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L'adénome hypophysaire est une entité bien connue touchant la glande hypophysaire. Toutefois, les facteurs de risques et les éléments physiopathologiques n'ont pas encore été parfaitement élucidés. Après exérèse transsphénoïdale, certaines analyses anatomo­ pathologiques n'ont pu mettre en évidence d'adénome hypophysaire. A ce jour, une seule étude publiée en 2012 par Yamada, S. et al. énonce cette particularité sans pour autant la définir. L'étude conduite a pour objectif de la caractériser et, si possible, de lui associer des facteurs prédictifs afin d’aider les cliniciens et les chirurgiens dans sa prise en charge.Echantillon et méthodologie : L'étude correspond à une analyse rétrospective mono-centrique de 496 résections transsphénoïdiales menées dans le cadre d'un diagnostic clinique d'adénome hypophysaire entre 1996 et avril 20 15. Les patients sont répartis en deux échantillons sur base des résultats histologiques, un premier groupe dit « contrôle » dans lequel l'anatomo-pathologie confirme la présence d'un adénome et un second échantillon dans lequel aucune trace d'adénome n'est retrouvée. Les informations collectées sont comparées. Celles-ci concernent l'âge, le rapport homme-femme, l'indice de masse corporel, les signes cl iniques, les résultats biologiques, les antécédents personnels et familiaux, les traitements habituels et préopératoires, le suivi postopératoire à court et à long terme. Leurs valeurs significatives sont obtenues à l'aide du « Student-t test » sous la forme de la « p­ value ».Résultats : L'adénome à histologie négative est observé dans 78 cas sur les 495 opérés, soit dans 15.75% des cas. Elle n’est pas retrouvée auprès des adénomes sécréteurs de TSH à l’origine d'une hyperthyroïdie. Cette entité touche préférentiellement les femmes, 75% des cas. Au niveau radiologique, les microadénomes représentant 61.5% (48/78) des lésions contre 29.5% (23/78) pour les macros. Dans 9% des cas (7/78), aucune lésion n’est mise en évidence à la résonance. Les analyses biologiques reviennent significativement différentes pour les adénomes corticotropes et somatotropes. Les manifestations cliniques sont assez similaires en ternie de fréquence dans les prolactinornes et les adénomes somatotropes alors que pour les non-fonctionne l s à histologie positive, le syndrome « d'effet de masse » est plus fréquemment observé. Pour les corticotropes, l'asthénie, l'hypertension artérielle et les signes propres à J'hypercorticisme sont plus fréquents dans l'échantillon étudié. De plus, il ressort de l'étude que certaines affections sont plus souvent rencontrées en cas d'absence de lésion histologique tel s que les troubles thyroïdiens (hypo- et hyper-thyroïdie, goitre), les troubles gynécologiques (fertilité et ménopause), l'ostéoporose ou l'ostéopénie. Conclusion : L'exérèse chirurgicale d'un adénome hypophysaire suivie d'une analyse anatomopathologique négative est assez fréquente. Toutefois, étant donné la petite taille des cohortes, il serait intéressant de comparer les résultats obtenus avec ceux de futures études et de tenir compte des taux de rémission, de récidive et du suivi à long-terme. Although pituitary adenoma is a well-documented lesion of the pituitary gland, risk factors and physiopathology elements describing the affection's developments are still not elucidated. A review of data's regarding pathology protocols after transsphenoidal surgery shows the absence of evidence of pituitary adenoma in some cases. This feature has been reported in only one article without further investigation s. The aims of this study were to analyze the 20-year pool of surgically treated pituitary adenoma, to define characteristics of this specific affection and to find predicting factors or associated sickness that could help clinicians to manage such cases. Patients and methods : Retrospective data over 496 patients clinically diagnosed with a pituitary adenoma and whom underwent transsphenoidal surgery from 1996 to April 2015 were collected. According to the pathology results, patients were divided in two pools: the first one with pathology evidence of the lesion, and the second one without evidence. Information’s about age, gender, body mass index, and previous persona! and familial medical stories, clinical signs, radiologic findings, biological findings, pre-operative treatment and usual treatments, surgical intervention, post-operative outcomes and long-term follow-up were compared. Statistical significance was established by the student-t test as p-value < 0.05. Results: Prevalence of the studied feature is about 15.75%, almost 78 cases reported on 495 interventions. lt was observed in any clinically diagnosed pituitary adenoma subtype except the TSH one. Overall sex ratio is about three women for one man. Only the non-functioning subtype shows a 10-year difference between the mean ages at surgery according to an earlier onset of the studied lesion. Micros are more frequent, about 48/78 (61.5%) and 23/78 (29.5%) are macros. In seven cases (9%), no evidence of pituitary lesions has been reported by imaging. ln some subtypes (corticotropic and somatotropic adenomas), biological findings may present significant differences, in others none (prolactionomas and non-functioning adenomas). In prolactinomas and somatotropic adenomas, no statistical differences of clinical t signs are been seen. Non-functioning adenomas with pathology evidence present more frequently mass effect syndrome than reported in the studied pool. Asthenia, hypertension and Cushing topics have a higher prevalence rate in case of corticotropic adenomas without histology evidence. Studied Iesions are more often associated with other affections such as thyroidopathy (hypothyroidism, hyperthyroidism, and goiter), gynecologic impairments (fertility concerns, menopause), osteoporosis or osteopenia. Conclusion: It is the first analysis studying this feature. It appears well defined in prolactinomas and corticotropic adenomas. It is kind of frequent but pools remain small. Moreover, information’s about remission and long-term follow-up are missing. Further studies should be undergone in order to compare results.

ACTH-Secreting Pituitary Adenoma --- Growth Hormone-Secreting Pituitary Adenoma --- Pituitary Neoplasms

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Pituitary Neoplasms. --- Cancer of Pituitary --- Cancer of the Pituitary --- Pituitary Adenoma --- Pituitary Carcinoma --- Pituitary Tumors --- Pituitary Cancer --- Adenoma, Pituitary --- Adenomas, Pituitary --- Cancer, Pituitary --- Cancers, Pituitary --- Carcinoma, Pituitary --- Carcinomas, Pituitary --- Neoplasm, Pituitary --- Neoplasms, Pituitary --- Pituitary Adenomas --- Pituitary Cancers --- Pituitary Carcinomas --- Pituitary Neoplasm --- Pituitary Tumor --- Tumor, Pituitary --- Tumors, Pituitary --- Adenoma, Basophil --- Adenoma, Chromophobe --- Adenoma, Acidophil --- Pituitary gland --- Tumors.

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Major technological advances in genomics have made it possible to identify critical genetic alterations in cancer, rendering oncology well along the path to “personalised cancer medicine”. Thanks to developments in genetics, several mutations and gene rearrangements have been identified in patients with endocrine cancers (e.g., thyroid and adrenocortical carcinoma). In particular, each patient can be considered as a unique, individual one, with unique genetic information. The aim of this Special Issue is to offer an overview of exciting new research in the area of endocrine tumours may set the stage for an innovative personalised management and precision medicine modalities for individualised care.New affordable individual genomic analyses, as well as the opportunity to test new compounds in primary cells may allow a personalised management of patients with endocrine malignancies. This approach may improve the prediction of clinical outcome and therapeutic effectiveness, as well as help to avoid the use of ineffective drugs. However, further efforts are needed to obtain an adjustment of clinical management in patients with endocrine cancers that would rely solely or in great part on genetic information. This Special Issue includes basic, translational, and clinical papers on personalised medicine in endocrine malignancies (i.e., thyroid and adrenal), especially focusing on diagnostic and prognostic biomarkers, as well as novel drug targets or targeted treatments, including eventual clinical trials.

Medicine --- papillary thyroid cancer --- SUV PET/CT --- BRAF V600E --- immune checkpoint inhibitors (ICIs) --- ipilimumab --- nivolumab --- prolactinoma --- Cushing’s disease --- aggressive pituitary tumor --- aggressive PitNET --- aggressive pituitary adenoma --- pituitary carcinoma --- adrenocortical cancer --- adrenal adenomas --- adrenal tumors --- p53 --- p27 --- ki-67 --- reticulin --- mitotane --- adjuvant treatment --- recurrence --- recurrence free survival --- timing --- intratumoral heterogeneity --- thyroid tumor --- BRAF --- RET/PTC rearrangements --- RAS mutation --- adrenal cortex --- carcinoma --- angiogenesis --- gene expression --- osteopontin --- hyaluronan synthase 1 --- multikinase inhibitors --- sorafenib --- lenvatinib --- differentiated thyroid cancer --- radioiodine resistance --- predictive marker --- predictors --- response to treatment --- survival --- information needs and preferences --- focus group interview --- personalized medicine --- neuroendocrine tumours --- phaeochromocytoma --- paraganglioma --- molecular clusters --- n/a --- Cushing's disease

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Major technological advances in genomics have made it possible to identify critical genetic alterations in cancer, rendering oncology well along the path to “personalised cancer medicine”. Thanks to developments in genetics, several mutations and gene rearrangements have been identified in patients with endocrine cancers (e.g., thyroid and adrenocortical carcinoma). In particular, each patient can be considered as a unique, individual one, with unique genetic information. The aim of this Special Issue is to offer an overview of exciting new research in the area of endocrine tumours may set the stage for an innovative personalised management and precision medicine modalities for individualised care.New affordable individual genomic analyses, as well as the opportunity to test new compounds in primary cells may allow a personalised management of patients with endocrine malignancies. This approach may improve the prediction of clinical outcome and therapeutic effectiveness, as well as help to avoid the use of ineffective drugs. However, further efforts are needed to obtain an adjustment of clinical management in patients with endocrine cancers that would rely solely or in great part on genetic information. This Special Issue includes basic, translational, and clinical papers on personalised medicine in endocrine malignancies (i.e., thyroid and adrenal), especially focusing on diagnostic and prognostic biomarkers, as well as novel drug targets or targeted treatments, including eventual clinical trials.

papillary thyroid cancer --- SUV PET/CT --- BRAF V600E --- immune checkpoint inhibitors (ICIs) --- ipilimumab --- nivolumab --- prolactinoma --- Cushing’s disease --- aggressive pituitary tumor --- aggressive PitNET --- aggressive pituitary adenoma --- pituitary carcinoma --- adrenocortical cancer --- adrenal adenomas --- adrenal tumors --- p53 --- p27 --- ki-67 --- reticulin --- mitotane --- adjuvant treatment --- recurrence --- recurrence free survival --- timing --- intratumoral heterogeneity --- thyroid tumor --- BRAF --- RET/PTC rearrangements --- RAS mutation --- adrenal cortex --- carcinoma --- angiogenesis --- gene expression --- osteopontin --- hyaluronan synthase 1 --- multikinase inhibitors --- sorafenib --- lenvatinib --- differentiated thyroid cancer --- radioiodine resistance --- predictive marker --- predictors --- response to treatment --- survival --- information needs and preferences --- focus group interview --- personalized medicine --- neuroendocrine tumours --- phaeochromocytoma --- paraganglioma --- molecular clusters --- n/a --- Cushing's disease

Choose an application

• Reference Manager
• EndNote
• RefWorks (Direct export to RefWorks)

Major technological advances in genomics have made it possible to identify critical genetic alterations in cancer, rendering oncology well along the path to “personalised cancer medicine”. Thanks to developments in genetics, several mutations and gene rearrangements have been identified in patients with endocrine cancers (e.g., thyroid and adrenocortical carcinoma). In particular, each patient can be considered as a unique, individual one, with unique genetic information. The aim of this Special Issue is to offer an overview of exciting new research in the area of endocrine tumours may set the stage for an innovative personalised management and precision medicine modalities for individualised care.New affordable individual genomic analyses, as well as the opportunity to test new compounds in primary cells may allow a personalised management of patients with endocrine malignancies. This approach may improve the prediction of clinical outcome and therapeutic effectiveness, as well as help to avoid the use of ineffective drugs. However, further efforts are needed to obtain an adjustment of clinical management in patients with endocrine cancers that would rely solely or in great part on genetic information. This Special Issue includes basic, translational, and clinical papers on personalised medicine in endocrine malignancies (i.e., thyroid and adrenal), especially focusing on diagnostic and prognostic biomarkers, as well as novel drug targets or targeted treatments, including eventual clinical trials.

Medicine --- papillary thyroid cancer --- SUV PET/CT --- BRAF V600E --- immune checkpoint inhibitors (ICIs) --- ipilimumab --- nivolumab --- prolactinoma --- Cushing's disease --- aggressive pituitary tumor --- aggressive PitNET --- aggressive pituitary adenoma --- pituitary carcinoma --- adrenocortical cancer --- adrenal adenomas --- adrenal tumors --- p53 --- p27 --- ki-67 --- reticulin --- mitotane --- adjuvant treatment --- recurrence --- recurrence free survival --- timing --- intratumoral heterogeneity --- thyroid tumor --- BRAF --- RET/PTC rearrangements --- RAS mutation --- adrenal cortex --- carcinoma --- angiogenesis --- gene expression --- osteopontin --- hyaluronan synthase 1 --- multikinase inhibitors --- sorafenib --- lenvatinib --- differentiated thyroid cancer --- radioiodine resistance --- predictive marker --- predictors --- response to treatment --- survival --- information needs and preferences --- focus group interview --- personalized medicine --- neuroendocrine tumours --- phaeochromocytoma --- paraganglioma --- molecular clusters --- papillary thyroid cancer --- SUV PET/CT --- BRAF V600E --- immune checkpoint inhibitors (ICIs) --- ipilimumab --- nivolumab --- prolactinoma --- Cushing's disease --- aggressive pituitary tumor --- aggressive PitNET --- aggressive pituitary adenoma --- pituitary carcinoma --- adrenocortical cancer --- adrenal adenomas --- adrenal tumors --- p53 --- p27 --- ki-67 --- reticulin --- mitotane --- adjuvant treatment --- recurrence --- recurrence free survival --- timing --- intratumoral heterogeneity --- thyroid tumor --- BRAF --- RET/PTC rearrangements --- RAS mutation --- adrenal cortex --- carcinoma --- angiogenesis --- gene expression --- osteopontin --- hyaluronan synthase 1 --- multikinase inhibitors --- sorafenib --- lenvatinib --- differentiated thyroid cancer --- radioiodine resistance --- predictive marker --- predictors --- response to treatment --- survival --- information needs and preferences --- focus group interview --- personalized medicine --- neuroendocrine tumours --- phaeochromocytoma --- paraganglioma --- molecular clusters