Recurrences of Pituitary Adenomas or Second De Novo Tumors: Comparisons with First Tumors
| Autor: | Ulrich J. Knappe, Michael Buchfelder, Rudolf Fahlbusch, Rolf Buslei, Maximilian Müller, Patricia Crock, Jörg Flitsch, Wolfgang Saeger, Dieter K. Lüdecke |
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| Rok vydání: | 2018 |
| Předmět: |
Adenoma
Male medicine.medical_specialty Proliferation index 030209 endocrinology & metabolism Gastroenterology Recurrent Tumor 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine Humans Tumor type Pituitary Neoplasms First Recurrence Retrospective Studies business.industry Pituitary tumors medicine.disease Pituitary Hormones Ki-67 Antigen Surgery Histopathology Female Neurology (clinical) Neoplasm Recurrence Local Tumor Suppressor Protein p53 business 030217 neurology & neurosurgery |
| Zdroj: | World neurosurgery. 119 |
| ISSN: | 1878-8769 |
| Popis: | Background Recurrences of pituitary adenomas are not so rare. Methods In the German Registry of Pituitary Tumors, more than 12,000 surgical specimens were collected between 1967 and 2012, of which 312 patients with altogether 334 recurrences (n = 646 specimens) were included in our study. Results The histopathology of 162 recurrent adenomas could be compared with the original tumor and 37 second recurrences could be compared with the first recurrence. Comparing the proliferation index (Ki-67) of the original and the first recurrent tumor (n = 162), we found an unchanged index in 43 cases (26%), whereas in 69 cases (43%) the index increased and in 50 cases (31%) it decreased. Comparing the first with the second recurrence (n = 37), we found an unchanged index in 8 cases (22%), an increased index in 15 cases (40%), and a decreased index in 14 cases (38%). The third recurrence showed an unchanged index in 1 case (20%), an increased index in 2 cases (40%), and a decreased index in 2 cases (40%). p53 was unchanged in recurrences in 44% of cases, increased in 33%, and decreased in 22%. In 4 cases, adenomas developed into adenomas with strongly increased proliferation (formerly atypical adenomas, now aggressive adenomas) for the first recurrence, and 9 recurrences became aggressive adenomas. A change of tumor type without change of the common transcription factor occurred in 82 cases. Conclusions A second independent de novo adenoma was present in 10 cases, probably due to changes of transcription factors. |
| Databáze: | OpenAIRE |
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