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  • 1
    Online Resource
    Online Resource
    First German Guideline on Diagnostics and Therapy of Clinically Non-Functioning Pituitary Tumors
    Georg Thieme Verlag KG ; 2021
    In:  Experimental and Clinical Endocrinology & Diabetes Vol. 129, No. 03 ( 2021-03), p. 250-264
    Details
    In: Experimental and Clinical Endocrinology & Diabetes, Georg Thieme Verlag KG, Vol. 129, No. 03 ( 2021-03), p. 250-264
    Abstract: Although non-functioning pituitary tumors are frequent, diagnostic and therapeutic concepts are not well standardized. We here present the first German multidisciplinary guideline on this topic. The single most important message is to manage the patients by a multidisciplinary team (consisting at least of an endocrinologist, a neurosurgeon, and a (neuro-) radiologist). The initial diagnostic work-up comprises a detailed characterization of both biochemical (focusing on hormonal excess or deficiency states) and morphological aspects (with magnetic resonance imaging of the sellar region). An ophthalmological examination is only needed in presence of symptoms or large tumors affecting the visual system. Asymptomatic, hormonally inactive tumors allow for a 'wait and scan' strategy. In contrast, surgical treatment by an experienced pituitary surgeon is standard of care in case of (impending) visual impairment. Therapeutic options for incompletely resected or recurrent tumors include re-operation, radiotherapy, and observation; the individual treatment plan should be developed multidisciplinary. Irrespective of the therapeutic approach applied, patients require long-term follow-up. Patient with larger pituitary tumors or former surgery/radiotherapy should be regularly counseled regarding potential symptoms of hormonal deficiency states.
    Type of Medium: Online Resource
    ISSN: 0947-7349 , 1439-3646
    URL: Article
    DOI: 10.1055/a-1373-4087
    RVK:
    XA 42403
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2021
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  • 2
    Online Resource
    Online Resource
    Immunoprofiling of glial tumours of the neurohypophysis suggests a common pituicytic origin of neoplastic cells
    Springer Science and Business Media LLC ; 2017
    In:  Pituitary Vol. 20, No. 2 ( 2017-4), p. 211-217
    Details
    In: Pituitary, Springer Science and Business Media LLC, Vol. 20, No. 2 ( 2017-4), p. 211-217
    Type of Medium: Online Resource
    ISSN: 1386-341X , 1573-7403
    URL: Article
    DOI: 10.1007/s11102-016-0762-x
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2017
    detail.hit.zdb_id: 2008775-5
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  • 3
    Online Resource
    Online Resource
    What to report in sellar tumor MRI? A nationwide survey among German pituitary surgeons, radiation oncologists, and endocrinologists
    Springer Science and Business Media LLC ; 2023
    In:  Neuroradiology
    Details
    In: Neuroradiology, Springer Science and Business Media LLC
    Abstract: While MRI has become the imaging modality of choice in the diagnosis of sellar tumors, no systematic attempt has yet been made to align radiological reporting of findings with the information needed by the various medical disciplines dealing with these patients. Therefore, we aimed to determine the prevailing preferences in this regard through a nationwide expert survey. Methods First, an interdisciplinary literature-based catalog of potential reporting elements for sellar tumor MRI examinations was created. Subsequently, a web-based survey regarding the clinical relevance of these items was conducted among board certified members of the German Society of Neurosurgery, German Society of Radiation Oncology, and the Pituitary Working Group of the German Society of Endocrinology. Results A total of 95 experts (40 neurosurgeons, 28 radiation oncologists, and 27 endocrinologists) completed the survey. The description of the exact tumor location, size, and involvement of the anatomic structures adjacent to the sella turcica (optic chiasm, cavernous sinus, and skull base), occlusive hydrocephalus, relationship to the pituitary gland and infundibulum, and certain structural characteristics of the mass (cyst formation, hemorrhage, and necrosis) was rated most important ( 〉  75% agreement). In contrast, the characterization of anatomic features of the nasal cavity and sphenoid sinus as well as the findings of advanced MRI techniques (e.g., perfusion and diffusion imaging) was considered relevant by less than 50% of respondents. Conclusion To optimally address the information needs of the interdisciplinary treatment team, MRI reports of sellar masses should primarily focus on the accurate description of tumor location, size, internal structure, and involvement of adjacent anatomic compartments.
    Type of Medium: Online Resource
    ISSN: 0028-3940 , 1432-1920
    URL: Article
    DOI: 10.1007/s00234-023-03222-w
    RVK:
    XA 10000
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1462953-7
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  • 4
    Online Resource
    Online Resource
    Outcome after pediatric craniopharyngioma: the role of age at diagnosis and hypothalamic damage
    Oxford University Press (OUP) ; 2023
    In:  European Journal of Endocrinology Vol. 188, No. 3 ( 2023-03-02), p. 300-309
    Details
    In: European Journal of Endocrinology, Oxford University Press (OUP), Vol. 188, No. 3 ( 2023-03-02), p. 300-309
    Abstract: Craniopharyngiomas (CP) are rare malformational tumors. Clinical presentation and outcome of pediatric patients with CP with specific regard to age at diagnosis is not clear. The aim of this cohort study was to determine clinical presentation and outcome in these patients diagnosed at different ages at diagnosis. Design Seven hundred and nine patients diagnosed with CP were recruited from 1999 to 2021 in HIT-Endo and KRANIOPHARYNGEOM 2000/2007/Registry 2019 and prospectively observed. Methods Age at diagnosis was categorized as infants and toddlers ( & lt;2 years), early childhood (2-6 years), middle childhood (6-12 years), and early adolescence (12-18 years). Overall and event-free survival (EFS), functional capacity (FMH), and quality of life (QoL) (PEDQOL) were assessed. Results Severe obesity (body mass index [BMI] & gt;3 standard deviation score [SDS]) was prevalent in 45.4% at last visit. A lower EFS but better QoL was observed in children with age at diagnosis & lt;6 years compared with ≥6 years. Reduced functional capacity percentiles were associated with increased BMI-SDS at last visit (rho = −0.125, 95% confidence interval [CI; −0.21; −0.04]) and age at diagnosis & lt;2 years. Posterior hypothalamic involvement and hypothalamic lesion (HL) were independent risk factors for reduced EFS (hazard ratio = 1.59, 95% CI [1.12-2.26]) and obesity at last visit (odds ratio = 2.94, 95% CI [1.73-5.08] ). Age at diagnosis did not contribute to severe obesity and reduced QoL. Conclusions Diagnosis of CP at age & lt;6 years may help patients to adapt early to disabilities but may lead to a higher probability of CP relapse. Not age at diagnosis but posterior HL may be the contributing factor to severe obesity and a reduced QoL. Clinical trial registration numbers NCT00258453; NCT01272622; NCT04158284.
    Type of Medium: Online Resource
    ISSN: 0804-4643 , 1479-683X
    URL: Article
    DOI: 10.1093/ejendo/lvad027
    RVK:
    WA 15000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 1485160-X
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  • 5
    Online Resource
    Online Resource
    Quantitation of Aging Products Formed in Biodiesel during the Rancimat Accelerated Oxidation Test
    American Chemical Society (ACS) ; 2014
    In:  Energy & Fuels Vol. 28, No. 9 ( 2014-09-18), p. 5849-5856
    Details
    In: Energy & Fuels, American Chemical Society (ACS), Vol. 28, No. 9 ( 2014-09-18), p. 5849-5856
    Type of Medium: Online Resource
    ISSN: 0887-0624 , 1520-5029
    URL: Article
    DOI: 10.1021/ef501118r
    Language: English
    Publisher: American Chemical Society (ACS)
    Publication Date: 2014
    detail.hit.zdb_id: 1483539-3
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  • 6
    Online Resource
    Online Resource
    Cerebral Infarction in Childhood-Onset Craniopharyngioma Patients - Results of KRANIOPHARYNGEOM 2007
    The Endocrine Society ; 2021
    In:  Journal of the Endocrine Society Vol. 5, No. Supplement_1 ( 2021-05-03), p. A639-A639
    Details
    In: Journal of the Endocrine Society, The Endocrine Society, Vol. 5, No. Supplement_1 ( 2021-05-03), p. A639-A639
    Abstract: Purpose: Cerebral infarction (CI) represents a vascular complication following treatment of suprasellar tumors. Risk factors for CI, incidence rate, and long-term prognosis are unknown for patients with childhood-onset craniopharyngioma (CP). Methods: MRI of 242 CP patients, recruited 2007-2019 in KRANIOPHARYNGEOM 2007, were reviewed for CI. Risk factors for CI and outcome after CI were analyzed. Results: Twenty-eight of 242 patients (11%) presented with CI based on reference assessment of MRI. One CI occurred before initial surgery and one case of CI after release of pressure via intracystic catheter. 26 of 28 CI were detected after CP resecting surgical procedures at a median postoperative interval of one day (range: 0.5-53 days). Surgical intraoperative vascular lesions were documented in 7 cases with CI. There was a trend (p=0.069) towards higher initial presurgical tumor volume in CI patients (21.7 cm3, range: 0.01-187.6 cm3) compared with non-CI patients (15.5 cm3, range: 0.01-286.3 cm3). The CI rate was lower in cases operated via transsphenoidal approach (4%) when compared with transcranial approach (13%). CP patient load of neurosurgical centers as a potential measure of surgical expertise was not associated with CI. In 12 irradiated patients, CI occurred before irradiation in all cases. Multivariate analyses showed that hydrocephalus and gross-total resection (GTR) at the time of primary diagnosis/surgery were independent risk factors for CI. Two-years progression-free survival rate was lower (p=0.023) after CI (0.310±0.095) when compared with the subgroup of patients without CI (0.604±0.034). After CI, quality of life (PEDQOL) and functional capacity (FMH) were impaired when compared with patients without CI. Conclusions: CI occurs in about 11% of CP cases mainly after surgery. Degree of resection and increased intracranial pressure are risk factors, which should be considered in the planning of surgical procedures for prevention of CI.
    Type of Medium: Online Resource
    ISSN: 2472-1972
    URL: Article
    DOI: 10.1210/jendso/bvab048.1302
    Language: English
    Publisher: The Endocrine Society
    Publication Date: 2021
    detail.hit.zdb_id: 2881023-5
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  • 7
    Online Resource
    Online Resource
    Drug priming enhances radiosensitivity of adamantinomatous craniopharyngioma via downregulation of survivin
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2016
    In:  Neurosurgical Focus Vol. 41, No. 6 ( 2016-12), p. E14-
    Details
    In: Neurosurgical Focus, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 41, No. 6 ( 2016-12), p. E14-
    Abstract: In this study, the authors investigated the underlying mechanisms responsible for high tumor recurrence rates of adamantinomatous craniopharyngioma (ACP) after radiotherapy and developed new targeted treatment protocols to minimize recurrence. ACPs are characterized by the activation of the receptor tyrosine kinase epidermal growth factor receptor (EGFR), known to mediate radioresistance in various tumor entities. The impact of tyrosine kinase inhibitors (TKIs) gefitinib or CUDC-101 on radiation-induced cell death and associated regulation of survivin gene expression was evaluated. METHODS The hypothesis that activated EGFR promotes radioresistance in ACP was investigated in vitro using human primary cell cultures of ACP (n = 10). The effects of radiation (12 Gy) and combined radiochemotherapy on radiosensitivity were assessed via cell death analysis using flow cytometry. Changes in target gene expression were analyzed by quantitative real-time polymerase chain reaction (qRT-PCR). Survivin, identified in qRT-PCR to be involved in radioresistance of ACP, was manipulated by small interfering RNA (siRNA), followed by proliferation and vitality assays to further clarify its role in ACP biology. Immunohistochemically, survivin expression was assessed in patient tumors used for primary cell cultures. RESULTS In primary human ACP cultures, activation of EGFR resulted in significantly reduced cell death levels after radiotherapy. Treatment with TKIs alone and in combination with radiotherapy increased cell death response remarkably, assessed by flow cytometry. CUDC-101 was significantly more effective than gefitinib. The authors identified regulation of survivin expression after therapeutic intervention as the underlying molecular mechanism of radioresistance in ACP. EGFR activation promoting ACP cell survival and proliferation in vitro is consistent with enhanced survivin gene expression shown by qRT-PCR. TKI treatment, as well as the combination with radiotherapy, reduced survivin levels in vitro. Accordingly, ACP showed reduced cell viability and proliferation after survivin downregulation by siRNA. CONCLUSIONS These results indicate an impact of EGFR signaling on radioresistance in ACP. Inhibition of EGFR activity by means of TKI treatment acts as a radiosensitizer on ACP tumor cells, leading to increased cell death. Additionally, the results emphasize the antiapoptotic and pro-proliferative role of survivin in ACP biology and its regulation by EGFR signaling. The suppression of survivin by treatment with TKI and combined radiotherapy represents a new promising treatment strategy that will be further assessed in in vivo models of ACP.
    Type of Medium: Online Resource
    ISSN: 1092-0684
    URL: Article
    DOI: 10.3171/2016.9.FOCUS16316
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2016
    detail.hit.zdb_id: 2026589-X
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  • 8
    Online Resource
    Online Resource
    Hypophysectomy for prostate cancer: a revival of old knowledge? : Case report
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2008
    In:  Journal of Neurosurgery Vol. 109, No. 4 ( 2008-10), p. 760-764
    Details
    In: Journal of Neurosurgery, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 109, No. 4 ( 2008-10), p. 760-764
    Abstract: The growth of prostate cancer is controlled by several hormones and growth factors. In cases of metastasized prostate cancer, antigonadotropic therapy is currently considered state-of-the-art treatment. Surgical therapies such as adrenalectomy and hypophysectomy are no longer in use. Nevertheless, hypophysectomy has proven efficacy for palliative pain treatment as well as increasing duration of survival. The authors present the case of a 63-year-old man with metastatic prostate cancer who presented with high serum prostate-specific antigen levels (1216 μg/L) and cavernous sinus syndrome. His disease was progressing despite leuprorelin and docetaxel therapy, and he had severe bone pain despite high-dose pain therapy. He was also anemic. Contrast-enhanced MR imaging showed a pituitary lesion as well as metastatic infiltration of the skull base including the cavernous sinus. The patient's serum level of prolactin was mildly elevated, testosterone was below the detection limit, and insulin-like growth factor–I (IGF-I) was in the upper range for a patient of his age (233 μg/L). Because of the elevated prolactin and high-normal IGF-I levels he was offered a hypophysectomy in addition to pituitary tumor removal. Histological examination of the resected lesion confirmed a nonsecreting pituitary adenoma with infiltration of prostate cancer cells. Postoperatively the patient's prostate-specific antigen levels dropped to 876 μg/L, his bone pain resolved, and the cavernous sinus syndrome improved. Nevertheless, he died of septicemia 4 months after surgery. Older publications as well as this case have shown the benefit of hypophysectomy for pain treatment. A reduction of IGF-I levels even in the final stage metastasized prostate cancer may play a major role. Respectively, clinical studies with somatostatin analogs are currently in progress, which may lead to a “new” way of treatment in these otherwise hopeless patients. On the basis of the pain relief seen after hypophysectomy in this case and similar benefits reported in older publications, the authors raise the question whether this treatment should be offered more frequently, and whether additional medical options of hormone treatment may be beneficial in similar cases.
    Type of Medium: Online Resource
    ISSN: 0022-3085 , 1933-0693
    URL: Article
    DOI: 10.3171/JNS/2008/109/10/0760
    RVK:
    XA 10000
    RVK:
    XA 55270
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2008
    detail.hit.zdb_id: 2026156-1
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  • 9
    Online Resource
    Online Resource
    Cavernous sinus sampling in patients with Cushing's disease
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2015
    In:  Neurosurgical Focus Vol. 38, No. 2 ( 2015-02), p. E6-
    Details
    In: Neurosurgical Focus, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 38, No. 2 ( 2015-02), p. E6-
    Abstract: Correct diagnosis and precise localization of adenomas in patients with Cushing's disease are essential for avoiding unsuccessful transsphenoidal pituitary exploration. In addition to the well-established inferior petrosal sinus sampling, preoperative cavernous sinus sampling (CSS) was introduced as a potentially improved way to predict adenoma lateralization. The authors present their results with CSS in a consecutive series of patients with Cushing's disease. METHODS During 1999–2014, transsphenoidal surgeries were consecutively performed in 510 patients with Cushing's disease. For most patients, suppression of cortisol in high-dose dexamethasone tests and stimulation of adrenocorticotropic hormone and cortisol after administration of corticotropin-releasing hormone were sufficient to prove the diagnosis of adrenocorticotropic hormone–dependent hypercortisolism. Of the 510 patients, 67 (13%) were referred to the department of neuroradiology for CSS according to the technique of Teramoto. The indications for CSS were unclear endocrine test results or negative MRI results. Data for all patients were retrospectively analyzed. RESULTS A central/peripheral gradient was found in 59 patients; lateralization to the left or right side was found in 51. For 8 patients with a central/peripheral gradient, no left/right gradient could be determined. For another 8 patients with equivocal test results, no central/peripheral gradient was found. No severe CSS-associated complications were encountered. Of the 51 patients who underwent transsphenoidal surgery, the predicted lateralization was proven correct for 42 (82%). CONCLUSIONS As MRI techniques have improved, the number of potential candidates for this invasive method has decreased in the past decade. However, because detecting minute adenomas remains problematic, CSS remains a useful diagnostic tool for patients with Cushing's disease.
    Type of Medium: Online Resource
    ISSN: 1092-0684
    URL: Article
    DOI: 10.3171/2014.10.FOCUS14687
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2015
    detail.hit.zdb_id: 2026589-X
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  • 10
    Online Resource
    Online Resource
    Intracystic interferon-alpha in pediatric craniopharyngioma patients: an international multicenter assessment on behalf of SIOPE and ISPN
    Oxford University Press (OUP) ; 2017
    In:  Neuro-Oncology Vol. 19, No. 10 ( 2017-10), p. 1398-1407
    Details
    In: Neuro-Oncology, Oxford University Press (OUP), Vol. 19, No. 10 ( 2017-10), p. 1398-1407
    Type of Medium: Online Resource
    ISSN: 1522-8517 , 1523-5866
    URL: Article
    DOI: 10.1093/neuonc/nox056
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2017
    detail.hit.zdb_id: 2094060-9
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