokines modulate the growth of pituitary adenoma/neuroendocrine tumors: preliminary results of a monocenter prospective pilot study.

Introduction: Cytokine and chemokines have been recognized to be involved in the progression and prognosis of pituitary adenoma/neuroendocrine tumors (PAs/PitNETs), also known as pituitary adenomas. We aim to investigate the expression of cytokine and chemokine in PAs/PitNETs, and their association with PAs/PitNETs clinical and biological behavior.

Patients And Methods: A prospective and monocenter study was performed on 16 patients diagnosed for PAs/PitNETs.

The Differential Diagnosis between Pseudo Cushing's Syndrome and True Cushing's Syndrome in a Septic Patient in the Pre-Agonal Phase: A Case Report.

Introduction: Sepsis is an illness characterized by a high-stress condition for patients, accompanied by alterations in biochemical processes, behavior, and levels of consciousness. Hormonal alterations that can be seen in this context include increased plasma cortisol values, a condition known as pseudo-Cushing's syndrome (PCS), which in exceptional cases requires a differential diagnosis from true Cushing's syndrome (CS).

Case Presentation: We report a septic patient with pseudo-Cushing's syndrome in the pre-agonal phase, suggesting that PCS during sepsis is an underestimated condition, as the severity of the patient's clinical condition is compounded by the difficulty of diagnosis itself.

Empty sella syndrome: an update.

Introduction: Empty sella is characterized by a flattened profile of the pituitary gland that represents in most cases only a radiological incidental finding. When endocrine, ophthalmic, and neurological symptoms occur, this condition is described as empty sella syndrome.

Materials And Methods: We searched MEDLINE (PubMed database) with the data filter 2024-2009 using the keywords listed above.

IGF-I levels during standard Lanreotide dose predicts biochemical outcome of high-frequency regimen in acromegaly.

Introduction: First-generation somatostatin receptor ligands (fg-SRLs) are the cornerstone of acromegaly treatment. Additional benefits were shown using high dose (HD) or high frequency (HF), relatively short-term regimens. Although several predictors of response to standard dose (SD)-fg-SRLs were reported, outcome biomarkers for HF administration are not yet available.

Temporoparietal Fascia Flap (TPFF) in Extended Endoscopic Transnasal Skull Base Surgery: Clinical Experience and Systematic Literature Review.

The temporoparietal fascia flap (TPFF) has recently emerged as an option for skull base reconstruction in endoscopic transnasal surgery when vascularized nasal flaps are not available. This study provides a systematic literature review of its use in skull base surgery and describes a novel cohort of patients. PRISMA guidelines were used for the review.

Endoscopic Transsphenoidal Surgery in Growth-Hormone Pituitary Adenomas (GH PitNETs): Current Indications, Limitations, and the Importance of a Multidisciplinary Approach.

Acromegaly and gigantism are rare diseases, usually caused by a growth hormone-secreting pituitary adenoma, recently renamed GH-secreting pituitary neuroendocrine tumor (GH-PitNET). The transsphenoidal approach is the mainstay of treatment, although a non-negligible number of patients require a multimodal approach with neo-adjuvant or adjuvant medical and radiation therapy. Understanding the clinical complexity of acromegaly and gigantism is essential to improve treatment safety and success.

GH receptor polymorphisms guide second-line therapies to prevent acromegaly skeletal fragility: preliminary results of a pilot study.

Background: Skeletal fragility is characterized by increased frequency of vertebral fractures (VFs) in acromegaly. Several trials were conducted to identify modifiable risk factors and predictors of VFs, with limited data on the prognostic role of GH receptor (GHR) isoforms. In this study, we investigated the potential role of GHR polymorphism on the occurrence of incidental VFs (i-VFs), in patients treated with second-line medical therapies.

Vitamin D in pituitary driven osteopathies.

The evidence that pituitary hormones may bypass peripheral endocrine glands to exert remarkable effects on the skeleton is gaining ground. Both hormonal excess and deficit may determine impairment in bone structure, and they commonly result in bone loss in patients affected by pituitary and neuroendocrine disorders. Vertebral fractures are the most common skeletal alterations and may occur independently of bone mass.