Long-Term Natural Course of Pituitary Tumors in Patients With MEN1: Results From the DutchMEN1 Study Group (DMSG)
| Autor: | Wouter P. Kluijfhout, Madeleine L. Drent, Alberto M. Pereira, Wouter W. de Herder, Ad R. M. M. Hermus, Gerlof D. Valk, Carolina R. C. Pieterman, Anouk N A van der Horst-Schrivers, Peter H. Bisschop, Olaf M. Dekkers, Joanne M. de Laat, Bas Havekes |
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| Přispěvatelé: | Guided Treatment in Optimal Selected Cancer Patients (GUTS), AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, AMS - Amsterdam Movement Sciences, Endocrinology, Internal medicine, Other Research, Interne Geneeskunde, RS: NUTRIM - R1 - Metabolic Syndrome, Internal Medicine |
| Rok vydání: | 2015 |
| Předmět: |
Male
endocrine system diseases Endocrinology Diabetes and Metabolism Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] Clinical Biochemistry BELGIUM Pituitary neoplasm Biochemistry DISEASE Endocrinology Non-U.S. Gov't Multiple endocrine neoplasia INCIDENTALOMAS Netherlands education.field_of_study CLINICAL-PRACTICE GUIDELINE Research Support Non-U.S. Gov't Middle Aged PREVALENCE MULTIPLE ENDOCRINE NEOPLASIA Disease Progression Female medicine.symptom Cohort study Adenoma Adult medicine.medical_specialty Adolescent Population Context (language use) Research Support DIAGNOSIS Asymptomatic TYPE-1 MEN1 Young Adult Internal medicine ADENOMAS medicine Multiple Endocrine Neoplasia Type 1 Journal Article Humans Pituitary Neoplasms Prolactinoma education business.industry Biochemistry (medical) Pituitary tumors medicine.disease business Follow-Up Studies |
| Zdroj: | Journal of Clinical Endocrinology and Metabolism, 100(9), 3288-3296. ENDOCRINE SOC Journal of clinical endocrinology and metabolism, 100(9), 3288-3296. The Endocrine Society Journal of Clinical Endocrinology and Metabolism, 100(9), 3288. The Endocrine Society Journal of Clinical Endocrinology and Metabolism, 100(9), 3288-3296. The Endocrine Society Journal of Clinical Endocrinology & Metabolism, 100(9), 3288-3296. Oxford University Press Journal of Clinical Endocrinology and Metabolism, 100, 3288-96 Journal of Clinical Endocrinology and Metabolism, 100(9), 3288-3296. Endocrine Society de Laat, J M, Dekkers, O M, Pieterman, C R C, Kluijfhout, W P, Hermus, A R, Pereira, A M, van der Horst-Schrivers, A N, Drent, M L, Bisschop, P H, Havekes, B, de Herder, W W & Valk, G D 2015, ' Long-Term Natural Course of Pituitary Tumors in Patients With MEN1: Results From the DutchMEN1 Study Group (DMSG) ', Journal of Clinical Endocrinology and Metabolism, vol. 100, no. 9, pp. 3288-3296 . https://doi.org/10.1210/JC.2015-2015 Journal of Clinical Endocrinology and Metabolism, 100, 9, pp. 3288-96 Journal of Clinical Endocrinology and Metabolism, 100(9), 3288-3296 |
| ISSN: | 1945-7197 0021-972X |
| Popis: | Context: Guidelines advise lifelong radiological followup for asymptomatic pituitary adenomas (PITs) because of the risk for growth and subsequent visual field defects. In the context of multiple endocrine neoplasia type 1 (MEN 1) an even more comprehensive screening is advised because PITs are presumed to manifest more aggressive behavior. We studied the long-term course of MEN 1related PITs, which may be used as a model for sporadically occurring PITs.Objective: The aim of our study is to assess the results of systematic pre-symptomatic PIT screening and subsequent long-term followup of PITs with emphasis on nonfunctioning microadenomas diagnosed by screening.Patients and Methods: A cohort study was performed using the Dutch national MEN1 database, including greater than 90"/o of the Dutch MEN 1 population older than 16 years (n = 323).Main Outcome Measures: Screening results, natural course, and effects of treatment of PIT were assessed.Results: PIT was diagnosed in 123 patients with M EN 1 (38.1 %), of whom 66 were diagnosed by MEN 1-related screening. Ninety-one percent of the nonfunctioning PIT detected during screening (n = 35), did not require intervention during followup (median, 6.0 y). Three microadenomas showed limited growth but did not progress toward macroadenomas. Both screening-detected and prevalent prolactinomas (n = 52) responded well to treatment with dopamine agonists.Conclusion: Systematic presymptomatic screening for PIT in patients with MEN 1 predominantly results in detection of nonfunctioning microadenomas. Prolactinoma in patients with MEN1 responded well to medical treatment. Microadenomas grew only occasionally and after many years without clinical consequences. Frequent magnetic resonance imaging followup of nonfunctioning microadenomas in the context of MEN1 and sporadically occurring PITs therefore seems debatable. |
| Databáze: | OpenAIRE |
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